Normally, following a total hysterectomy, there are no glandular cells to be found in the vagina. Endometrial cells will have been removed, and the glandular cells lining the endocervical canal will likewise be removed with the cervix.

If the Pap smear identifies glandular cells following a hysterectomy, it suggests that at least some fragment of the cervix remains at the vaginal vault, metaplastic change has occured along the incision line of the vagina, or glandular cells have seeded to the upper vagina. In any event, these patients should be considered to still have some cervical tissue and regular Pap smears performed, as though they had not undergone a hysterectomy.