Gwen's Story*
Step 1
Gwen discovered what mattered
Gwen (she/her) is a 68-year-old retired primary school principal who had been living with worsening prolapse symptoms for three years. The dragging sensation by the end of each day was unbearable - she had stopped playing tennis and was avoiding intimacy with her husband. After exhausting conservative treatment options, she'd made the difficult decision to have prolapse repair surgery combined with a hysterectomy but felt anxious and unprepared for the recovery, her gynaecologist suggesting pre- and post-op physio would be beneficial. Gwen knew it was important to exercise for her osteoporosis but she had been afraid it would make her prolapse worse and then worried about exercise undoing the surgery. Working together, we discovered that while Gwen's prolapse was significant, her pelvic floor muscles had reasonable strength but poor endurance. She also had mild stress urinary incontinence and constipation that would have negatively impacted surgical recovery if not addressed.
Gwen's Pelvic Health Goals:
- Know that I'm doing absolutely everything I can to get the best outcome from surgery.
- Understand exactly what to expect during recovery so I can plan properly, I get anxious when things don’t go to plan.
- Get rid of this awful heaviness once and for all, return to tennis and see my friends and feel comfortable being active.
- Feel confident to travel overseas to visit my daughter
- Return to physical intimacy with my husband
- Go to the gym and use weights to improve my bone health
Step 2
Gwen restored what mattered
Pre-surgery, the focus was on optimising her pelvic floor and abdominal muscles, addressing her constipation through bowel retraining and dietary changes – to ensure Gwen didn’t strain with her bowels. Education about surgery, recovery timelines, and post-operative lifestyle modifications helped Gwen plan effectively.
Post-surgery, we reassessed and gradually rebuilt her pelvic floor strength while respecting healing tissues, this quickly reduced her urine leakage with coughing and sneezing. We designed a graduated return to activities program including sport-specific exercises to prepare her for tennis. Education and support addressed her return to intimacy.
Step 3
Gwen enjoyed what mattered
After 4 months, Gwen had exceeded her recovery expectations. Her bowels were functioning well, she had commenced a light weights program at the gym and was back on the tennis court in just under 6 months, playing confidently without pads. She and her husband had reconnected intimately. Eight months post-surgery, she travelled to London visiting her daughter – doing 20 000 steps exploring the city without discomfort. A year after surgery, Gwen wrote: "I can't believe I lived with that discomfort for so long. Having a great surgeon and expert support made such a difference - I recovered better than I imagined. I'm doing everything I love again!"