This book follows the first edition of State-of-the-Art: Vaginal Surgery and has been updated with addition of several new chapters, videos and illustrations. Although enormous advances have occurred in the medical management of a number of conditions, surgical therapy continues to be vital. Surgery remains an art backed by scientific reason and thought. Vaginal surgery in particular is a skill to be learnt and mastered. Most gynecological conditions can be dealt through the vaginal route particularly disorders of pelvic floor, pelvic organ prolapse, and benign vulval, vaginal, uterine and urological conditions. Ablative and excision therapy for intraepithelial neoplasia along with radical surgeries for genital malignancies are also approached vaginally.