Many women in their lifetime may experience something called the “Pelvic Organ Prolapse”, which is when a pelvic organ, like the bladder, uterus or rectum, starts to dip down into the vaginal canal.

While there are conservative options for prolapse management, surgical repair is often warranted when these options don’t work. Here are 7 tips for post-prolapse surgery recovery.

1. Make sure you can activate your pelvic floor muscles. You need to have strong pelvic floor muscles to ensure your pelvic organs are supported. These muscles ensure you don’t have bowel or bladder leakage. It is really important to get these muscles working properly after surgery.Even if you still have stitches, you can do gentle pelvic floor muscle exercises. However if there is still a catheter in place, we recommend waiting till it is taken out. Think of activating your pelvic floor like you are trying to stop the flow of urine or you are holding back gas.

   Make sure you breathe normally while you are activating your pelvic floor. You don’t want to do a big suck in and hold your breath as this can put a lot of pressure down through the pelvic area. Since the area just went through a major surgery, you want to ensure you are not putting more pressure through the area.

   We recommend doing a gentle contract-relax of the pelvic floor muscles, and do some quick squeezes. For longer holds, first start with contracting for 3-5 seconds, and work your way up to 10 second holds, repeating this 10x. The easiest position to start this is laying down, but as you get stronger, try it in sitting or standing.

2. Try a “knack”, a “knack” is a pre-contraction of the pelvic floor muscles prior to a cough, laugh or sneeze. Since you just had surgery, you want to ensure you have the support of the muscles in and around the pelvic floor and belly area, this pre-contraction can take some of the pressure off the pelvic floor and belly to make it more comfortable to cough, laugh etc. to prevent leakage and excessive pressure.
3. Eat a healthy, balanced diet. After a major surgery, your body needs enough nutrients to heal. Make sure you are eating a diet high in fiber, fruits, vegetables, whole grain breads, cereals. Make sure you are drinking plenty of fluids, mainly in the form of water.
4. If you are a smoker, please try and stop before you have surgery, and if that is not possible, try to at least stop while you are healing afterwards. Stopping smoking benefits your health in several ways but for surgical recovery specifically it can lessen the chances & risk for wound infections.
5. Make sure you set yourself up to have nice healthy bowel movements. The bowels sometimes take some time to return to normal after an operation especially you had to take pain medications.You may need to take a laxative or a stool softener initially to avoid straining and constipation as you want to decrease the pressure down through the healing tissue in your pelvic floor. Try positioning yourself with a small stool underneath your feet to get your knees up higher, like a squatty potty can make it easier to pass bowel movements.
6. This is a major surgery, and your body needs rest to recover. Plan ahead and prep meals or have friends and family members that can help out with taking care of kids or walking the dogs. The first week should be focused on rest and reducing straining movements but definitely don’t sit the whole time. Light activities around the house are best.  Listen to your doctor for how long they say to take off and how long they say to limit lifting.
7. Partner with a Pelvic Floor Physical Therapist –  As you get further out from surgery, you will want to get back to moving fast and return to heavy lifting activities, but we caution you to ensure the tissue is healed prior to returning and your body is ready for these movements.Once you get the green light from your surgeon to be more active, which is usually around the 6 week time frame, this is a good time to schedule an evaluation with a pelvic floor physical therapist. We caution you to think of the green light, as a yellow light, and monitor how each movement feels on your pelvic floor.

   If you are used to doing crossfit workouts or HIT workouts, and you want to get back to these, partnering with a pelvic floor therapist can help you get there safely and efficiently.

   Think about pelvic floor surgery like this: if you’ve had a surgery, maybe you injured your ACL or you injured your rotator cuff, and you’ve had surgery to repair it, the surgery does a good job to repair the injured tissue, but it doesn’t do anything to fix the muscles and make the muscles stronger and working better together, the same thing goes for a pelvic floor area.

   You need to make sure that all muscles in and around the pelvic floor are coordinating together, so that you don’t end up re-injuring this newly fixed tissue.