By Pelvic floor exercises are often the first line of defence for those dealing with pelvic floor problems. Whether you’re experiencing bladder leakage, bowel issues, or pelvic organ prolapse, these targeted movements can make a world of difference. But can they go so far as to prevent surgery? That’s the question many patients ask their pelvic floor specialist or colorectal surgeon when symptoms start to interfere with everyday life.
In this article, we’ll explore the role of pelvic floor exercises in managing symptoms, the evidence supporting their effectiveness, and when surgery may still be needed.
What Are Pelvic Floor Exercises?
Pelvic floor exercises, also known as Kegel exercises, strengthen the muscles that support your bladder, bowel, and reproductive organs. These muscles work like a supportive sling from your pubic bone to your tailbone. When they weaken—often due to childbirth, ageing, surgery, or chronic straining—pelvic floor problems can occur.
Symptoms might include:
- Incontinence (bladder or bowel leakage)
- Pelvic heaviness or pressure
- Difficulty controlling wind
- Pain during sex
- Frequent urinary urges
Many people, especially women after childbirth or during menopause, experience these symptoms. However, men can also develop pelvic floor issues, particularly after prostate surgery.
The Science Behind the Squeeze
A growing body of evidence supports pelvic floor training as an effective, non-invasive treatment option. According to studies, women who undertake pelvic floor muscle training are more likely to report cure or improvement in their symptoms compared to those who do not receive treatment. The UK’s National Institute for Health and Care Excellence (NICE) recommends supervised pelvic floor muscle training for at least three months before considering surgery for stress incontinence or prolapse. Similarly, the Continence Foundation of Australia promotes pelvic floor exercises as a first-line treatment for most pelvic floor problems.
A well-designed training plan, often supervised by a pelvic floor physiotherapist or pelvic floor specialist, helps you locate the right muscles, contract them properly, and build strength over time.
Can These Exercises Actually Prevent Surgery?
For many patients, the answer is yes—especially when pelvic floor exercises are started early. Strengthening the pelvic floor can reduce symptoms of prolapse and incontinence enough to avoid or delay surgery altogether. Even when surgery is eventually required, having strong pelvic muscles beforehand may improve outcomes and recovery.
Let’s take pelvic organ prolapse as an example. If caught in the early stages, regular exercise can relieve the sensation of vaginal heaviness and reduce the bulge, particularly when paired with lifestyle changes like weight management and avoiding constipation.
For patients with bowel dysfunction, such as faecal incontinence or obstructed defecation, working with a colorectal surgeon and pelvic floor specialist can lead to a conservative management plan that includes diet, exercise, and behaviour modification. In many cases, this can postpone the need for rectal surgery or other interventions.
When Is Surgery Still Needed?
While pelvic floor exercises are effective, they aren’t a magic fix for everyone. In moderate to severe cases of prolapse, or when muscle damage is significant (e.g. following a complex vaginal delivery), surgery may still be the best option.
Your colorectal surgeon or pelvic floor specialist will assess the severity of your condition using tools like pelvic ultrasound, physical examination, and sometimes urodynamic studies. They’ll work with you to explore conservative options first but will discuss surgery when it’s clear that exercises alone aren’t enough.
Prevention Is Powerful, but Surgery Has Its Place
Pelvic floor exercises are one of the most powerful tools we have to manage—and in many cases prevent—serious pelvic floor problems. Whether you’re dealing with mild symptoms or hoping to avoid recurrence after surgery, a proactive approach makes all the difference. Speaking with a pelvic floor specialist early, especially if you’ve had children, are peri- or post-menopausal, or are recovering from pelvic surgery, can set you on the right path. A good colorectal surgeon will always consider non-surgical options first and may even refer you for physiotherapy before discussing any procedures. In short: don’t wait. Start the conversation, start the exercises, and take control of your pelvic health.