Patient Voices in a Digital Space: Thematic Analysis of YouTube Comments on Pelvic Floor Content

Women with pelvic floor disorders (PFDs), such as urinary urgency, pelvic organ prolapse, and pelvic pain, often benefit from pelvic floor physical therapy (PFPT). Barriers such as cost, location, and referral access limit utilization. YouTube has emerged as a platform offering freely available PFPT resources. This study evaluates the viewer engagement of popular PFPT videos addressing common PFDs.

We conducted a cross-sectional qualitative descriptive analysis of YouTube PFPT content. Searches included "pelvic floor exercises," "urinary incontinence exercises," "dyspareunia exercises," and "pelvic prolapse exercises." Channels were included if they featured exercise-based PFPT content. The first 20 channels were identified until search redundancy was reached, and the top three most-liked videos per channel were documented. The top 40 videos by viewer count were selected, and publicly available comments were extracted using an online scraper. A hybrid inductive-deductive process was utilized to identify themes until coding saturation was achieved.

Forty videos yielding 14.7 K comments were included in our analysis. Three major themes emerged: (1) Desire for Community-viewers shared personal experiences, tracked symptoms, and sought validation for stigmatizing conditions; (2) Healthcare Experiences-comments reflected medical mistrust, inadequate prior care, and reluctance to pursue medical intervention; and (3) Desire for Knowledge-viewers sought guidance on exercise safety, condition-specific adaptations, and management during pregnancy or with comorbidities.

YouTube serves as a vital resource for individuals with PFDs, especially those with limited access to care. Beyond education, the platform fosters community and empowerment that traditional healthcare settings fail to provide for stigmatizing conditions.