Pelvic Surgery and Your Pelvic Floor: Why Recovery Should Include Physiotherapy

Pelvic surgeries can be life-changing for many women. Procedures like hysterectomy, prolapse repair, endometriosis surgery, and other gynecological operations can relieve pain, heavy bleeding, and other disruptive symptoms.

But what many women are not told before surgery is that these procedures can also affect the pelvic floor, and recovery involves much more than just healing an incision.

Understanding how pelvic surgery impacts the body and how pelvic health physiotherapy can support recovery, can make a meaningful difference in long-term health.

Hysterectomy: A Common Surgery with Lasting Impacts

Hysterectomy is one of the most commonly performed surgeries worldwide.

In fact, approximately 1 in 3 women will have a hysterectomy by age 60.

For many women, the procedure provides relief from conditions such as:

• Fibroids

   

• Endometriosis

   

• Adenomyosis

   

• Heavy or irregular bleeding

   

• Chronic pelvic pain

   

While hysterectomy can improve quality of life for many patients, it is still a major surgery that alters the anatomy and support structures of the pelvis.

During surgery, ligaments and tissues that help support the pelvic organs are cut or repositioned, which can change how the bladder, bowel, and pelvic floor muscles function.

This is why some women experience new or ongoing symptoms after surgery.

Post-Surgical Pelvic Floor Challenges

Research shows that pelvic floor symptoms are common after hysterectomy (or surgeries like hysterectomy).

Some reported complications include:

• Up to 25% of women report chronic pain one year after hysterectomy

   

• 42% experience bowel dysfunction, such as constipation or straining

   

• 30% develop bladder issues, including urgency or leakage

   

• Around 20% experience pelvic floor dysfunction that interferes with daily life

   

Pelvic floor dysfunction can present in many ways, including:

• Urinary leakage

   

• Urgency or difficulty emptying the bladder

   

• Constipation or straining with bowel movements

   

• Pelvic pressure or heaviness

   

• Pain with intercourse

   

• Core weakness

   

Large research reviews have also found that hysterectomy is associated with increased risk of urinary incontinence and pelvic organ prolapse years after surgery, highlighting the importance of long-term pelvic floor health.

Why Does Surgery Affect the Pelvic Floor?

The pelvic floor is a group of muscles and connective tissues that support the bladder, uterus, and bowel.

During gynecological surgery:

• Support ligaments may be cut or repositioned

   

• Tissue tension and alignment can change

   

• Scar tissue may form

   

• Muscles may become weak, overactive, or poorly coordinated

   

The result is that the pelvic floor sometimes struggles to adapt to its new anatomy and workload.

Think of it like renovating a house without adjusting the foundation. The structure may still stand, but things may shift in ways that need attention.

The Missing Piece: Pelvic Health Physiotherapy

Pelvic health physiotherapy is one of the most effective ways to support recovery after pelvic surgery.

Research shows that pelvic floor rehabilitation can improve muscle strength, reduce urinary symptoms, and improve quality of life after gynecological procedures.

Yet surprisingly, it is not routinely included as part of surgical care.

Many women only learn about pelvic health physiotherapy after symptoms develop, rather than as a proactive step in recovery.

The Role of “Prehabilitation”

One emerging concept in healthcare is prehabilitation, preparing the body for surgery before it happens.

Meeting with a pelvic health physiotherapist before surgery can help women:

• Learn how to properly activate and relax pelvic floor muscles

   

• Improve breathing and core coordination

   

• Reduce strain on the pelvic organs

   

• Understand how to safely return to exercise and daily activities

   

Patients who go into surgery with better muscle awareness and strength often recover more smoothly.

Post-Surgical Physiotherapy: What It Helps With

After surgery, pelvic health physiotherapy can help address:

Bladder symptoms

• Urgency

   

• Leakage

   

• Difficulty emptying

   

Bowel symptoms

• Constipation

   

• Straining

   

• Incomplete bowel movements

   

Pain

• Pelvic pain

   

• Scar tissue restrictions

   

• Pain with intercourse

   

Core recovery

• Restoring abdominal and pelvic stability

   

• Improving posture and movement patterns

   

Treatment may include:

• Pelvic floor muscle retraining

   

• Breathing and pressure management

   

• Scar tissue work

   

• Mobility and strengthening exercises

   

• Education around safe lifting, exercise, and return to activity

   

So Why Isn’t This Standard Care?

Many women are surprised to learn that pelvic health physiotherapy is not automatically included in surgical recovery.

Some reasons include:

• Limited awareness among patients

   

• Time constraints in surgical care

   

• Lack of routine referral pathways

   

• Assumptions that symptoms will resolve on their own

   

But the reality is that pelvic health plays a major role in long-term recovery and quality of life.

Addressing it early can prevent many of the symptoms women struggle with months (or even years) after surgery.

The Bottom Line

Pelvic surgery can be an important and necessary step toward better health.

But recovery should not end when the surgical incision heals.

Your pelvic floor plays a critical role in:

• bladder function

   

• bowel health

   

• sexual function

   

• core stability

   

• overall comfort in daily life

   

Pelvic health physiotherapy can help support these systems before and after surgery, allowing the body to adapt, recover, and function at its best.

Because when it comes to surgery, the goal is not just surviving the procedure, it’s thriving afterward.

If pelvic surgery is something you’re considering, or if you’re recovering from a hysterectomy or other gynecological procedure, pelvic health physiotherapy may be an important part of your recovery.

If you’re looking for help and want to book in with our pelvic health physiotherapist, call us at 519-265-8035 or book online! Located downtown Guelph. 

Medical Disclaimer

The information in this article is intended for educational purposes only and should not be considered medical advice. Every individual is different. If you have questions about your symptoms or your health, consult a qualified healthcare professional for an assessment and personalized recommendations.