Hysterectomy is traditionally performed through the abdominal route when the uterus is not prolapsed.This involves pain at the incision site. The majority of patients find it painful to turn over,walk,etc on the second post-operative day.The patient has to be hospitalised for 5-9 days and has to take rest from heavy jobs for a period of 3 months at least. In vaginal hysterectomy,the patient can usually go home on the third day itself.

Vaginal hysterectomy:
Advantages:

1.When the procedure is done entirely through the vaginal route, there is no incision on the abdomen.

As there is no incision on the abdomen, there is no chance of wound infection or incisional hernia.

2.The patient has very little pain and is very comfortable while bending,turning over,walking,etc from the second day itself.

3.Internationally, various studies have shown that ureteric injuries are fewer when hysterectomy is performed this way.

The patients normally go home on the 3rd post-operative day and are even allowed to travel by bus .

They can resume normal duties within 7-10 days of surgery.

Indications:
In the author's unit, vaginaly hysterectomy is the routine mode of hysterectomy and 99% of all hysterectomies are performed through the vaginal route.Uterus with fibroids upto the size of a six month pregnant uterus (uterus palpaable over the umbilicus) has also been succesfully removed through the vaginal route.  

When there are adhesions in the abdomen due to previous surgery or some other conditions like infection or endometriosis,

or if there is an ovarian cyst in addition to the pathology in the uterus, a Laparascopic Assisted Vaginal Hysterectomy may be done .

An instrument called the laparoscope is inserted through tiny holes in the abdomen and part of the hysterectomy is done using laparoscopic instruments. The rest of the job is completed vaginally.

This procedure also leaves the patient painfree and she can go home on the 3rd day itself.

Cost: Vaginal hysterectomy costs the same as Abdominal hysterectomy.

At Elite Mission Hopital in normal course of events, the rough cost may be just around Rs.15,000.totally. Laparoscopic assistance may cost a bit more.