Hysterectomy booked for January. Should I restart my old pelvic floor programme now, and what happens to it after?

Some of you know my history on here. Course in my forties, discharged, kept a version going on the kettle ever since, mostly fine.

Now a different thing. Years of very heavy periods, fibroids, the lot, and after a lot of back and forth I have a date for a hysterectomy in January. Laparoscopic, they think. The consultant was good on the operation and said nothing at all about my pelvic floor, and I did not think to ask until I was in the car.

Three questions rattling round. Should I go back to the full programme now, the proper one with the sets, rather than my kettle version? What happens to my exercises after the operation, do I stop, and for how long? And I read somewhere that a hysterectomy can cause a prolapse, which given everything feels like a cruel joke. Is that true?

No experience of the operation, but on question one: if you have a review option, ask for one before January rather than rebuilding the old sheet from memory. Mine changed a lot between the first sheet and the second.

My aunt had one a few years ago and said the ward physio came round on day two with a leaflet and some very gentle exercises. So at least some places do bring it up. Do not count on yours though, given the consultant.

Lindsey, three good questions, and I will take them in order. As always, I cannot assess you from here, and your own surgical team's instructions on the operation they are doing take precedence over anything general.

The prolapse question first, because it is the one that is frightening you. It is true that the NHS lists pelvic surgery such as a hysterectomy among the causes of pelvic organ prolapse, alongside childbirth, being overweight, constipation, persistent coughing and age. It is not true that a hysterectomy means you will get one. It means the pelvic floor is worth looking after before and after, and that new symptoms such as heaviness, a bulge or new leaking afterwards are worth reporting rather than putting up with.

Restarting now. Going into an operation knowing how to do a good contraction, and with the muscle in good condition, is generally easier than learning it in the sore weeks afterwards. Trampolineban's suggestion is a good one: if you can get a review before January, it lets someone check the contraction and set a sensible programme, rather than you reconstructing an old sheet. The principle is covered in physiotherapy before and after pelvic floor surgery.

After the operation. Do not assume either "carry on as normal" or "stop for months". The NHS recovery advice is no heavy lifting during recovery, and says hospital staff may show you pelvic floor exercises. When to restart and how gently is a question for your surgical team, because it depends on what is done and how it goes. Ask them before you go in, in those words.

Bethan Rowsell said:

It is not true that a hysterectomy means you will get one.

Thank you. That is the sentence I was missing. I had gone from "can cause" to "will cause" somewhere between the car park and home.

Ringing the physio service on Monday to ask whether I can self refer back for a review before January.

Different operation entirely, but I was taught mine before my surgery rather than after and I am glad of it. In the first fortnight afterwards I could not have learned anything new. Knowing what I was meant to be doing already saved me.

Update. Self referral accepted, review in mid November. Also had the pre-op phone call last week and asked the surgical nurse the exact question about when to restart. She said they would show me gentle exercises on the ward and give me a written plan to take home, and that I should bring up my old programme with the physio at the November review so the two match.

Feels a lot less like a cruel joke now and more like a plan.