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By Riva Preil

When conservative approaches don’t achieve the desired effect, surgical interventions are at times warranted. However, it is important to understand the affect that surgery has on muscle, fascia, and connective tissue, especially in regards to the pelvic floor. In men, a prostatectomy and bladder replacement for post-cancer treatment can aggravate pelvic floor disorder. In addition, several types of surgical procedures can result in female pelvic floor dysfunction. Cesarean section deliveries may result in abdominal weakness, low back pain, scar adhesions, poor posture, poor body mechanics, and visceral dysfunction. Hysterectomy, either vaginal or abdominal procedure, may result in scar adhesions, and/or tensions or weakness in the pelvic floor, abdomen, or hip flexors. An episiotomy is vaginal tearing during childbirth which may result in scar adhesions, pelvic floor muscle weakness, pain, and dyspareunia (pain during vaginal penetration). Finally, laparoscopic surgery may result in abdominal and visceral scar adhesions. In all of these cases, pelvic floor physical therapy with manual therapy and connective tissue mobilization, including scar massage, may be indicated. If you think that you may benefit from such treatment, please request a referral to pelvic floor physical therapy from your doctor.

Adapted from Amy Stein’s Heal Pelvic Pain

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