# Community Prevalence and Predictors of Pelvic Floor-Related Symptoms in Saudi Men: Implications for Physiotherapy-Led Care

## TL;DR

A study of 458 Saudi men found that 14% had urinary incontinence and that smoking and frequent voiding were linked to higher pelvic floor symptoms, suggesting physiotherapy-led care could help.

## Contribution

The study identifies smoking and preventive voiding as key predictors of pelvic floor symptom burden in Saudi men, offering guidance for physiotherapy interventions.

## Key findings

- 14% of Saudi men in the study reported urinary incontinence.
- Current smoking and preventive voiding were significant predictors of higher pelvic floor symptom burden.
- Symptom incidence increased with age (p < 0.001).

## Abstract

What are the main findings?
In a community sample of 458 Saudi men, urinary incontinence was reported by 14% of participants, and overall pelvic floor-related symptom burden was generally low-to-moderate.Current smoking (OR = 1.34) and “preventive/just in case” voiding to avoid leakage (OR = 1.54) were the only significant independent predictors of higher symptom burden.

In a community sample of 458 Saudi men, urinary incontinence was reported by 14% of participants, and overall pelvic floor-related symptom burden was generally low-to-moderate.

Current smoking (OR = 1.34) and “preventive/just in case” voiding to avoid leakage (OR = 1.54) were the only significant independent predictors of higher symptom burden.

What are the implications of the main findings?
Primary care screening can pragmatically target modifiable behaviors—especially smoking and preventive voiding—using brief questions to identify men at higher risk of pelvic floor-related symptoms.Findings support physiotherapy-led conservative pathways focusing on smoking cessation support and structured bladder training (with escalation when needed), alongside education on pelvic floor muscle training.

Primary care screening can pragmatically target modifiable behaviors—especially smoking and preventive voiding—using brief questions to identify men at higher risk of pelvic floor-related symptoms.

Findings support physiotherapy-led conservative pathways focusing on smoking cessation support and structured bladder training (with escalation when needed), alongside education on pelvic floor muscle training.

Background: Research in pelvic floor muscle-related symptoms (PFM-related symptoms) in Saudi Arabia remains limited. Clearer identification of symptom burden and its predictors is needed to guide physiotherapy strategies for prevention and management. Objective: We aimed to determine the prevalence of PFM-related symptoms among adult Saudi men and identify behavioral and lifestyle predictors associated with symptom burden. Methods: A community-based cross-sectional survey was conducted among 458 men aged >18 years from the Al-Baha region of Saudi Arabia. PFM-related symptoms were assessed using five items adapted from the Pelvic Floor Distress Inventory-20 (PFDI-20), their impact using five items from the Pelvic Floor Impact Questionnaire-7 (PFIQ-7), and urinary incontinence using the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF). Data were analyzed with descriptive statistics, correlation analysis, one-way ANOVA, and binary logistic regression. Results: Urinary incontinence was reported by 14% (86% reported none), but 19% disclosed regular “preventive” voiding. Symptom incidence increased with age (p < 0.001). Logistic regression identified smoking (OR = 1.34, p = 0.029) and preventive voiding (OR = 1.54, p = 0.002) as significant predictors of greater symptom burden. Conclusions: These results highlight the need for physiotherapy-led strategies in primary care, prioritizing smoking-cessation support and structured bladder training, with escalation when required. Prospective studies are needed to confirm temporality and to develop a practical rehabilitation pathway for men.