VAGINAL HYSTERECTOMY IN MODERN GYNAECOLOGY

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Despite the fact that vaginal hysterectomy is acknowledged to be the fastest and least expensive technique available to achieve removal of the uterus and cervix, it is used in only 23 - 25% of the hysterectomies performed. Traditionally, many surgeons have avoided vaginal hysterectomy or used it only in carefully selected patients. Until recently, the procedure was rarely used in patients who have difficult anatomy with limited visibility, including those with narrow vagina without uterine descent, an enlarged uterus, extensive pelvic adhesions, or a history 'of prior pelvic radiation. Other commonly cited contraindications to the vaginal approach have included nulliparity, obesity, or previous pelvic surgery.

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