ABSTRACT
Hysterectomy was the most commonly performed major surgery until 1990 and has been second only to caesarean section between then and 2000. A striking feature from many reports is that 70% of these operations and, in a few centres, as many as 85% are done abdominally, whereas only about 30% are done vaginally [1]. The practice style and personal preference of the surgeon, which are dependent on early training, play a significant role in the selection of the hysterectomy type. The absence of clear guidelines for selecting a surgical route, lack of patient knowledge about the options, and inappropriate decisionmaking all combine to lead to this ratio of 3:1 abdominal versus vaginal operations.
