The Efficacy of Physiotherapy Intervention on Core and Pelvic Floor Muscles among Post Hysterectomy Women

Abstract

Background: Hysterectomy is one of the most commonly performed gynecological surgeries worldwide, second only to cesarean section. Despite advancements in surgical techniques, including minimally invasive approaches, postoperative complications affecting pelvic floor function remain prevalent. These complications are often associated with pelvic floor muscle weakness, altered core stability, and reduced functional support to pelvic organs. Following hysterectomy, disruption of pelvic floor musculature and its interaction with core stabilizing muscles can lead to decreased muscle strength, impaired coordination, and compromised lumbopelvic stability, ultimately affecting functional outcomes and quality of life. However, despite growing recognition of these impairments, there is limited consolidated evidence focusing on the combined role of pelvic floor muscle training and core strengthening exercises in post-hysterectomy rehabilitation, highlighting the need for further research in this area.

Objective: To evaluate the effectiveness of pelvic floor muscle training combined with core strengthening exercises in reducing urinary incontinence and improving pelvic floor function in post-hysterectomy women.

Method: In order to identify relevant evidence on pelvic floor muscle training and core strengthening following hysterectomy, a PRISMA-guided review was conducted using electronic databases including PubMed, Scopus, Google Scholar, and PEDro (2005–2025). Studies meeting predefined inclusion criteria were screened and selected. Methodological quality of the included studies was assessed using standardized tools, and the findings were synthesized through qualitative and narrative analysis.

Result: According to the reviewed literature, pelvic floor muscle training significantly improves pelvic floor strength, muscular endurance, and functional support of pelvic organs following hysterectomy. When combined with core strengthening exercises, greater improvements were observed in lumbopelvic stability, muscle coordination, and overall functional performance. Integrated training approaches demonstrated enhanced outcomes in muscle activation patterns, postural control, and quality of life compared to isolated interventions. The evidence suggests that structured, progressive, and supervised exercise programs yield the most effective results in restoring pelvic floor function. However, despite positive findings, variability in study designs, intervention protocols, and small sample sizes highlight the need for standardized rehabilitation guidelines and further high-quality research.

Conclusion: Post-hysterectomy women demonstrate significant improvement with both pelvic floor muscle training and core strengthening interventions. Pelvic floor muscle training enhances muscle strength, support, and functional control, while core strengthening primarily improves lumbopelvic stability and coordination. A combined, individualized, and evidence-based rehabilitation approach appears to be the most effective strategy for optimizing functional outcomes and quality of life. However, further highquality research is required to establish standardized protocols and to determine long-term effectiveness.