Pelvic Floor Ultrasound in Men: Seeing the Muscles Respond in Real Time

After a prostatectomy, an unexpected episode of urine leakage, or pelvic discomfort that's hard to explain, many men come to the clinic with the same question: “could this be a pelvic floor problem?” It's a reasonable doubt. The pelvic floor is a group of muscles you can't see or check by looking in a mirror, and training blind for weeks, without knowing whether the movement is correct, is more common than it seems. At KINEO Benidorm we resolve that uncertainty with a tool few people expect to find in a physiotherapy clinic: the ultrasound scanner.

Why palpation isn't always enough

Manual assessment of the pelvic floor gives valuable information about tone, sensitivity or tender points, but it has a clear limit: it doesn't let us see the muscle moving while it works. It's the same difference as listening to an engine running versus opening the bonnet to see whether all the pistons are moving as they should. You can sense that something's wrong, but not pinpoint exactly what, or correct it on the spot.

In practice, this has very concrete consequences. It's common for a man to be told to “contract the pelvic floor” and, without realising it, end up tightening the abdomen, the glutes, or even pushing down as if straining to defecate — exactly the opposite pattern to the one intended. Without a way to check it, that mistake can repeat session after session.

What functional ultrasound shows that manual examination can't

Functional pelvic floor ultrasound (usually suprapubic or transperineal) is a non-invasive, painless test with no radiation, widely used in pelvic floor physiotherapy as an assessment and biofeedback tool. With the transducer resting on the skin, the screen shows live how the bladder base and the pelvic musculature behave on contracting, relaxing, coughing or during a Valsalva-type strain.

This turns the session into something far more objective: the patient themselves sees on screen whether the movement is going in the correct direction (lifting) or the opposite one (descending), and can correct it there and then, with immediate feedback that no verbal instruction can match. It also lets us detect whether, instead of contracting, what predominates is difficulty fully relaxing the area between efforts — something more common than people think, and easy to miss without this image.

Who it's suitable for

The most common case is post-prostatectomy, where surgery can affect control of the muscles involved in continence, and where we've already covered in detail how we approach recovery with specialised physiotherapy. But it isn't the only situation: it's also useful for urine leakage without any surgery involved, persistent pelvic discomfort, or simply to confirm, before starting an exercise programme, that your starting technique is correct.

At KINEO Benidorm, this assessment is carried out by Carles, the only male physiotherapist in Benidorm specifically dedicated to male pelvic floor dysfunction. A space designed to approach the consultation with the same ease and rigour as any other musculoskeletal assessment, with no awkwardness and no rush.

If you've been told about pelvic floor exercises and you're not sure you're doing them correctly, or if you'd like an objective assessment before or after a procedure, we can look at it together with pelvic floor ultrasound.

Book an appointment at KINEO Benidorm and we'll resolve that doubt in the same session.