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Natural orifice hysterectomy.

Michael D Moen¹, Michael B Noone, Denise M Elser

¹Illinois Urogynecology Ltd., 1875 Dempster St., Park Ridge, IL 60068, USA. michael.moen-MD@advocatehealth.com

International Urogynecology Journal and Pelvic Floor Dysfunction

|June 12, 2008

Summary

This summary is machine-generated.

Vaginal hysterectomy (VH), a minimally invasive surgery (MIS), has been available for over a century. Evidence supports VH for benign conditions, yet laparotomy remains common; VH should be the preferred MIS hysterectomy option.

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Published on: September 12, 2025

Area of Science:

Gynecology
Surgical Innovation
Minimally Invasive Surgery

Background:

Minimally invasive surgery (MIS) is often perceived as recent due to new technologies.
Natural orifice/MIS approaches for hysterectomy, like vaginal hysterectomy (VH), have existed for over 100 years.
VH is traditionally linked to urogynecology and pelvic organ prolapse repair.

Purpose of the Study:

To highlight the long-standing availability and benefits of vaginal hysterectomy (VH) as a minimally invasive surgical (MIS) option.
To advocate for increased utilization of VH for benign uterine conditions beyond pelvic organ prolapse.
To address the underutilization of VH compared to laparotomy despite evidence supporting its efficacy.

Main Methods:

Review of existing evidence supporting VH for benign gynecological conditions.
Comparison of VH with other hysterectomy approaches, including laparotomy and other MIS techniques.
Analysis of current trends in hysterectomy procedures.

Main Results:

Vaginal hysterectomy (VH) is a well-established, natural orifice/minimally invasive surgery (MIS) approach.
Evidence supports VH for benign conditions like uterine fibroids and abnormal bleeding, not just pelvic organ prolapse.
The majority of hysterectomies are still performed via laparotomy, despite the availability of MIS options.

Conclusions:

Vaginal hysterectomy (VH) represents the least invasive method for hysterectomy.
VH should be promoted as the primary minimally invasive surgery (MIS) choice for women needing hysterectomy for benign conditions.
Increased adoption of VH can improve patient outcomes by favoring less invasive surgical techniques.