There are many reasons why a woman may need a hysterectomy. Often it is part of the management of a bladder, bowel or prolapse issue, but it could also be due to bleeding or a cancer. In the UK most women having a hysterectomy to help with prolapse will have already been working on her pelvic floor muscle exercises before an operation as part of our NICE guide lines pathway of care. Even so women can be surprised how long it can take to get back to their normal level of activity after their op.
Gynaecological surgery can have an incredible impact on pelvic floor muscles, with women often finding that they feel weak, unsupported or de- conditioned in the weeks following their operation This is partly because the surgical work in the area affects the blood flow, nerves, and surrounding tissues; women will also be a bit sore and less active for a few weeks during recovery. Immediately post-op, once the catheter is removed, women will be encouraged to do regular pelvic floor exercise sessions several times a day. Even baby pulses of the muscles will help the healing process by improving blood circulation to the area, reducing swelling, and strengthening the muscles.
Then over the next few weeks the aim is to build up good muscle strength and endurance again which we need for secure bladder and bowel control. Exercises will also improve the muscle tone which we need to prevent further pelvic organ prolapse, and to feel supported. Pelvic floor exercises are particularly important after surgery for prolapse as this type of problem can re-occur. It’s important to build up a strong area of muscles to support all the lifting and carrying and impact of normal life. We often relate preparing and recovering from gynaecological surgery to how one would expect to prepare to have a new knee or hip joint. You know that if you do the "pre-hab" and post op "re-hab" you can expect to get better results than the person who only relies on the surgery for their "fix". In the first 12 weeks after your surgery, you should do classic pelvic floor exercises, but independently - using your brain and muscles only. As the body is healing and sensations can be altered, it is not advised to use a muscle STIM device in this early phase. However, after 12 weeks post-op, the Kegel8® Ultra 20 can be used to exercise the pelvic floor muscles. This can be particularly helpful for people who find it difficult to feel the area, want support to do the exercises correctly and those who get distracted easily or need a bit of extra focus and motivation each day!
You can use a stimulation machine to help your muscles to work after all types of hysterectomy, including removal of the cervix. However, if you have had pelvic surgery for a cancer related issue you should get guidance from your doctor. The Kegel8 Ultra 20 comes with our Let’s Get Started Guide, which includes a step by step 12 week guided pathway for Rehabilitation after Gynaecological Surgery, devised by a specialist physiotherapist. In the first phase you allow the electrical impulses to come and go in cycles of stimulation and rest periods. This will help you "find and feel" your muscles again and improve blood flow to the area. Then you start to join in with the contractions to teach your brain how to squeeze the muscles correctly, but as you get tired the machine continues to do this for you.
The programmes build the intensity and range of patterns until you have developed strong and co-ordinated muscles again. If you still have some prolapse after your surgery, or prior to surgery you can still use a Kegel8 stimulation machine as part of your package of things you are doing to improve your pelvic floor support. As the prolapse can push downwards on to the pelvic floor area many women find it easiest to get the internal probe into a good position by lying down for 5-10 mins first to tip things literally (!) back out of the way and to do their Kegel8 programme in this position. Stimulation can be really helpful if the prolapse is making it hard to tell where your muscles are or putting a lot of pressure on the muscles. As prolapse can be a complicated system it would be best to get a full assessment of your personal situation from a specialist physiotherapist and they will guide you on making modifications to get the best results.
