Vaginal hysterectomy is a surgical procedure in which the uterus is removed through the vagina, without the need for an abdominal incision. As a minimally invasive approach, it is often associated with a shorter hospital stay, quicker recovery, and no visible external scarring. It may be recommended for a variety of benign gynaecological conditions. The suitability of vaginal hysterectomy depends on several individual factors, including the size and mobility of the uterus, the underlying medical condition, previous pelvic surgeries, vaginal anatomy, and overall reproductive health.

When is Vaginal Hysterectomy Considered?

Vaginal hysterectomy may be considered for women with conditions such as:

• Uterine prolapse
• Abnormal or heavy uterine bleeding not responding to other treatments
• Small to moderately sized uterine fibroids
• Adenomyosis
• Chronic pelvic pain related to uterine conditions
• Certain non-cancerous conditions where the uterus is of a size and position suitable for vaginal removal

Before recommending the procedure, the doctor may evaluate:

• The size, shape, and mobility of the uterus.
• The presence of uterine prolapse, if any.
• Vaginal anatomy and any restrictions to access.
• Previous pelvic or vaginal surgical history.
• Overall health and fitness for surgery.
• Whether the ovaries and/or fallopian tubes should also be removed.

A detailed evaluation helps determine whether vaginal hysterectomy is a suitable and safe option compared to other surgical approaches.

What Happens During Vaginal Hysterectomy?

Before the procedure, the doctor reviews the patient’s medical and surgical history and conducts relevant investigations to assess the uterus and pelvic anatomy. The procedure is performed under general or regional anaesthesia. During surgery, an incision is made at the top of the vagina, through which the uterus is carefully separated from its surrounding ligaments and blood vessels and then removed. No external abdominal incision is required. Depending on clinical need, the fallopian tubes and/or ovaries may also be removed at the same time. The exact surgical technique depends on the underlying condition, uterine size, and the surgeon’s clinical assessment.

Recovery After Vaginal Hysterectomy

Recovery after vaginal hysterectomy is generally quicker than abdominal hysterectomy, as there is no abdominal incision to heal. Patients are generally advised to follow their doctor’s postoperative instructions carefully. Important aspects of recovery may include:

• Following guidance on vaginal care and hygiene during healing.
• Taking prescribed medications for pain relief and infection prevention.
• Gradually resuming daily activities while avoiding heavy lifting or strenuous exertion.
• Avoiding sexual intercourse until cleared by the doctor.
• Attending scheduled follow-up appointments.
• Discussing when it is appropriate to resume normal activities, including work and exercise.

Your doctor will provide personalised guidance based on your recovery and overall health.

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