What is the male pelvic floor

The pelvic floor is a group of muscles and tissues that forms the base of the pelvis, supporting the bladder, intestine and, in men, the prostate. The main actor is the pubococcygeus (PC) muscle, which runs from the pubic bone to the coccyx and controls urine flow and erections.

Although the pelvic floor has historically been associated with women's health, men have exactly the same musculature. In fact, 50% of men over 50 have some degree of weakness in this area, according to data from the European Association of Urology (EAU).

Why men should do Kegel exercises

Clinical evidence identifies three areas of proven benefit for men:

Urinary control

Male urinary incontinence primarily affects two groups: men with stress incontinence (leaks when coughing, sneezing or exercising) and men recovering from prostatectomy. In both cases, Kegel training is the first-line treatment according to EAU clinical guidelines.

A 2019 meta-analysis published in BJU International analysed 15 controlled trials and concluded that pelvic floor training significantly reduces male urinary incontinence episodes.

Sexual performance and erectile function

The ischiocavernosus and bulbocavernosus muscles, part of the pelvic floor, are directly involved in erectile rigidity and ejaculation control. Strengthening these muscles improves blood flow to the penis and the ability to maintain an erection.

Clinical data: A study by Dorey et al. (2005) in BJU International showed that 40% of men with erectile dysfunction recovered normal function after 6 months of pelvic floor training, with no other treatment.

Recovery after prostate surgery

Radical prostatectomy (prostate removal) is the main cause of surgically treated male urinary incontinence. Starting Kegel training before surgery (prehabilitation) and resuming it immediately after reduces the recovery time to continence by an average of 3–4 weeks, according to Cochrane Collaboration data (2015).

How to identify the correct muscles

This is the most critical step and where most men fail at first. There are two reliable techniques:

  • Urine stream technique: Try to stop the flow mid-stream. The muscle that contracts is the pubococcygeus. Note: use this only to identify the muscle, not as a regular exercise.
  • Elevation technique: Lying on your back, imagine trying to lift the scrotum towards your body. You should feel a slight internal tension without moving your legs, abdomen or buttocks.

If when contracting you notice you are tensing your abdomen, glutes or thighs, you are not correctly isolating the pelvic floor. Practise in front of a mirror until the contraction is clean and internal.

Correct technique step by step

Basic sustained contraction exercise

Step 1

Starting position

Lying on your back with knees bent and feet on the floor. Breathe normally throughout the exercise.

Step 2

Contraction

Contract the pubococcygeus muscle and hold for 3–5 seconds. Do not hold your breath or tense your abdomen or glutes.

Step 3

Full relaxation

Release completely for 5–10 seconds. Relaxation is just as important as the contraction: it allows the muscle to recover.

Step 4

Repetitions

Perform 10–15 repetitions per set, 3 sets per day. You can do them in any position once you have mastered the technique.

Quick contraction exercise

Complement sustained contractions with sets of quick contractions: contract and release in 1–2 seconds, repeat 15–20 times per set. This type trains the fast-twitch muscle fibres, key for urge urinary “accidents”.

Weekly progressive programme

The correct progression has two main phases:

  • Initiation phase (weeks 1–4): short contractions, few sets, total focus on isolating the correct muscle.
  • Progression phase (week 5 onwards): gradual increase in duration and sets according to your muscular response.

The exact load —contraction duration, number of repetitions and sets— depends on your starting point and how your body responds. PrimeFlow Core calculates and adjusts this progression automatically session by session, so you never have to manage any numbers yourself.

Common mistakes to avoid

  • Tensing the abdomen or glutes: compensations that indicate you are not isolating the pelvic floor.
  • Holding your breath: increases abdominal pressure and can worsen incontinence in the long term.
  • Using Kegel to stop urination regularly: useful for identifying the muscle, but doing it routinely can interfere with normal bladder emptying.
  • Overtraining: excessive load creates hypertonia (overly tense muscle), which paradoxically worsens symptoms. If you feel pain or spasms, stop.
  • Expecting results in one week: muscle tissue needs time to adapt. Consistency matters more than intensity.

Realistic results and timelines

Timelines depend on multiple individual factors: your starting point, training regularity, technique quality and your body’s response. The clinical literature indicates that the first noticeable improvements can appear between 4 and 16 weeks, with high variability between individuals.

What is consistent across all studies: without objective tracking, it is very difficult to know whether you are progressing or plateauing. Subjective sensation alone is not enough to adjust training.

Just as in any physical discipline —strength training, swimming, cycling—, the pelvic floor has three stages that are not “completed” and forgotten: initiation, progression and active maintenance. The maintenance phase is not optional: clinical evidence shows that pelvic floor muscle strength declines progressively when training is abandoned, with symptom recurrence in 60–70% of cases within a year of stopping.

PrimeFlow Core is designed to accompany you through all three stages: it guides you from the very first exercise, adapts the load to your real progress using artificial intelligence, and keeps the muscle at its optimal level long term.