Pelvic Floor Recovery After Hysterectomy

Undergoing a hysterectomy is a life changing experience. 1 in 5 UK women will have a hysterectomy by the age of 60 yet it seems to be one of those taboos that are never discussed! This leads to many women not having the information they need to make the right lifestyle choices. Here at Kegel8 we believe that women’s health issues aren’t something that should be swept under the rug. Given our specialism in the workings of the pelvic floor, we wanted to create a guide especially for those of you who’ve had hysterectomies. We hope that this information will empower you to feel in control of your body post-surgery and live a full and happy life!

Recovering from Your Operation – The First 6 Weeks

As women we can quite often be expected to be everything to everyone, all of the time. If you have a partner, husband, kids – even just a cat! – there can be a never-ending list of tasks that somehow always fall to you. Try not to put too much pressure on yourself; many women feel that they are the only ones who can take care of household duties and get tempted to ignore their doctors instructions and take on too much before they are ready, risking their pelvic floor. Make sure that your partner realises just how serious what you’ve been through is and how important it is that you get proper rest. It’s not the end of the world if your home gets a bit messy, and it will be good for those you care for to learn how to take care of themselves for a change!

If you live alone, see if nearby friends or family can help you to take care of things like cooking and basic cleaning while you are recovering. Consider investing in a ‘grabber’ tool to help you avoid bending over or reaching for things. It is really important that you avoid lifting anything heavier than 2kg for your first six weeks of recovery; consider getting your food shopping delivered. If there’s nobody who can help with cooking and cleaning, prepare basic meals that only require limited time on your feet and only do simple cleaning for the first six weeks – no vacuuming, gardening, or anything else that requires lifting or bending.

Making Positive Choices Post-Hysterectomy

Whether total or partial; abdominal, vaginal or laparoscopic, a hysterectomy is major surgery with major implications. This can be a scary time and you are most likely still in pain and wondering how you will ever get back to your normal life. Consider buying Sue Croft’s book ‘Pelvic Floor Recovery’ – it offers amazing advice that will take you step-by-step from before your surgery to post-recovery. Once you’re past the six week mark, you can start thinking about small changes you can make to your lifestyle to optimise your future pelvic health:

1. You may find that after your hysterectomy you being to gain weight. If you have had your ovaries removed as well this may be partially due to hormones, but often it happens because you are unable to move around as much during recovery. Eating a healthy diet with plenty of protein and iron will control your weight and optimise your recovery. Drinking enough water (around 2 litres a day) and making sure you eat plenty of fibre will ensure that your bowels are healthy and avoid any risky straining on the toilet.

2. It’s important to choose the right kind of exercise to do post-hysterectomy, to avoid unnecessary stress on your pelvic floor. Sue Croft recommends low impact exercise like walking, cycling (with a good gel seat to take off perineal pressure!) and swimming. Her book also includes a programme of specially designed, low-impact abdominal exercises that are a great alternative to definite no-no’s like sit ups and planks.

3. If you ever have to cough, sneeze or vomit, try to support yourself with your hand or sit on the edge of something to support your pelvic floor and counteract the downwards forces that occur.

4. You can start doing your Kegels again from about 12 weeks post-op (clear this with your doctor first). By doing regular pelvic floor exercises, you can make sure that your internal organs are supported, your bladder and bowel function properly and that you are minimising your risk of having a prolapse – all extra important if you have had a hysterectomy.

In her excellent book, ‘Pelvic Floor Recovery’ renowned physiotherapist Sue Croft emphasises how important it is that you pay attention to your pelvic health not just when you are in recovery, but for the rest of your life. Here are her top tips for optimising your Kegel regime:

1. Stand, sit or lie down with a normal curve in your back. Close off and draw up around the urethra, vagina and anus. Hold for 10 seconds, then release. Build up slowly to repeat this action 5 to 10 times, 3 sessions each day. Note that lying down makes this movement easier as you don't have gravity to pull against so lying could be a good place to start; but be sure to challenge yourself as your muscle strength improves and progress to sitting and standing exercise.

2. Don’t strain – even if all you are able to do is a gentle contraction, this is a great start. Trying too hard to contract your muscles could put too much stress on them and cause damage. 

3. Don’t tense your inner thigh muscles or buttocks, and don’t bear down as this will strain your pelvic floor. Sue suggests that if you’re unsure of whether you are doing Kegels correctly, a good option is electrical stimulation - such as that offered by the Kegel8 Ultra 20 Pelvic Floor Exerciser. Not only doees it exercise your muscles automatically, it also calms bladder nerves that might be feeling 'jangly' following your op.

4. If your pelvic floor is particularly weak (which it may well be after hysterectomy) you might struggle to do many Kegels at first. Don’t be discouraged! As with any exercise programme, it will take time to build up strength in your muscles. Just take things at your own pace and you will begin to see results.