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Writer's pictureCarly Gossard

Pelvic Floor Therapy Before and After a Hysterectomy

A hysterectomy, the surgical removal of the uterus, is a common procedure for various conditions, including fibroids, endometriosis, chronic pelvic pain, and certain cancers. While this surgery can relieve symptoms and improve quality of life, it can also impact the pelvic floor, which plays a crucial role in supporting organs, maintaining bladder and bowel control, and ensuring stability in the pelvis and core. Because of this, pelvic floor therapy before and after a hysterectomy is highly recommended to ensure the best surgical outcomes and overall pelvic health.


1. Understanding the Pelvic Floor and Its Role

The pelvic floor is a group of muscles, ligaments, and connective tissue that support the pelvic organs (bladder, uterus, and rectum) and help control urinary and bowel functions. It also contributes to sexual health and stability for the core and lower back. During a hysterectomy, the removal of the uterus can disrupt this network of muscles and tissue, potentially leading to pelvic floor dysfunction.

Without adequate support, patients may experience symptoms like urinary incontinence, pelvic pain, prolapse (the dropping of other organs into the space once occupied by the uterus), and discomfort during physical activities. Pelvic floor therapy helps to prevent and manage these potential issues by retraining the muscles around the pelvic area.


2. Benefits of Pelvic Floor Therapy before a Hysterectomy

Engaging in pelvic floor therapy before a hysterectomy can greatly improve outcomes by preparing the body for the changes that will occur after surgery. Some of the benefits include:

  • Getting a baseline of pelvic floor muscle tone, strength and coordination: Pre-operative therapy helps optimize the function of the pelvic floor muscles, so muscles are better able to heal after surgery.

  • Reducing Complications: Pelvic floor muscles that have both good mobility and strength can support improved bloodflow, faster recovery and reduce the likelihood of complications like incontinence or prolapse.

  • Improving Body Awareness: Patients learn about their pelvic muscles and how to engage them correctly, which can make post-operative exercises and recovery smoother and faster.

  • Reducing Anxiety and Preparing Mentally: Working with a therapist before surgery provides valuable insights into what to expect, which can reduce anxiety and prepare you for surgery and recovery.


3. Importance of Post-Operative Pelvic Floor Therapy

After a hysterectomy, the pelvic floor has to adapt to the absence of the uterus and any scar tissue or shifts that occur. Pelvic floor therapy after a hysterectomy is essential to help patients recover and regain control over their pelvic health. Some key benefits of post-surgical pelvic floor therapy include:

  • Regaining Muscle Function and Tone: Therapy helps reestablish strength and control in the pelvic muscles, preventing issues like incontinence and pelvic organ prolapse.

  • Minimizing Pain and Scar Tissue: Post-operative exercises can prevent excessive scar tissue from forming and reduce pain by improving blood flow and flexibility in the pelvic area and any resultant scar tissue.

  • Improving Bladder and Bowel Control: Many women experience temporary bladder or bowel changes after surgery. Therapy can help restore control and confidence.

  • Rebuilding Core Stability and Mobility: Pelvic floor muscles contribute to core strength, which is important for balance, posture, and mobility. Therapy aids in regaining core stability, which may be impacted after surgery.


4. Long-Term Benefits of Pelvic Floor Therapy

Beyond addressing immediate post-surgical needs, pelvic floor therapy offers long-term benefits that contribute to overall health and well-being. Improved pelvic floor health can enhance sexual function, prevent future pelvic organ prolapse, and support lower back health, ultimately helping patients maintain a more active, fulfilling lifestyle.


Pelvic floor therapy is a valuable component of a hysterectomy preparation and recovery plan. By engaging in therapy before and after surgery, women can strengthen their pelvic floor, reduce the risk of complications, and enjoy smoother, more effective recovery. For anyone undergoing or considering a hysterectomy, consulting with a pelvic floor therapist can provide essential support to make the transition as comfortable and smooth as possible.


Health & Happiness,

Dr. Carly

 

References:

Lemack, G. E., & Zimmern, P. E. (2000). Urinary Incontinence and Pelvic Floor Dysfunction Following Hysterectomy. Obstetrics & Gynecology.

Dumoulin, C., Cacciari, L. P., & Hay-Smith, E. J. C. (2018). Pelvic Floor Muscle Training Versus No Treatment for Urinary Incontinence in Women: A Cochrane Review Summary. Journal of Women’s Health Physical Therapy.

Hagen, S., & Stark, D. (2011). Conservative Prevention and Management of Pelvic Organ Prolapse in Women. Cochrane Database of Systematic Reviews.

Huebner, M., Riemer, K., & Rahlfs, V. W. (2006). Pelvic Floor Muscle Training for Female Urinary Incontinence. Physical Therapy Reviews.

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