Hysterectomy is the commonest gynaecological surgery. The study aimed to determine the rates and compare the outcomes of the different routes, and ascertain the visibility of an option. A 5-year retrospective study of all hysterectomies at the University of Uyo teaching hospital: their routes and associated morbidities; and assess the possibility of the vaginal route in total abdominal hysterectomies using a checklist designed for the study. 116 hysterectomies accounted for 27.9% of major gynaecological surgeries. 107 (92.2%) were for benign gynaecological conditions. Twenty-six (22.41%) hysterectomies were vaginal with uterovaginal prolapse as the sole indication. The peak age range of women who had vaginal hysterectomy was 50-59 years (46.2%), mean, 53.8years. Vaginal hysterectomy was associated with fewer complications, X 2 /P-value of 16,091/0.01.6. Twenty-nine (35.80%) total abdominal hysterectomies could have been carried out vaginally. There was under-utilisation of the vaginal route even in the absence of major contraindications to it. There is therefore an urgent need for a survey amongst gynaecologist to investigate the reasons for restrictive use of vaginal hysterectomy especially non descent procedures.
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