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Why Pelvic Floor Physical Therapy is Essential Before and After Endometriosis Excision Surgery

Jessie Angowski
Feb 114 min read

Endometriosis is a chronic condition where tissue similar to the lining of the uterus grows outside of it, often causing severe pain and other debilitating symptoms. To read more about endometriosis- check out our last post (Understanding Endometriosis). Excision surgery is considered the gold standard for treating endometriosis, as it removes the endometrial lesions and offers relief. However, while this surgery can significantly reduce symptoms, it can also lead to pelvic floor dysfunction due to factors like pain, scarring, and surgical trauma. Pelvic floor physical therapy (PFPT) plays a crucial role in optimizing recovery by addressing these issues and reducing pain post-surgery. In this blog, we’ll explore how pelvic floor therapy before and after surgery can make a significant difference in the recovery process and overall well-being.


What is Excision Surgery for Endometriosis?

Excision surgery for endometriosis involves the removal of endometrial-like tissue that has grown outside the uterus, often in areas like the ovaries, fallopian tubes, or the pelvic lining. This surgical approach is considered the gold standard as it offers the best chance for long-term symptom relief. While excision surgery can significantly reduce pain and improve quality of life, it can sometimes lead to pelvic floor dysfunction, including issues like muscle tightness, pelvic pain, incontinence, and painful intercourse. PFPT is essential in addressing these concerns, helping to restore pelvic floor function and alleviate discomfort post-surgery.


The Benefits of Pelvic Floor Physical Therapy BEFORE Excision Surgery

Preparing the Pelvic Floor for Surgery

PFPT before excision surgery plays a key role in optimizing the body’s readiness for the procedure. By focusing on improving muscle function, pre-surgical PFPT helps relax tight muscles and enhance pelvic floor flexibility, which can make the surgery itself smoother and more effective. For many individuals with endometriosis, pelvic pain, urinary issues, and painful intercourse are already present, and PFPT can alleviate these symptoms, offering greater comfort prior to surgery. Additionally, PFPT can address musculoskeletal imbalances caused by chronic pelvic pain or compensatory movement patterns. Therapy also equips patients with valuable education on body mechanics, relaxation techniques, and pelvic floor awareness, empowering them with tools to manage their condition and feel more in control heading into surgery.


Reducing Post-Surgical Complications

Pre-operative PFPT is not just about preparing the body—it can also help reduce the risk of post-surgical complications. By improving circulation and muscle tone, PFPT helps support the healing process after excision surgery. It can also reduce the formation of adhesions and scar tissue, while preventing further pelvic floor dysfunction, setting the stage for a smoother and faster recovery.


The Benefits of Pelvic Floor Physical Therapy AFTER Excision Surgery

Reducing Pain and Scar Tissue Formation

After excision surgery, the pelvic floor muscles may go into spasm, contributing to pain and discomfort. PFPT helps release muscle tension, which can aid in pain management. Manual techniques like myofascial release and scar mobilization can break down adhesions and prevent the formation of new scar tissue, helping the pelvic floor recover more effectively.


Restoring Pelvic Floor Function

PFPT is key in restoring normal pelvic floor function after surgery. Muscles that may have become weakened or tight during the procedure can be strengthened and rehabilitated. For those experiencing painful intercourse or ongoing pelvic discomfort, PFPT offers specific interventions to desensitize tissues and improve your pelvic floor functioning. 


Improving Bladder and Bowel Function

Following excision surgery, urinary urgency, frequency, or difficulty with bowel movements are common concerns. PFPT helps to restore normal bladder and bowel function. 


Promoting Emotional Healing

Pelvic floor dysfunction can have an emotional impact, affecting intimacy, body image, and self-confidence. PFPT is not only about physical recovery but also plays a role in emotional healing by addressing pain and dysfunction. By improving pelvic health, it helps rebuild confidence in one’s body and reduces the emotional toll that both endometriosis and surgery can take.


How Long Should You Start PFPT After Surgery?

Starting PFPT as soon as possible after excision surgery is crucial for promoting a faster recovery and achieving better long-term outcomes. Ideally, you should begin PFPT within a few weeks after surgery, as early intervention plays a key role in muscle re-education, scar tissue management, and pain reduction. The sooner you address pelvic floor dysfunction, the better equipped your body will be to heal and regain normal function. However, it’s important to remember that recovery should be gradual. Working with a skilled pelvic floor PT ensures that you can progress through each stage of healing at a pace that’s right for you.


To Sum It All Up

PFPT is essential before and after excision surgery for endometriosis. It helps manage pain, prevent pelvic floor dysfunction, and restore muscle function, leading to better long-term outcomes and an improved quality of life. If you're considering or recovering from surgery, incorporating PFPT into your care plan is crucial for a smoother recovery. With the right treatment and support, significant improvements in pelvic function and overall well-being are possible.


Ready to start your recovery journey? 

Contact us (or a trusted pelvic floor physical therapist) for an assessment or to learn more about how PFPT can help. Call (201) 305-0130 for more information or to book an initial evaluation today.


 

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