Objective To evaluate the possibility of vaginal hysterectomy for patients with moderately enlarged uterus of benign lesions. Methods One hundred and seventeen women with benign uterine diseases underwent vaginal hysterectomy. These patients were divided into two groups according to uterine weight. Group Ⅰ contained 60 patients with uterine enlargement to a weight of 200 to 750 g

and group Ⅱ contained 57 patients with uterine weight of less than 200 g. Uterine morcellation was performed in some cases. The peri-operative data in both groups were analyzed. Results In group Ⅰ

59 cases underwent transvaginal hysterectomy successfully

except 1 case con-verted to abdominal operation and the uterine morcellation was performed in 21 women. In group Ⅱ

all patients successfully underwent transvaginal hysterectomy without any assistance of special technique. The mean uterine weight of group Ⅰ was significantly heavier than that of group Ⅱ（280.18 ± 100.40 g vs 146.48 ± 35.19 g）. The mean operating time was significantly longer for group Ⅰ than that for group Ⅱ（83.93 ± 26.26 minutes vs 35.22 ± 20.55 minutes）. There were no significant differences in blood loss and complications between groupⅠ and group Ⅱ. There was no injury of urinary bladder or rectum

and no vaginal vault infection. Conclusions Vaginal hysterectomy of moderately enlarged uterus can be safely and effectively performed by experienced operators. In some cases

in order to reduce the uterine volume

uterine mor-cellation should be used to shorten operative time

reduce the bleeding

and lower the postoperative complications.