Verbal Instruction for Pelvic Floor Muscle Contraction among Healthy Young Males

Teaching Pelvic Floor Muscle (PFM) contraction is a challenging task for clinicians and patients, as these muscles cannot be directly visualized. Thus, this study's objective is to compare the effectiveness of six verbal instructions for contracting the PFM among young men, as observed with transabdominal ultrasound imaging. Thirty-five male physiotherapy students, mean age 25.9 ± 1.9 years, participated in the study. A 6 MHz 35-mm curved linear array ultrasound transducer (Mindray M5) was placed in the transverse plane, supra-pubically, and angled 15-30° from the vertical plane. During crook lying, participants received six verbal instructions for contracting the PFM, with bladder base displacement and endurance evaluated. Following the instructions, "squeeze your anus", "shorten the penis", and "elevate the scrotum", over 91% of the participants performed a cranial (upward) bladder base displacement. During instruction six, "draw in", which involves breathing, the PFM, and the transversus abdominis, only 25% performed cranial bladder base displacement (p < 0.001), and the endurance was the lowest (p < 0.001). Our findings suggest that several simple verbal instructions can be used for teaching PFM contraction to young males. Moreover, two instructions should be avoided: "draw in" and the general instruction "squeeze your PFM", as they did not produce effective elevation of the bladder base.