Male Pelvic Health in Saudi Arabia: Knowledge-Practice Gap in Pelvic Floor Muscle Exercises and Implications for Preventive Physiotherapy and Health Policy.

OBJECTIVES

To assess the knowledge, attitudes, and practices (KAP) of Saudi men toward pelvic floor muscle training (PFMT) and to identify demographic and clinical predictors of awareness and practice.

METHODS

A cross-sectional survey was conducted among 458 Saudi men in Al-Baha using a validated Arabic questionnaire adapted from the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), and International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF). Data were analyzed with chi-square tests, analysis of variance (ANOVA) and reliability testing (Cronbach's α= 0.862).

RESULTS

Awareness of PFMT was moderate (63.1%), but only 13.1% knew how to perform PFMT correctly. Attitudes were largely positive (72.9%), citing benefits such as relief of back/pelvic pain (33.7%) and core strengthening (32.9%). Practice was limited, with only 11.6% performing PFMT regularly. Knowledge and positive attitudes were significantly associated with practice (χ2, p <0.001). Urinary incontinence was uncommon (86% reported none), though symptoms such as incomplete bladder emptying (27.7%) and defecation difficulty (31%) were frequent. Older men (≥55 years) and divorced men reported significantly higher symptom scores (p <0.01).

CONCLUSION

This first KAP study of PFMT among Saudi men demonstrated a gap between awareness and regular practice. The findings highlight the need for physiotherapist-led education, structured skills training, and scalable digital platforms to transform awareness into sustainable practice and improve men's pelvic health.