Vaginal hysterectomy in the absence of prolapse



The perceived advantages of subtotal hysterectomy have not been realised and the procedure can result in continued symptoms in 10% of women. Vaginal hysterectomy should be considered the operation of choice for the majority of women with dysfunctional uterine bleeding. Many of the traditional contraindications to vaginal hysterectomy are no longer valid and the incidence of operative injury is low. Most gynaecologists have the skills required to perform vaginal hysterectomy in the absence of prolapse and there are distinct advantages to this approach. An effort should be made to encourage the next generation of gynaecologists to acquire the appropriate skills.