Exploring pelvic floor muscle activity in men with lower urinary tract symptoms

Ruben O. Vrolijks, Françoise J. M. Notenboom-Nas, Deborah de Boer, Tamara Schouten, Alice Timmerman, Aylene Zijlstra, Lambertus P. W. Witte, Grietje E. Knol-de Vries, Marco H. Blanker*

*Corresponding author for this work

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Aim We aimed to explore the utility of the Multiple Array Probe Leiden (MAPLe) device to assess pelvic floor muscle activity in men with lower urinary tract symptoms (LUTS).

Methods This was an observational cohort study performed at the urology outpatient department of a large teaching hospital in the Netherlands between April and October 2018. We recruited male patients referred for the assessment of LUTS, without a history of prostate surgery, if they had an International Prostate Symptom Score greater than or equal to 8. The MAPLe device was then used to assess the puborectalis, pubococcygeus, iliococcygeus, urogenital diaphragm, and the internal and external anal sphincters during three tasks: a rest period (1 minute), five maximum voluntary contractions (held for 3 seconds each), and three maximal endurance contractions (held for 15 seconds each).

Results In total, 57 patients were included, 5 of which had diabetes mellitus. Muscle activity at rest was significantly lower than during either contraction task and did not differ between the muscle groups. By contrast, the external anal sphincter had significantly less activity than any other muscle group during the endurance task, and the internal anal sphincter and puborectalis had significantly less activity during the maximum voluntary contraction task. No association was found between pelvic floor muscle activity and LUTS severity during any task.

Conclusion Pelvic floor muscle activity and LUTS severity appear to be unrelated, but this does not completely exclude the possibility of muscle involvement in the development or experience of symptoms. Further research is needed.

Original languageEnglish
Pages (from-to)732-737
Number of pages6
JournalNeurourology and urodynamics
Issue number2
Publication statusPublished - Feb-2020


  • electromyography
  • IPSS
  • MAPLe
  • observational study
  • symptom severity

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