There are a variety of gynaecological surgeries that a woman can be offered depending upon her symptoms and problems. These are discussed with the Gynaecologist and their team, and are usually offered once other non-invasive, non-surgical options have been explored and trialled. The most common types of major gynaecological surgery, that may benefit from Specialist Physiotherapy support afterwards are listed below….

Total Hysterectomy:

The removal of the uterus (womb) and cervix. The fallopian tubes and ovaries stay in situ.

You can be given an abdominal hysterectomy where the uterus is removed through an incision in the abdomen, or a vaginal yysterectomy where the uterus is removed through the vaginal opening.

A Subtotal Hysterectomy:

The removal of just the uterus, the cervix stays in place.

Hysterectomy with salpingo-oophorectomy:

The removal of one or both ovaries, and the fallopian tubes, along with the uterus.

Wertheims (Radical) Hysterectomy:

The removal of the uterus, the cervix, and the top part of the vagina. The pelvic lymph nodes may also be removed.

Anterior Vaginal Wall Repair (Colporrhaphy):

The repair of the anterior vaginal wall and pelvic floor muscles

Posterior Vaginal Wall Repair (Colporrhaphy or Colpoperineorrhaphy):

The repair of the posterior vaginal wall and pelvic floor muscles, and in some cases the perineum.

Colposuspension:

Through a small incision, or keyhole surgery, stitches put in situ to support the neck of the bladder.

Sacrocolpopexy:

The attachment of the vaginal vault to the sacrum (the tailbone) using synthetic mesh.

Vulvectomy:

The partial or complete removal of the vulva.

Myomectomy:

The removal of fibroids from the uterus.

As these major surgeries involve incisions, removal and/or repairs to the tissue within the pelvic area, vaginal area or abdominal area, it is essential to look after your body post-op. The muscles will be weak and vulnerable to stress and stretch. The last thing you want is to have on-going problems following the surgery that is designed to help and improve your symptoms. Looking after your health and wellbeing is paramount.

You will have most likely been given advice or leaflets pertaining to your surgery, and how best to care for yourself in the days and weeks following the procedure. If you have forgotten, if there’s new concerns, if you’d like further information and guidance then don’t hesitate to contact Embrace Physio for expert advice and help! Give yourself the best opportunity to recover successfully.

Physiotherapy following Gynaecological Surgery:

• In depth assessment of gynaecological and surgical history, current concerns and symptoms
• Physical examination of spine and pelvis
• Physical and internal examination (with consent) to assess scarring, sensation, muscle activity
• Teaching correct and effective pelvic floor muscle and abdominal muscle exercises
• Advice on care for wound, scar, health and wellbeing
• Advice on lifestyle – activities, diet, exercise
• Bladder health and re-training
• Manual therapy as indicated: soft tissue release, massage, scar care, stretching
• Pain management
• Acupuncture
• Emotional support