Vaginal route: a gynaecological route for much more than hysterectomy

Vaginal hysterectomy is the method of choice for gynaecologists who carry out hysterectomies. Undertaking this procedure regularly will enhance the gynaecologist's level of skill and enable conditions such as ovarian cysts, broad ligament fibroids and other adnexal pathology to be dealt with vaginally during hysterectomy surgery without abdominal invasion. It is also important as the vaginal route allows access to the posterior cul-de-sac, which can facilitate surgery or offer an alternative route to achieving the desired outcome. In this chapter, we look at the main indications for vaginal surgery, and also at other conditions in which vaginal surgery may be suitable (e.g. benign and malignant conditions). We believe that gynaecologists who include vaginal surgery in their armamentarium are better equipped to serve their patients.