What are my restrictions after pelvic floor surgery?
One of the most frequent questions women ask before pelvic floor surgery is “What will my restrictions be?” Some are concerned about falling off their exercise routine or damaging their repair by lifting something that is too heavy. Others wonder how long they will have to abstain from sex.
In the past, we have placed significant lifting and activity restrictions on women who have undergone pelvic floor surgery for prolapse. In some cases, those restrictions have not just been in the early postoperative period but for life.
New studies have show that these recommendations may have been a little overkill. In fact, a recent multicenter randomized study showed that women who were told to “liberally resume their activities” after surgery for prolapse were just as satisfied with the results of their surgery as their counterparts who were told to restrict their activity.
Furthermore, those who were instructed to resume normal activity after surgery were less likely to experience prolapse and urinary symptoms at three months. The authors conclude that getting back to normal activities may actually help women to heal and improve their surgical outcomes. Of note, both groups were told to refrain from putting anything in the vagina for six weeks including sex, tampons and douching.
The study lacks long-term outcomes, but in my practice, I follow similar guidelines. I tell my patients that my surgeries should be fairly durable and–unless they are doing something extreme–damaging the repair is unlikely. I do warn against straining too hard for a bowel movement (use a glycerin suppository if you have too!) and avoiding chronic cough (see your primary doctor!). Lifting and activities of daily lifting are not going to increase the pressure on your pelvic floor like straining and coughing.
As always, when in doubt, ask your surgeon their opinion on activity level after a pelvic floor procedure for prolapse.
Mueller, M. G., Lewicky-Gaupp, C., Collins, S. A., Abernethy, M. G., Alverdy, A., & Kenton, K. (2017). Activity Restriction Recommendations and Outcomes After Reconstructive Pelvic Surgery: A Randomized Controlled Trial. Obstet Gynecol, 129(4), 608-614. doi:10.1097/AOG.0000000000001924