Safe Bowel Movement After Prolapse Surgery

Bowel movement position after prolapse surgery

Are you worried about straining and causing another prolapse with your bowel movement after prolapse surgery?

 

Straining with constipation is a major risk for repeat prolapse after prolapse surgery.

 

 

Read on now to learn:

  • The best position for your bowel movement after prolapse surgery
  • Correct technique to avoid straining 
  • How to get the right stool consistency 

The Best Position for Your Bowel Movement After Prolapse Surgery

  • Sit on the toilet seat (never hover)
  • Place your feet flat on the floor
  • Rest your hands or forearms on your thighs to support your trunk
  • Lean your trunk forwards
  • Keep the inward curve in your lower back during emptying (see bowel emptying position above)

Optional

  • A pad or wad of toilet paper rolled up can be placed against the pelvic floor using one hand for support. This technique is known as pelvic splinting. This added support can improve your comfort and limit downward pelvic floor movement when emptying your bowels.
  • Some women find that having their knees raised assists bowel emptying. This position can be achieved with the legs apart by placing each foot on a toilet roll, thick book or block.

Correct Technique to Avoid Straining

The correct technique for your bowel movement after prolapse surgery is the ‘Brace and Bulge’ Technique.

    1. Prepare for emptying by taking 5-6 relaxed breaths (breathing into your belly with slow deep breaths helps your pelvic floor muscles relax)
    2. Brace your abdominal muscles to by making the sound “m” or “s”. This action makes your waist wider and provides pushing force for your bowel movement.

Bracing bowel movement after prolapse surgery

3. Now bulge your lower abdomen forwards. You can do this by is making the “oo” sound. Bulging your abdomen forwards relaxes and opens your anal sphincter for your bowel movement to pass.

Bulge abdomen technique for bowel movement after prolapse surgery4. If you need more pressure make your waist wider by bracing once more.

Watch our online video demonstrating this bowel movement position and technique

How to Get the Right Stool Consistency

Having the correct stool consistency is vital. If your stool is too hard or too soft it can be difficult to empty your bowels completely and avoid straining.

The Bristol Stool Chart below shows you the ideal stool consistency for your bowel movement.

Bristol Stool Chart

Click to enlarge

Type 3-4 is the ideal stool consistency – it is soft well formed and smooth

Type 1-2 causes constipation and straining – when the stool is hard, cracked or lumpy

Type 5-7 can cause diarrhoea and straining as the stool is not well formed

Solutions for Stool Consistency After Prolapse Surgery

You may experience short-term constipation after surgery as a result of being less active than usual, taking pain relieving medications and change in diet.

If you have long-term constipation and straining or diarrhoea it’s vital to rectify this to avoid repeat prolapse after your surgery.

Solutions:

  • Use a stool softener/osmotic laxative (e.g. Movicol) to keep your stool soft and easy to pass – especially during your short-term recovery. Discuss the best stool medication with your medical care provider.
  • Adhere to the correct diet to keep your stool soft if you suffer from constipation
  • Maintain adequate fluid intake especially if you are taking pain relief or osmotic laxatives
  • Stay active with appropriate exercise after prolapse surgery to help keep your bowels regular
  • Anticipate events that make you constipated e.g. travel and take appropriate preventative action
  • Anticipate lifestyle factors that can cause diarrhoea e.g. stress or bowel irritant foods

It is vital to avoid bearing down and straining during your regular bowel movement after prolapse surgery protect your prolapse repair long-term. Practicing this bowel movement method will help you manage your prolapse repair long-term.

PROLAPSE EXERCISES BOOK

prolapse exercises

with Pelvic Floor Physiotherapist Michelle Kenway

Learn how to exercise safely, strengthen your prolapse and reduce your risk of repeat prolapse.

Prolapse Exercises is a complete exercise guide for women after prolapse surgery seeking to exercise safely and protect their pelvic floor.

READ MORE NOW

 

We Welcome Your Comments

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Comments

  1. ⚠️⚠️⚠️⚠️⚠️Trigger warning ⚠️⚠️⚠️⚠️⚠️⚠️

    Hi I had my prolapse surgery July 14th and I still don’t poop but once a week if that and I know it’s nasty but it gets so bad I have to dig it out and I take Stool softeners every day I’ve actually did a suppository and it took three hours for it to work can y’all help me in any sort of way

    Thank you in advance

  2. I had radical hysterectomy vaginally about 3 weeks ago. it’s been impossible to poop because my abdomonal cramps are so severe I cannot bear down at all. I did do a pre colonoscopy treatment which ended up in diarhea but it was great to get it out. Then on week 2 I did the same thing and did not poop whatsoever. I’ve taken laxatives, am eating right, drinking lots of water and walking…all recommended by my family physician. I’ve really hit a wall as to what to do…. I cannot sit in a bathtub with epson salts which my body is craving. only showers till my follow up in 3 weeks if things are OK. What would you personally do? It’s crazy painful to walk cause it makes cramps even worse!

  3. I had a rectocele repair and a vagina hysterectomy on Tuesday. I still have not had a bowel movement since before surgery. Before surgery I could only empty my bowels through vagina stripping. Should I be worried??

  4. I have a hand held bidet. Could it be used to gently press against the rectum
    to allow a small amount of warm water to enter the rectum to aid in evacuation?
    I am planning on recycled surgery soon.

  5. Hi there, I had a posterior repair 2 days ago and have noticed it’s difficult to stand from sitting on the toilet comfortably. Do you know what would be a safe way of standing from sitting on toilet without putting pressure on my repair? Thank you

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Vicki
      1. Don’t sit on the toiled for too long at the moment – 5 mins max
      2. Ideally one foot forward and one foot back sit upright – then in one movement bring your shoulders forward in front of your knees as you move into standing. The momentum of the shoulders moving forwards will help the ease of movement, if you hesitate and move slowly this will be more difficult.
      3. You can also make a wad of toilet paper and hold it against your perineum as you move into standing to provide additional support if this helps.
      All the best for your recovery, Oh and don’t forget the importance of keeping your stool soft during your recovery (some ladies take Movicol daily for 6 weeks)

  6. I had rectocele surgery at UCLA on July 20. I have suffered a great deal of pain with only a few days without excruciating pain. I feel terribly constipated. I use Mira Lax and have not heard of the medication you recommended. Will this end on its own? Does it mean something will be wrong forever? I am going to watch the film on having a bowel movement and maybe that will help. Do you recommend sitting in a swimming pool for a zits bath?

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Linda
      My apologies I only just came across your message – I hope you’re constipation has been sorted out and you’re recovering well. In this situation the surgeon needs to be phoned regarding appropriate medication to soften the stool and empty the bowel and then also appropriate medication to continue for at least the first 6 weeks of recovery to keep the stool soft. All the best for your recovery

  7. Hi I was wanting some advice please, I had bowel and Virginia prolapse surgery 19 days ago today I had to push a lot to empty my bowels just at the start and now I do have a ache in my bottom area ! Due to covid I can’t speak to my surgeon and I was wondering if you think I could of wrecked my whole surgery by doing this ? I had no mesh it was all done by stitches I have no bleeding just sore ! I would love input this has only happened once since my surgery but I don’t want everything that I have gone through to be distorted because I had to push so hard

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Rachel I understand your predicament, unfortunately I can’t say whether you’ve just strained a little or otherwise. Rachel we very often get women to take osmotic laxatives for (at least) 6 weeks post op to keep the stool soft. Osmotic laxatives are available under the brand name Movicol or GaviLAX in the US. These don’t irritate the bowel rather, they work by drawing fluid into the bowel which softens the stool as it passes through the bowel helping motility and emptying. I suggest you speak with your pharmacist or doctor about this option. You may also like to watch this bowel emptying video as this is the technique to avoid straining taught to post op prolapse patients for use long-term. The stool needs to be soft and well formed for this technique to work. I hope this helps, all the best for your recovery

    • I had both done in July and still can’t go

  8. I had a rectocele repair & hysterectomy 4 years ago & have been constipated ever since. I eat very healthy & know I should drink more water & exercise more, though I try to walk 4 times a week. It seems to me that a squatty potty would make more pressure on my anus, causing more bulging, no? & what do you think of a squat toilet like many other countries use? Or a bidet toilet attachment?

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Yes Shelby the squatty potty is not necessarily the solution and this depends upon the leg length of the individual (longer legs require less height/leg raise). I can’t comment on bidet however squat toileting can definitely improve the ease of emptying, this is what nature intended! All the best

      • Michelle, thanks for your response. I have long legs, so I guess I have my own built-in squatty potty :)
        I was wondering if the pressure of a bidet could be a problem for me or not?
        As for the squat toilet….you say on your page not to hover over the toilet. That to me sounds very similar to the position of a squat toilet, no?
        Also, my midwife used to volunteer once a year in Nepal to help with rectocele surgeries. She said it was a big problem there because women spent so much time squatting. Can you please clarify? Thanks so very much.

        • Author: Michelle Kenway Pelvic Floor Physiotherapist says

          Hi Shelby
          I don’t think a bidet is an issue. The issue with hovering is that your abdominal contract and close the anal sphincter at the same time. I believe we’re designed to squat and some women from some Asian countries where squatting is routine have been noted to have very strong pelvic floor muscles. I do think squatting deeply and straining if the pelvic floor is weak is potentially compromising for the pelvic floor. Hope this answers your questions, cheers

  9. I had my third prolapse surgery and was told I’d be constipated short term but I gave developed long term constipation sling with acid reflux or ibs doctors have given me all kinds of tests and all are negative. I got an ultrasound of the abdomen, a cat scan etc but nothing shows up I also got an endoscopy and nothing. I feel nauseous and I’m not having a normal stool emptying. Not sure what’s next.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Patricia
      This may sound left of field but have you thought about seeing a qualified dietician? It sounds as though your gut microbiome may be imbalanced. The balance in gut flora can become unbalanced after surgery and lead to symptoms like yours that can’t be explained otherwise leading to symptoms such as nausea, bloating, constipation, diarrhoea. You may like to read this article on diet after hysterectomy for some more information on FODMAPS too and see whether it seems relevant to you (while the title reads hysterectomy it also applies to prolapse surgery). Always keen to hear how you go if you have time, I hope this helps you

  10. My daughter had rectal prolapse surgery late Mid August. She was doing great for a few weeks after the surgery. She is now having immense pain and constipation blockage in the upper portion of her bowel. What could be causing the constipation?

    • Michelle Kenway Physiotherapist says

      Hi Renae
      Many factors can cause constipation after prolapse surgery. It’s impossible to know without a thorough assessment and this needs to be undertaken by her doctor. All the best

    • Would wearing a faja waist/torso type griddle support help after surgery?

  11. What is “hover”?