How Pelvic Floor Therapy Can Help with Post-Operative Surgeries

Pelvic floor therapy can offer significant benefits in the recovery process following abdominal surgeries, such as abdominoplasty, hernia repair, or gender-affirming procedures. These surgeries can lead to pain, swelling, scar tissue, and restricted mobility as the body heals. Pelvic floor therapists use specialized techniques to alleviate discomfort, reduce swelling, improve tissue mobility, and enhance blood flow. These therapies help address not just the immediate post-operative symptoms, but also contribute to long-term healing, ensuring a smoother recovery and improved overall function of the abdominal and pelvic region.

Abdominoplasty: 

• Also known as a “tummy tuck”, is a procedure performed to reduce excess skin and fat from the abdominal wall. This surgery is usually performed for cosmetic reasons, and will leave a scar along the lower abdomen from hip to hip.

Hernia Repair:

• A hernia is when an internal organ or tissue pushes through a weaker spot in the abdominal wall, groin, or diaphragm. A hernia repair is usually a laparoscopic procedure performed to push the herniated tissue back into the abdominal wall and stabilize the weakened muscle, often with surgical mesh. 

Prostatectomy 

• A prostatectomy is the removal of the prostate, usually due to prostate cancer. This procedure is usually performed laparoscopically using the “Da Vinci Method”. During this procedure the prostate is removed by making an incision above and below the prostate. The urethra (which runs through the prostate) is then pulled up and attached to the base of the bladder.

Gender Affirming Surgery

• Vaginoplasty: 
• A vaginoplasty is a gender affirming surgery that creates a vaginal canal or just the vulvar anatomy externally. This surgery can be performed to remove masculine appearing genitalia in those assigned male at birth for an appearance and function that aligns more with the patients gender, or to repair an injury or genital anomly. When this procedure is performed in people assigned male at birth, the existing tissue from the penis and scrotum is used to create the vaginal canal and external structures, including the clitoris.
• Phalloplasty: 
• A phalloplasty is a gender affirming surgery that creates a penis-like structure in patients assigned female at birth. There are several techniques to perform this surgery, but the most common involve taking skin from the forearm, thigh or groin to create the penis, and then testicular implants are placed using existing structures. 
• Top Surgery: 
• Top surgery is a gender affirming surgery that refers to the masculinzation or feminization of the chest, depending on the patients goals. This includes removal or augmentation of breast tissue and reshaping the chest and nipples to creat a more masculine or feminine appearance for transgender or nonbinary people. 

How can pelvic floor therapy help you post-operation?

When any type of invasive surgery is performed on the body, there will be a period of post-operative recovery that will have to take place. This can include increased pain/tenderness at incision sites, increased swelling, increased fatigue, increased constipation, and decreased activation of appropriate musculature during the healing stage. Another consideration is the chance of adhesions, which is scar tissue that can occur between the connective tissue that connects organs or at the abdominal wall. These adhesions are usually stiff, and can cause pain, immobility, and impact function of the affected sites. Seeing a pelvic floor therapist post-op can be incredibly helpful in the acute healing stage after your surgery because of the soft tissue and manual techniques we can perform. These include: 

• Lymphatic Drainage - This is a technique that can assist in moving excess fluid from body that occurs post-op to decrease swelling
• Cupping -  A technique using a suction cup to lift up the skin on areas of tension to help promote blood flow. Initially this is usually performed on areas surrounding the abdomen, including the low back, glutes, inner thighs, shoulders. Once incisions have healed and the abdomen is less tender cupping can be performed on the abdomen and incisions. This can help increase mobility of incisions, and decrease soreness, and can also be as aggressive or gentle as the patient requires.. 
• Visceral Mobilization - A technique that gently works to mobilize organs and connective tissue surrounding organs (also known as “viscera”). When incisions are performed there is a chance of adhesions and scar tissue to form, which can cause restriction at the viscera. Performing this manual technique can help improve mobility that may have become restricted after surgery.
• Dry Needling - A more direct manual technique that can be performed at areas of tension. An acupuncture like needle (very fine gauged and dry - meaning there is nothing in it) is inserted into areas of tension with the purpose of encouraging a “twitch” response which is the muscle quickly contracting and relaxing. This can very quickly help alleviate muscle tension, and will usually result in mild soreness for 6-8 hours that should subside and leave you feeling more relaxed. This technique is usually performed on areas surrounding the abdomen, including the low back, glutes, inner thighs, shoulders during the acute stage of healing. Once incisions are fully healed and no longer tender, dry needling can be extremely helpful when done on scar tissue to help promote blood flow, decrease restrictions, and even lighten the appearance of scars. 
• Soft Tissue Massage - Various manual techniques that are performed with a therapist’s hands to help promote blood flow to areas of restriction. This can feel very similar to a massage you would get for relaxation. 
• Exercise - Not exactly a “manual technique”, but seeing a pelvic floor therapist post-op can help get you back to doing things you love by very gently helping you regain strength and coordination. This also can include going over appropriate breathing strategies to help manage pressure in your abdomen post-op.