The Missing Link in Prolapse Surgery: Why Pelvic Therapy Is the Game Changer You Didn’t Know You Needed
For many women, the decision to undergo prolapse or bladder sling surgery feels like the final chapter in a long, frustrating story. Years of discomfort, pressure, or leakage have led to the ultimate conclusion: surgery seems like the only solution. But what if I told you that there’s a crucial piece missing from this narrative?
Enter pelvic therapy.
When you hear about surgeries like bladder slings or mesh repairs, you’re probably not also hearing about the role of your pelvic floor muscles in your recovery—or how therapy can make your surgery more effective and long-lasting. Let’s break it down so you can make informed decisions about your body and your health.
What Is a Prolapse, and Why Surgery?
Pelvic organ prolapse happens when the muscles and connective tissues in your pelvic floor become dysfunctional and unable to support organs like the bladder, uterus, or rectum. This can lead to symptoms like:
A heavy or bulging sensation in the vagina or rectum
Difficulty emptying your bladder or bowels
Urinary leakage
Pain or discomfort during intimacy
Bladder sling and mesh surgeries aim to restore support to these organs. A bladder sling helps to keep the urethra in place, reducing leakage, while mesh surgeries reinforce weakened tissues to correct the prolapse.
Surgery addresses the structural issues. But here’s what surgery doesn’t do: rebuild the muscles and movement patterns that likely caused the prolapse in the first place.
Why Pelvic Therapy Before Surgery?
Think of pelvic therapy before surgery like preparing your soil before transplanting a flower. It's going to grow better when you've done the preparation to nourish the environment that it is in!
Surgery might give you the structural “fix,” but if the muscles and connective tissues are weak, tight, or poorly coordinated, the results won’t be as robust. Here’s why pre-surgery therapy matters:
Strengthens the Foundation: Pelvic therapy focuses on retraining your pelvic floor muscles to better support your organs, improving your overall function.
Optimizes Surgical Outcomes: By reducing inflammation, tension, and improper movement patterns beforehand, therapy creates a more stable environment for the surgery’s success.
Prepares You Mentally and Physically: Therapy helps you understand your body’s mechanics and builds confidence in your recovery process.
Why Pelvic Therapy After Surgery?
After surgery, your body has a new internal landscape. Scar tissue forms, your muscles need to adjust, and your body must relearn how to move and function. Without therapy, the muscles might remain undertrained or develop compensatory patterns that could lead to discomfort or even a recurrence of prolapse.
Here’s how post-surgery therapy can help:
Rehab Like Any Other Surgery: Just like with a knee replacement, the surrounding muscles and tissues need to be retrained to work with the surgical repair. Skipping rehab for your pelvic floor is like skipping physical therapy for a new joint.
Scar Tissue Management: Therapy can help minimize the impact of scar tissue, improving mobility and reducing pain or pulling sensations. I have seen many prolapse repair have some internal scar tissue that caused symptoms such as abdominal discomfort.
Restores Strength and Coordination: Surgery addresses structure, but therapy ensures the muscles can support that structure. You’ll relearn how to move, lift, and exercise without putting excess strain on your repair.
Prevents Future Problems: Therapy helps you address underlying movement patterns that may have contributed to the prolapse in the first place, reducing the risk of recurrence.
Pelvic Therapy Isn’t Just Kegels
Many people think pelvic therapy is all about squeezing and strengthening. But a tailored program looks at the big picture:
Are your muscles too tight or overactive? Therapy can teach you how to relax them.
Are your core muscles working in harmony with your pelvic floor? If not, therapy can integrate these systems.
Do you have habits (like poor posture or breath holding) that contribute to pelvic floor strain? Therapy addresses those too.
I even assess your prolapse in standing to give you tips on how to improve your posture when gravity is a factor.
The Bigger Picture: You Deserve More Than a Quick Fix
Pelvic floor dysfunction isn’t just about your muscles or your organs—it’s about how your entire body moves and supports itself. Surgery is one important tool, but it’s not the whole solution. Pairing it with pelvic therapy gives you the best chance to:
Feel confident in your body’s strength and function
Return to activities you love
Avoid future surgeries
Don’t wait for your doctor to bring it up—ask about pelvic therapy today! You’ve already made the courageous decision to seek help for your prolapse; now take it one step further to ensure you’re not just fixed but truly healed.
