Why You Should See a Pelvic Floor Therapist Following a Hysterectomy

By Dr. Christine Martirez PT, DPT on 8/6/2024

Undergoing a hysterectomy is a significant medical procedure that involves the surgical removal of the uterus. This operation, while often necessary for various health conditions, can have a considerable impact on the pelvic floor and overall well-being. Pelvic floor physical therapy can play a crucial role in your recovery process, helping to manage and alleviate common post-surgery issues. In this blog post, we’ll explore the anatomy of a hysterectomy, the potential pelvic floor issues that can arise, and how pelvic floor therapy can help you recover effectively.

Anatomy of a Hysterectomy

A hysterectomy can be performed using different surgical approaches, each with specific anatomical implications:

1. Total Hysterectomy:

   This involves the removal of the entire uterus, including the cervix.

2. Subtotal (Partial) Hysterectomy:

   This involves the removal of the upper part of the uterus while leaving the cervix intact.

3. Radical Hysterectomy:

   This procedure includes the removal of the uterus, cervix, part of the vagina, and surrounding tissues, often performed for cancer treatment.

4. Hysterectomy with Salpingo-Oophorectomy:

   This involves the removal of the uterus along with one or both ovaries and fallopian tubes.

The surgery can be carried out through different methods:

• Abdominal Hysterectomy:

  Through an incision in the abdomen.

• Vaginal Hysterectomy:

  Through the vagina.

• Laparoscopic Hysterectomy:

  Using small incisions and a camera to guide the surgery, which is minimally invasive.

Pelvic Floor Issues After a Hysterectomy

Following a hysterectomy, several pelvic floor issues may arise due to the changes in pelvic anatomy and the healing process. Some of the most common problems include:

1. Pelvic Pain:

   The surgical removal of the uterus can cause scar tissue formation and changes in the pelvic floor muscles, leading to discomfort or pain in the pelvic region.

2. Urinary Incontinence:

   The removal of the uterus can affect the support structures of the bladder, leading to stress urinary incontinence or an overactive bladder.

3. Constipation:

   Changes in the pelvic floor muscles and altered bowel habits post-surgery can lead to constipation and difficulty with bowel movements.

How Pelvic Floor Physical Therapy Can Help

Pelvic floor physical therapy offers a range of interventions tailored to address the specific challenges faced during recovery from a hysterectomy:

Comprehensive Assessment:

• A pelvic floor physical therapist will conduct a thorough evaluation of your pelvic floor function, posture, and overall physical condition. This assessment includes reviewing your medical history, surgery details, and current symptoms.

Pain Management:

• Manual Therapy:

  Techniques such as myofascial release, trigger point therapy, and soft tissue mobilization can help reduce scar tissue adhesions and alleviate pelvic pain.

• Modalities:

  Use of thermotherapy, cryotherapy, electrical stimulation, and other modalities to reduce pain and promote healing.

Strengthening and Rehabilitation:

• Pelvic Floor Exercises:

  Customized exercises to strengthen and relax the pelvic floor muscles, improving their function and reducing symptoms of incontinence and pain.

• Core Stabilization:

  Exercises to strengthen the core muscles, which support the pelvic floor and improve overall stability.

Bladder and Bowel Management:

• Bladder Retraining:

  Techniques to help regain control over bladder function, reducing urgency and frequency issues.

• Bowel Management:

  Strategies to improve bowel habits and alleviate constipation, including dietary recommendations and bowel re-education techniques.

Education and Lifestyle Modifications:

• Postural Training:

  Guidance on maintaining proper posture to reduce strain on the pelvic floor and support recovery.

• Activity Modifications:

  Advice on safe ways to return to daily activities and exercises, ensuring a gradual and safe return to normalcy.

• Self-Care Techniques:

  Education on self-massage, relaxation techniques, and pelvic floor awareness to empower you in your recovery journey.

Recovering from a hysterectomy involves addressing the significant changes and challenges that your body undergoes. Pelvic floor physical therapy provides a holistic and effective approach to manage and alleviate post-surgery issues such as pelvic pain, urinary incontinence, and constipation. By focusing on personalized assessments, targeted exercises, pain management, and lifestyle modifications, pelvic floor therapy can help you achieve a smoother and more comfortable recovery. If you are recovering from a hysterectomy, consider consulting one of our pelvic floor physical therapists to develop a tailored plan that supports your unique needs and promotes optimal recovery.

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