ABSTRACT
The purpose of this chapter is to discuss women who are considered ‘high risk’ by many gynaecological surgeons to the vaginal approach to hysterectomy. Traditional high-risk conditions included large leiomyomas, previous pelvic surgery, history or suspicion of pelvic inflammatory disease, endometriosis, adnexal pathology, chronic pelvic pain, and nulliparity with a limited vaginal access defined as a vagina narrower than two finger-breadths at the apex, especially with an undescended or immobile uterus [1-7].
