Pelvic Surgical Prehab and Rehab Physical Therapy in San Francisco, CA

Just about any orthopedic surgery would warrant physical therapy afterward and occasionally before. Unfortunately, the same precautions are absent for pelvic injuries in most cases. Many patients are left to endure the consequences of weakened pelvic floor muscles, which come with a new set of issues. Pelvic floor physical therapy has proven to improve surgical outcomes and reduce pelvic pain.

Prehab refers to the practice of strengthening the pelvic floor before undergoing a pelvic floor procedure or reconstruction. By improving pelvic floor health before surgery, PHRC hopes to provide a better surgical outcome and decrease the recurrence of pelvic issues.

Pelvic Floor Physical Therapy and Pelvic Surgeries


We suggest pelvic floor physical therapy before and after:

  • Hysterectomy
  • Pelvic Organ Prolapse Repair: cystocele, rectocele, enterocele, urethrocele, anal prolapse
  • Mesh excision
  • Hemorrhoidectomy, fissurectomy, sphincterotomy
  • Prostatectomy
  • Endometriosis excision and/or ablation
  • Vestibulectomy
  • Cesarean Section
  • Pudendal Nerve Decompression
  • Gender affirmation procedures
  • Hernia repairs


  • Pelvic pain
  • Urinary urgency, frequency, hesitancy, weak stream, incontinence (leaking)
  • Bowel urgency, frequency, hesitancy, incomplete and/or difficulty emptying
  • Erectile dysfunction
  • Painful intercourse
  • Sexual dysfunction and painful or diminished/absent orgasm
  • Abdominal, spine, hip, and leg pain

Causes of Persistent Postoperative Symptoms

The majority of people undergoing these procedures typically have pelvic floor dysfunction before the procedure, except for people undergoing gender affirmation procedures. For this reason alone, it is helpful for people to optimize their pelvic health before surgery to reduce post-operative pain, scar tissue, and other musculoskeletal complications. In general, surgical procedures carry the risk of postoperative pain and dysfunction. Pelvic surgeries are no different. Despite numerous studies demonstrating the benefits of pelvic floor physical therapy before and after surgical procedures, many surgeons are unaware of the benefits of pelvic floor physical therapy and may not recommend it to their patients. Unfortunately, this can result in unnecessary pain and suffering.

How We Can Help You

Pelvic floor physical therapy is beneficial before these surgical procedures to reduce musculoskeletal and nervous system impairments. Even if you did not have physical therapy before your surgery, we can still help you afterward with your rehabilitation. Typically, patients are safe to begin physical therapy six to eight weeks after their surgical procedure. During the evaluation, the physical therapist reviews your history and symptoms with you and discusses what is new, different, or unchanged since your surgical procedure. We review your operative reports. We also discuss previous diagnoses you may have been given, pain, and function. Importantly, we understand what you have been through. As part of your initial examination, the physical therapist will monitor movement patterns while inspecting your muscles, nerves, joints, and tissues. Once your physical therapist completes the examination they review your findings with you. The physical therapist creates an assessment that explains how you developed pain and creates short and long-term goals for your treatment plan. Typically, the frequency of physical therapy treatment is one to two times per week for roughly 12 weeks. You are given a home exercise program to complement your in-person sessions, and your physical therapist will help to coordinate your recovery with your surgeon and the other members of your treatment team. We are here to work with you and on your behalf so you no longer have to navigate this process on your own! We will help you reach your goals and help you live the life you want to live.

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Pelvic Health and Rehab Center