The pelvic floor is a complex muscular structure that most men are largely unaware of, and its importance for continence and sexual function is often underestimated. Awareness usually only arises when problems such as incontinence or erectile dysfunction occur. Biofeedback-based training can be an effective way to maintain or restore the functionality of these often neglected structures.
Author: Dr. rer. biol. hum. Ina Schicker, who earned her doctorate in Medical Psychology and has been working as a science and medical journalist since 1996. Her main areas of focus include complementary medicine and geriatrics.
Urinary incontinence remains a highly taboo topic. Among men over 60, nearly one in five is affected, and among those over 80, almost one in three (Kozomara-Hocke, 2016). The primary causes are typically changes in the bladder, prostate, and pelvic floor muscles, although surgeries on the prostate or other areas of the pelvic region can also increase the risk. In most cases, incontinence is associated “with significant physical and psychological impairments as well as reduced quality of life” (Beutel, 2005).
Causes and Types of Continence Disorders
The causes can be varied. Clinically, a distinction is generally made between storage disorders, such as urge incontinence or stress incontinence, and voiding disorders, which include overflow incontinence. Mixed forms may also occur.
In overflow incontinence, small amounts of urine are released only when the bladder is full. This condition can result from myogenic or neurogenic factors, or from an obstruction syndrome due to prostate enlargement. Surgical removal of the prostate for benign prostatic hyperplasia (BPH) or prostate cancer may relieve the obstruction; however, parts of the bladder’s internal sphincter are often removed during surgery, which can impair function. Additionally, the pelvic floor muscles may exhibit altered tension after surgery, potentially leading to erectile dysfunction and voiding difficulties.
Urge incontinence occurs when uncontrollable detrusor contractions lead to urine leakage despite normal sphincter function.
The most common form of urinary incontinence in men — approximately 40–80 percent (Kozomara-Hocke, 2016) — is stress incontinence, where involuntary urine leakage occurs during physical exertion (such as coughing, sneezing, running, or sports). This is usually due to insufficient sphincter control or direct damage or weakening of the pelvic floor muscles.
Conservative Treatment Through Pelvic Floor Training
When contraindications such as organ prolapse or severe nerve damage as the cause of incontinence can be excluded, physiotherapeutic approaches are considered a guideline-recommended first-line option. Multiple meta-analyses show that targeted pelvic floor muscle training provides an accessible and effective way to restore the functionality of impaired or weakened structures. Ideally, this approach can even help avoid surgery altogether, or it can be used prehabilitatively or as part of rehabilitation after a procedure to optimize treatment outcomes. A meta-analysis by Luqiang Zhou et al. (2023) demonstrates that patients who undertake pelvic floor training before a radical prostatectomy experience significantly less involuntary urine loss during the first three months post-surgery compared to patients who did not receive such training.
Importance of Therapeutic Guidance and Targeted Feedback
Positive outcomes are enhanced through careful therapeutic guidance, according to a meta-analysis by Baumann et al. (2022). Without professional instruction and feedback, no benefits were observed compared to control groups that did not receive training.
Since most people have limited experience in perceiving and actively controlling their pelvic floor muscles, biofeedback-based methods offer particularly effective learning opportunities (Hsu et al. 2016). Especially accessible and compliance-friendly are methods that noninvasively measure pelvic floor muscle activity and – like the PelvicTool pelvic floor training device from the Swiss company Alonea – provide users with real-time visual feedback via a simple app. Using a game-like interface, patients can independently follow individualized training programs after thorough instruction by a therapist who defines the specific therapy goals.
“The PelvicTool provides a fun and effective way to train the pelvic floor – and this is precisely what makes it especially appealing for men. Since most men pay less attention to their pelvic floor than women, the visual biofeedback offers valuable support: it increases awareness and makes the topic tangible and accessible. Moreover, it helps break the taboo and encourages open discussion about this important part of the body. Consequently, men are usually highly motivated to train with the PelvicTool.”
The PelvicTool Home & Sport pelvic floor trainer features an ergonomic seat cushion with a soft sensor tube that highly sensitively detects all movements of the pelvic floor muscles. Under therapeutic supervision, patients complete training programs tailored to their individual needs and can then continue training independently at home. Through digital documentation of their exercises, therapists can monitor the training process and, if necessary, provide corrective guidance or adjust the program to match progress. Sustainable therapeutic outcomes are further supported by integrating the trained muscle activities into everyday movements.
“Although I could no longer feel my pelvic floor muscles after a radical prostatectomy, I learned to control my pelvic floor muscles and alleviate my incontinence symptoms with the help of the PelvicTool. Seeing my progress in the app motivated me to keep going.”
The PelvicTool Home & Sport, developed by the Swiss medical technology company Alonea AG, is available in selected specialist retailers as well as in the Alonea webshop.
How the PelvicTool Pelvic Floor Trainer from Alonea Works:
Mit dem Laden des Videos akzeptieren Sie die Datenschutzerklärung von YouTube.
Mehr erfahren
References for the Report
Baumann, F. T., Reimer, N., Gockeln, T., Reike, A., Hallek, M., Ricci, C., Zopf, E. M., Schmid, D., Taaffe, D., Newton, R. U., Galvão, D. A., & Leitzmann, M. (2022). Supervised pelvic floor muscle exercise is more effective than unsupervised pelvic floor muscle exercise at improving urinary incontinence in prostate cancer patients following radical prostatectomy: A systematic review and meta-analysis. Disability and Rehabilitation, 44(19), 5374–5385. https://doi.org/10.1080/09638288.2021.1937717
Beutel, M. E., Hessel, A., Schwarz, R., & Brähler, E. (2005). Prävalenz der Urininkontinenz in der deutschen Bevölkerung: Komorbidität, Lebensqualität, Einflussgrößen [Prevalence of urinary incontinence in the German population]. Der Urologe A, 44(3), 232–238. https://doi.org/10.1007/s00120-005-0791-y
Hsu, L. F., Liao, Y. M., Lai, F. C., & Tsai, P. S. (2016). Beneficial effects of biofeedback-assisted pelvic floor muscle training in patients with urinary incontinence after radical prostatectomy: A systematic review and meta-analysis. International Journal of Nursing Studies, 60, 99–111. https://doi.org/10.1016/j.ijnurstu.2016.03.013
Kozomara-Hocke, M., Hermanns, T., & Poyet, C. (2016). Urininkontinenz beim Mann: Ein Tabuthema. Praxis, 105(5), 269–277. https://doi.org/10.1024/1661-8157/a002297
Zhou, L., Chen, Y., Yuan, X., Zeng, L., Zhu, J., & Zheng, J. (2023). Preoperative pelvic floor muscle exercise for continence after radical prostatectomy: A systematic review and meta-analysis. Frontiers in Public Health, 11, 1186067. https://doi.org/10.3389/fpubh.2023.1186067
