Hysterectomy and the pelvic floor
What is a hysterectomy?
A hysterectomy is a surgical procedure involving the removal of the uterus or womb. There are various reasons for why your gynaecologist may perform hysterectomy surgery and a range of different hysterectomy procedures that may be used varies according to the medical reason for your surgery.
The main types of hysterectomy are
Total abdominal hysterectomy: A total abdominal hysterectomy involves the surgical removal of the uterus and cervix through an abdominal incision. The incision is usually made along the bikini line (pubic hair line) although a vertical incision is sometimes used form below the navel to the pubic hair line. An abdominal incision increases hysterectomy recovery time and makes mobility more challenging when compared with a vaginal hysterectomy. Hysterectomy recovery time is usually a total of three months following a total abdominal hysterectomy and the first six weeks are usually the most challenging, with mobility and activities most restricted during this time.
Subtotal hysterectomy: A subtotal hysterectomy involves the surgical removal of the uterus without removing the cervix. Some women are concerned about sex after a hysterectomy. The cervix can be involved in orgasm and for some women, removal of the cervix may reduce sexual response.
Vaginal hysterectomy : A vaginal hysterectomy involves the surgical removal of the uterus and cervix through an incision high inside the vagina. A vaginal hysterectomy does not involve an abdominal incision which usually improves hysterectomy recovery time and makes post-operative mobility easier when compared with an abdominal hysterectomy.
Laproscopic hysterectomy: A laparoscopic-assisted vaginal hysterectomy involves the use of a fine telescope that is passed via small abdominal incision into your abdomen. Part of the surgery is conducted through small keyhole abdominal incisions and part is conducted as a vaginal hysterectomy. The uterus and cervix are both removed with this procedure. The advantage of this procedure is that it does not require a large abdominal incision which usually reduces hysterectomy recovery time when compared with an abdominal hysterectomy.
Pelvic floor exercises after a hysterectomy
Your pelvic floor muscles should work to support your remaining pelvic organs post hysterectomy. These muscles also assist your bladder and bowel storage and emptying. A weak pelvic floor will not work well to support your internal organs and stitches after your hysterectomy. It makes good sense to train your pelvic floor muscles into their best possible condition to prepare for hysterectomy surgery. After a hysterectomy, check with your gynaecologist regarding his/her preference for when you are able to commence gentle pelvic floor exercises.
Since your pelvic floor muscles are hidden from view inside your body, performing correct pelvic floor exercises can seem mysterious and confusing. If you are at all uncertain about how to perform your pelvic floor exercises using the correct technique after a hysterectomy, contact a physiotherapist or continence advisor to help you to find and train these important muscles.
Pelvic Floor Recovery : A Physiotherapy Guide For Gynaecological Repair Surgery by physiotherapist Sue Croft is an excellent start to your recovery. This book will assist your recovery from hysterectomy, covering everything from first days post-op in hospital to the following weeks of recovery.
Inside Out by Michelle Kenway, with Dr Judith Goh and Inside Out Prolpase Exercise by Michelle Kenway are also excellent resources for exercise recovery following a hysterectomy.
The material presented here is intended as an information source only. The information is provided solely on the basis that readers will be responsible for making their own assessment of the matters presented herein and are advised to verify all relevant representations, statements and information. The information should not be considered complete and should not be used in place of the advice of a health care provider. Pelvic Floor Exercise does not accept liability to any person for the information or advice provided , or for loss or damages incurred as a result of reliance upon the material contained herein.
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