ABSTRACT
Hysterectomy has traditionally been an abdominal procedure with the vaginal route reserved for certain indications.This route has usually been limited to cases of benign pathology in patients with a uterine size equivalent to less than a 14-week pregnancy and to patients with significant uterine prolapse.Where there are particular risks associated with an abdominal incision, the vaginal route is considered more readily. In cases such as procidentia or massive fibroids, the clinical circumstances dictate the appropriate route for surgery. In the remaining majority of cases where surgery by either route is feasible, preference and personal skills have driven the choice of route for hysterectomy more than any other factor. This is despite
evidence of fewer complications and faster recovery after vaginal surgery (Table 33.1) [1].
