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Urinary Incontinence and Hysterectomies: How to Strengthen Your Pelvic Floor and Avoid Leaks


A uterus with a heart in the middle
Hysterectomies and bladder leaks

If you’ve had a hysterectomy, you may have noticed changes in how your body functions—especially when it comes to bladder control. Stress urinary incontinence (SUI), which is when you leak urine during activities like coughing, sneezing, or lifting, is a common side effect after a hysterectomy. The good news? With the right exercises and a few helpful habits, you can regain control and prevent leaks.


In this post, we’ll explain why a hysterectomy can lead to SUI and how pelvic floor exercises can help. We will also share some other simple tips to reduce pressure on your pelvic floor. Plus, if you’re struggling with sticking to your exercise routine, HappySneeze can help guide you with video tutorials, reminders, and weekly support.




What Is a Hysterectomy and Why Is It Needed?


A hysterectomy is a surgery that removes the uterus and, in some cases, other reproductive organs like the ovaries or fallopian tubes. It's a procedure done for several reasons, including:


- Uterine fibroids: benign growths that can cause pain or heavy bleeding

- Endometriosis: painful tissue growth outside the uterus

- Cancer of the uterus, ovaries, or cervix

- Prolapse: when the uterus slips into the vaginal canal due to weakened support

- Chronic pain: when other treatments don’t work


The surgery can be life-changing for many women, but it also impacts the pelvic area. Since the uterus is part of the support system for your pelvic organs, its removal can affect how your bladder and urethra function, making SUI more likely.


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Why Does a Hysterectomy Lead to SUI?


SUI happens when pressure on the bladder (from sneezing, laughing, or lifting) causes urine to leak. After a hysterectomy, a few key changes in your body can make this more likely:


1. Loss of pelvic support: The uterus helps support your bladder and urethra. Without it, these organs might shift slightly, making it harder for the urethra to stay closed when there’s pressure on your bladder.

2. Weakened pelvic floor muscles: Surgery can sometimes weaken the muscles and ligaments in the pelvic floor, the group of muscles that support your bladder, uterus, and bowels.

3. Nerve damage: The surgery can affect some of the nerves that control the muscles around the bladder, making it harder to contract those muscles when you need to.

4. Changes in hormones: If your ovaries are removed, estrogen levels drop. Estrogen helps keep your pelvic tissues healthy and strong, so this change can weaken them over time.


Now that we understand why SUI can happen after a hysterectomy let's look at what you can do to strengthen your pelvic floor and prevent leaks.


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Strengthening Your Pelvic Floor: Kegels and Beyond


You've probably heard of Kegel exercises—they're a great way to strengthen your pelvic floor muscles. When done regularly, Kegels can help improve bladder control by tightening the muscles that keep urine from leaking.


But pelvic floor health is about more than just Kegels! You also need to focus on how you move throughout the day to avoid putting too much pressure on your pelvic floor.


Functional Exercises to Protect Your Pelvic Floor


Here are some exercises and tips for everyday movements that can help you protect your pelvic floor:


- Squats: Learning to squat properly is essential for everyday activities, like picking something up off the floor. When you squat, focus on keeping your chest lifted and pushing your hips back as if sitting into a chair. This helps engage your leg and core muscles instead of putting pressure on your pelvic floor.

- Lifting techniques: When lifting something heavy, whether it’s groceries or a child, avoid bearing down. Instead, bend at the knees and hips, engage your pelvic floor (think about gently lifting or tightening the muscles), and exhale as you lift the object. This reduces strain on your bladder and pelvic muscles.


- Breathing exercises: Learning to coordinate your breath with your movements is key. When you hold your breath during activities, it increases pressure on your pelvic floor. Practice exhaling during effortful movements, like lifting or getting up from a chair.


These simple functional exercises and movement habits can make a big difference in reducing stress on your pelvic floor during everyday activities.



Toileting Tips to Reduce Leaks


Believe it or not, the way you use the bathroom can affect your bladder health too! Here are some **toileting techniques** to make sure you're minimizing stress on your pelvic floor:


- **How to pee**: When using the bathroom, sit fully on the toilet (don't hover!) and make sure you relax your pelvic floor. Leaning slightly forward can help fully empty your bladder. Avoid pushing or straining to urinate, as this increases pressure on your pelvic floor.


- **How to poop**: Proper positioning is key to reduce straining when you have a bowel movement. Use a footstool (like a Squatty Potty) to elevate your feet and bring your knees above your hips. This position helps straighten your rectum and makes it easier to go without straining, which is better for your pelvic floor.


Learning these simple techniques can help reduce leaks and protect your pelvic floor from unnecessary pressure.



Staying Consistent with Your Exercises: HappySneeze Is Here to Help!


If your healthcare provider has recommended pelvic floor exercises like Kegels—or you want to start practicing good movement habits after your hysterectomy—it can be tough to stay consistent. That’s where HappySneeze comes in!


We know it’s hard to keep up with exercises on your own, especially when you're not sure if you're doing them correctly. HappySneeze offers:


- Easy-to-follow video tutorials: We guide you through the exercises, so you know exactly how to engage the right muscles.

- Reminders and weekly check-ins: We send gentle reminders and tips to keep you motivated, so you can stay on track with your pelvic floor routine.

- Community support: You’re not alone! Our supportive community of women is going through the same journey, and we’re here to help you succeed.


By following these exercises and tips—and with the help of HappySneeze—you’ll strengthen your pelvic floor, improve your bladder control, and feel more confident in your body’s ability to handle day-to-day movements.


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Incontinence and Hysterectomies: Final Thoughts


A hysterectomy can impact your pelvic floor, but it doesn’t mean you have to live with urinary incontinence. By incorporating pelvic floor exercises, learning functional movement techniques, and using helpful toileting tips, you can take control of your bladder health and reduce the chances of leaks.


If you’re feeling overwhelmed or struggling to stay consistent with your pelvic floor routine, HappySneeze is here to help you every step of the way. With personalized support, guided videos, and regular reminders, we’ll make it easier for you to strengthen your pelvic floor and protect it from everyday pressures.


References:

  • Bump, R. C., Mattiasson, A., Bø, K., Brubaker, L. P. (1996). The Standardization of Terminology of Female Pelvic Organ Prolapse and Pelvic Floor Dysfunction. American Journal of Obstetrics and Gynecology, 175(1), 10-17.

  • Subak, L. L., Wing, R., West, D. S., et al. (2009). Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women. The New England Journal of Medicine, 360, 481-490.

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