Use of Ultrasound in Pelvic Floor Physical Therapy among Men: Narrative Review

Abstract Introduction and Hypothesis To review current knowledge on the use of ultrasound in pelvic floor physical therapy for men and provide recommendations for its integration into the evaluation and treatment of male pelvic floor disorders. Methods A comprehensive search was conducted in PubMed, Medline, and Google Scholar from January to September 2024 using keywords such as “ultrasound”, “transperineal ultrasound”, “transabdominal ultrasound”, “real-time ultrasound”, “pelvic floor men”, “prostatectomy”, “chronic pelvic pain syndrome” and “anorectal dysfunction”. Studies were included if they investigated ultrasound techniques for male pelvic floor rehabilitation and compared ultrasound with other therapeutic methods. Non-peer-reviewed articles, case reports, and studies lacking clear outcomes were excluded. Results The reviewed studies indicate that ultrasound has been used as a biofeedback modality to support the teaching of pelvic floor muscle activation, particularly in men with urinary incontinence following prostatectomy. Real-time visual feedback was reported to assist patient understanding of pelvic floor muscle contraction and may be associated with improved engagement in rehabilitation protocols. In addition, ultrasound has been applied for the assessment of pelvic floor function in men with chronic pelvic pain syndrome and anorectal dysfunction. Providing a non-invasive means of evaluating pelvic floor dynamics. However, the literature also highlights several limitations, including anatomical variability, challenges in imaging resolution, and patient-related factors that may affect the consistency and clinical applicability of ultrasound-based assessments. Discussion This review contextualizes the current literature on ultrasound use in male pelvic floor assessment within the broader challenges of clinical implementation and evidence development. While ultrasound offers a non-invasive approach with potential applications across functional assessment and rehabilitation, its use in male populations remains less established than in female pelvic health. Methodological heterogeneity, technical constraints, and limited male-specific research currently restrict definitive conclusions regarding its routine clinical role. These considerations underscore the importance of standardized protocols and targeted research to better define the contribution of ultrasound to male pelvic floor practice. Conclusion Ultrasound, especially non-invasive techniques such as transperineal and transabdominal ultrasound, holds significant promise in improving pelvic floor therapy for men by providing real-time biofeedback and increasing patient compliance. While its adoption is growing, a critical need remains for standardized protocols and increased awareness among practitioners to fully capitalize on ultrasound’s potential in male pelvic floor rehabilitation. Brief Summary Ultrasound is an emerging diagnostic and therapeutic tool with growing potential in the evaluation and treatment of male pelvic floor dysfunction.