Maximizing Hysterectomy Recovery with Pelvic Floor Therapy: What Are the Benefits?

After c-sections, hysterectomies are the second most common surgical procedure for women in the United States, with over 600,000 performed annually. Of these procedures, a substantial 80% are carried out for benign reasons, which only increases the importance of ensuring a smooth and comfortable recovery process. Pelvic floor therapy is a pivotal tool in not only facilitating post-hysterectomy recovery, but also in preparing women for surgery, often referred to as “prehab”.

Understanding Hysterectomy and Its Impact:

There are three different types of hysterectomy procedures: partial, total, and radical. A partial hysterectomy involves the surgical removal of the uterus while preserving the cervix, whereas a total hysterectomy removes both the uterus and the cervix. A radical hysterectomy goes a step further, removing the uterus, cervix, and ovaries. Hysterectomies are indicated for various medical reasons, including cancer, fibroids, abnormal bleeding, adenomyosis, endometriosis, pelvic pain, and even during cesarean sections. Remarkably, 60% of women who undergo planned, non-emergent hysterectomies do not explore conservative management options before opting for this procedure.

Post-Operative Challenges and Symptoms:

Following a hysterectomy, women encounter a wide range of physical and emotional challenges. Persistent pelvic inflammation and irritation can hamper the pelvic floor muscles' ability to contract and relax, leading to involuntary muscle tightening and potential long-term dysfunctions. Physical symptoms encompass pain, abdominal pressure, incontinence, and more, necessitating therapeutic intervention. Emotionally, the surgery can evoke complex feelings, including a sense of identity loss, exacerbated by hormonal fluctuations impacting stress, anxiety, and emotional regulation.

In the immediate post-operative phase, women may experience symptoms like pelvic inflammation, swelling, diminished cardiovascular strength, pelvic pain, scar tissue formation, and desensitization due to nerve involvement. Gastrointestinal issues such as irritation or constipation may also arise, often triggered by anesthesia, reduced activity levels, pain medications, or abdominal gas used for surgical visualization. Additionally, some women may grapple with painful sexual experiences post-hysterectomy, often due to "surgical menopause" caused by the removal of the ovaries. This hormonal shift can result in decreased blood flow and lubrication in the pelvic region, leading to symptoms like vaginal dryness, urinary leakage, decreased libido, or changes in pelvic floor muscle strength. The good news is that pelvic floor therapy can provide relief by mitigating the severity of these common side effects, ultimately enhancing post-operative comfort and overall well-being.

Benefits of Pelvic Floor Physical Therapy:

Pelvic floor therapists can identify these dysfunctions and deliver effective treatment, along with prescribing appropriate exercises to address areas in need of improvement. Early intervention can lead to a shorter recovery time, fewer altered movement patterns, and less disrupted behaviors. Importantly, pelvic floor therapy doesn't exclusively target pelvic muscles; it comprehensively addresses the entire core, which includes the diaphragm, abdominal muscles, back muscles, and pelvic floor muscles.

The Role of Prehabilitation (Prehab):

Planning for a hysterectomy? Initiating physical therapy before the surgery can be an excellent strategy. This proactive approach allows for identifying areas of stiffness or weakness to strengthen the core before surgery, ensuring muscles remain healthy and enabling you to stay active and mobile.

The Road to Recovery:

The duration of your hospital stay post-surgery may vary depending on the type of hysterectomy you undergo, potentially up to seven days. After discharge, it is beneficial to contact a pelvic floor therapist as early as possible, as recommended by your doctor. The initial weeks may involve gentle abdominal strengthening, posture and positioning recommendations, scar management, pain management techniques, and exercises aimed at strengthening the pelvic floor. Over time, treatment will progress to include activities that facilitate a return to normal daily routines, such as increased strength and abdominal exercises, varied pelvic floor exercises, and functional activities.

In conclusion, achieving a smooth and comfortable recovery following a hysterectomy is crucial for women's well-being. Pelvic floor therapy can be a transformative factor in this journey. At Healthy Core Wellness & Rehab, our team comprises highly skilled physical therapists trained in hysterectomy recovery and prehab. Whether you're preparing for surgery or have already undergone a hysterectomy, our experts are here to provide the guidance and support necessary to regain your strength and enhance your quality of life. Do not hesitate to reach out to us and take the initial step toward a healthier, happier you. Your well-being is our top priority.

Lyons, Michelle. "Living Well After Hysterectomy." Pelvicon, 9 Sept. 2023, Atlanta, GA.

written by Joanna Pavlak, DPT - October 2023