Vaginal Hysterectomy is primarily a gynaecological operation for the treatment of women who have symptomatic uterine prolapse and women with abnormal uterine bleeding. It can only be performed if there is enough uterine descent down the vagina to allow for surgical access. In such cases it is the operation of choice.
Uterine prolapse usually occurs in women who have suffered weakening of their pelvic ligaments from vaginal childbirth and women who have reached the menopause and have weakening of the pelvic floor ligaments due to oestrogen deficiency. Some women can have congenitally weak pelvic ligaments causing uterine prolapse. These women would be eligible to have a vaginal hysterectomy.
Vaginal hysterectomy can often be used to treat women with menstrual bleeding problems. These women may not have enough uterine prolapse to cause them symptoms. They may however have enough prolapse to allow for a vaginal hysterectomy if they are having period problems.
The greatest benefit of a vaginal hysterectomy is that the operation is performed through the vagina and the patient can avoid having an abdominal incision and scar. The vaginal approach is often associated with less pain in the recovery period.The vaginal surgical approach offers a great advantage especially in obese women who can avoid abdominal surgery and in turn avoid many of the associated operative risks.
Vaginal hysterectomy may be combined with a vaginal repair as many women often have uterine and vaginal prolapse simultaneously. In these cases it is a great operation.
It is usually safer, cosmetically better and can be associated with faster recovery.