Can Kegel Exercises Help Relieve Tight Anal Muscles After Surgery?

Is it advisable to perform Kegel exercises if the anal muscles are prone to tension?

Hello, Director Ke:
I have two questions I would like to ask:
1.
I underwent surgery for anal fissures and hemorrhoids in February of this year.
I have been trying to maintain a habit of drinking plenty of water and eating more fruits and vegetables, but I still frequently experience pain during bowel movements or discomfort around the anal area.
During my follow-up visit, the doctor mentioned that the muscles around the anus might be too tense and suggested that I perform some stretching exercises to relax the muscles.
Are there any other methods to improve this condition? Or could there be other potential causes for this discomfort?
2.
I am currently experiencing frequent urination and an inability to hold my urge to urinate.
I would like to know if Kegel exercises could help improve this issue.
However, I am concerned that doing Kegel exercises might further tighten the muscles around my anus, potentially leading to a recurrence of anal fissures or other problems.
I appreciate your time in addressing these two questions.
Thank you!

Niming, 30~39 year old female. Ask Date: 2021/10/20

Dr. Ke Fangxu reply Surgery

1.
To determine if there is increased anal pressure, a digital rectal examination or pressure testing is necessary.
However, theoretically, undergoing surgery for anal fissures should improve the issue of excessive anal pressure, as the procedure typically involves sphincterotomy.
Other methods for improvement are mainly limited to warm sitz baths.

2.
Kegel exercises can indeed help alleviate urinary frequency, but they may also potentially increase anal pressure, worsening the issue of anal fissures.
It is advisable to consult a urologist for potential solutions.

Reply Date: 2021/10/20

More Info

Kegel exercises, primarily known for strengthening the pelvic floor muscles, can indeed play a role in managing tight anal muscles after surgery, such as for anal fissures or hemorrhoids. However, it is essential to approach this with caution, especially considering your recent surgical history and ongoing symptoms.

1. Understanding Muscle Tightness and Pain: After surgeries like anal fissure repair or hemorrhoidectomy, it is common to experience tightness in the anal sphincter muscles. This tightness can lead to discomfort during bowel movements and may contribute to a cycle of pain and muscle tension. The tightness can be exacerbated by anxiety related to bowel movements, which is not uncommon after such surgeries. It is crucial to address both the physical and psychological aspects of recovery.

2. Kegel Exercises and Their Benefits: Kegel exercises involve the contraction and relaxation of the pelvic floor muscles. They can help improve muscle tone and control, which may alleviate some discomfort associated with tight anal muscles. However, if your anal muscles are already tight, the focus should initially be on relaxation rather than strengthening. This means that while Kegel exercises can be beneficial, they should be introduced gradually and with a focus on relaxation techniques.

3. Alternative Relaxation Techniques: In addition to Kegel exercises, consider incorporating other relaxation techniques. These may include:
- Deep Breathing Exercises: Focusing on deep, diaphragmatic breathing can help relax the pelvic floor muscles.

- Gentle Stretching: Engaging in gentle stretches that target the pelvic area can help relieve tension.

- Warm Baths: Soaking in warm water can provide relief and promote relaxation of the anal muscles.

- Biofeedback Therapy: This technique can help you become more aware of your muscle tension and learn how to relax those muscles effectively.

4. Addressing Urinary Symptoms: Regarding your concerns about frequent urination and urgency, Kegel exercises can be beneficial for strengthening the pelvic floor muscles, which support the bladder and help manage urinary incontinence. However, if you are concerned that these exercises might exacerbate your anal tightness, it may be wise to consult with a pelvic floor physical therapist. They can provide personalized guidance and ensure that you are performing the exercises correctly without causing additional tension in the anal area.

5. Consulting with Your Healthcare Provider: Given your recent surgery and ongoing symptoms, it is essential to maintain open communication with your healthcare provider. They can assess your specific situation and provide tailored recommendations. If you experience persistent pain or discomfort, further evaluation may be necessary to rule out any complications from the surgery.

In summary, Kegel exercises can be part of your recovery strategy, but they should be approached with care, especially considering your current symptoms. Focus on relaxation techniques and consult with a healthcare professional for personalized advice. Your recovery journey is unique, and addressing both the physical and emotional aspects will be key to achieving relief and restoring function.

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