Which of the following procedures carries the risk of developing post-op pelvic floor weakness?

A hysterectomy is indeed associated with the risk of developing post-operative pelvic floor weakness. This procedure involves the removal of the uterus, and depending on the technique used (abdominal, vaginal, or laparoscopic), it can have implications for the pelvic support structures. The pelvic floor consists of muscles, ligaments, and connective tissues that support pelvic organs, including the bladder, uterus, and rectum. Disruption or removal of pelvic structures during a hysterectomy can lead to weakening of the pelvic floor, which may result in conditions such as pelvic organ prolapse or urinary incontinence.

In contrast, the other procedures listed are less likely to directly affect the pelvic floor. An appendectomy primarily involves the removal of the appendix and typically does not disturb pelvic support structures. A cholecystectomy involves the gallbladder and is focused on the upper abdomen, with minimal relevance to pelvic floor integrity. Hernia repair can involve various hernias (inguinal, umbilical, etc.), but is more focused on restoring abdominal wall integrity rather than directly impacting the pelvic floor muscles.