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

Abstract

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.