vaginal Hysterectomy

-Explains and promotes the vaginal route of hysterectomy.
-Illustrated with line drawings and full-color photographs.
-Contains step-by-step surgical techniques.
-Covers the nulliparous patient, uterine fibroids, debulking, the
oophorectomy, adnexectomy for adnexal pathology, hormone replacement
therapy, and more.
-For advanced students, residents, and practitioners.





List of Contributors
Introduction
1 The history of vaginal hysterectomy 1
2 Indications and contraindications 7
3 Preoperative assessment 15
4 Access to vesicouterine and rectouterine pouches 29
5 Vaginal hysterectomy for genital prolapse 43
6 Simplified technique of vaginal hysterectomy 57
7 The nulliparous patient 69
8 Uterine fibroids 79
9 Uterine debulking at vaginal hysterectomy 95
10 Use of gonadotrophin-releasing hormone agonist before hysterectomy
111
11 Hysterectomy after previous abdominopelvic surgery 127
12 Contraindicated abdominal route 137
13 The place of prophylactic oophorectomy at hysterectomy 143
14 Oophorectomy 153
15 Adnexal pathology 165
16 Subtotal vaginal hysterectomy 179
17 The difficult vaginal hysterectomy 189
18 Hysterectomy on high-risk women 199
19 Malignancy related to vaginal hysterectomy and laparoscopically
assisted vaginal hysterectomy 207
20 Technical minutiae of vaginal hysterectomy 213
21 Newer perspectives 221
22 Associated urethral sphincter incompetence 229
23 Associated non-gynaecological surgery 237
24 Opportunity to initiate prophylaxis 243
25 Place of sacrospinous colpopexy at vaginal hysterectomy 249
26 Hysterectomy and hormone replacement therapy 263
27 Psychological outcome of hysterectomy 275
28 Hysterectomy and sexuality 287
29 Vaginal or abdominal hysterectomy? 301
30 Vaginal hysterectomy versus laparoscopically assisted vaginal
hysterectomy 321
31 Vaginal hysterectomy versus transcervical resection of the
endometrium 331
32 Complications, morbidity, and mortality of vaginal hysterectomy
341
33 Decision-making for vaginal and abdominal hysterectomy 355