When people undergo surgical interventions for orthopedic injuries, physical therapy is always prescribed afterwards, and sometimes before. The same should be true for pelvic surgeries given the complex and crucial functioning of the pelvic floor, but sadly, this is not always the case. Patients who are frustrated with persistent symptoms after surgery often find us on their own. 

The term ‘prehab’ refers to optimizing pelvic health before a surgical procedure, such as a prostatectomy or pelvic floor reconstruction. Research shows that patients have better outcomes when undergoing pelvic floor physical therapy before and after these surgical procedures.

Pelvic Floor Physical Therapy and Pelvic Surgeries

Pelvic floor physical therapy is warranted before and after:

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

Symptoms

  • 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

Symptoms

  • 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 prior to the procedure, with the exception of people undergoing gender affirmation procedures. For this reason alone, it is helpful for people to optimize their pelvic health prior to 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.

Treatment:

How We Can Help You

Pelvic floor physical therapy is beneficial prior to these surgical procedures to reduce musculoskeletal and nervous system impairments. Even if you did not have physical therapy prior to your surgery, we can still help you afterwards 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. During the physical examination the physical therapist examines muscles, tissues, joints, nerves, and movement patterns. Once your physical therapist completes the examination they review your findings with you. The physical therapist creates an assessment which 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 compliment 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.

Treatment:

How We Can Help You

Pelvic floor physical therapy is beneficial prior to these surgical procedures to reduce musculoskeletal and nervous system impairments. Even if you did not have physical therapy prior to your surgery, we can still help you afterwards 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. During the physical examination the physical therapist examines muscles, tissues, joints, nerves, and movement patterns. Once your physical therapist completes the examination they review your findings with you. The physical therapist creates an assessment which 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 compliment 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.

2000 Van Ness Ave Ste 603, San Francisco, CA 94109

Phone:    (415) 440-7600
Fax:         (415) 440-6803
Hours:    Mon-Fri 8am – 5pm
Email:      info@pelvicpainrehab.com
Staff:      Molly Bachmann, Karah Charette, Kelsey Peterson

Liz and Stephanie opened their first PHRC location in 2006 in San Francisco. Since 2006 we have remained in the Medical Arts building on the corner of Jackson and Van Ness Avenue due to its convenient location.

We are minutes from downtown San Francisco as well as the Golden Gate bridge, allowing easy access to Marin County. We are easily accessible by MUNI lines 47, 49, 19, 10, 12, and 1. There is metered street parking as well as several parking garages within easy walking distance.

2000 Van Ness Ave Ste 603, San Francisco, CA 94109

Phone:    (415) 440-7600
Fax:         (415) 440-6803
Hours:    Mon-Fri 8am – 5pm
Email:      info@pelvicpainrehab.com
Staff:      Molly Bachmann, Karah Charette, Kelsey Peterson

Liz and Stephanie opened their first PHRC location in 2006 in San Francisco. Since 2006 we have remained in the Medical Arts building on the corner of Jackson and Van Ness Avenue due to its convenient location. We are minutes from downtown San Francisco as well as the Golden Gate bridge, allowing easy access to Marin County. We are easily accessible by MUNI lines 47, 49, 19, 10, 12, and 1. There is metered street parking as well as several parking garages within easy walking distance.