Images are highly effective tools for medical instructional media, including the user’s manual for medical devices. An appropriate image conveys meaning very effectively. However, the image must be carefully planned and patient usability monitored to know if the images are effective or needs adjustment. Patient feedback provides critical information and guidance to know if revisions are necessary to the approval of a final appropriate design. This article examines the protocol used to create and evaluate images for a FDA-cleared medical device to treat female urinary incontinence. Female urinary incontinence is widespread among women, affects their socioeconomic wellbeing and is treatable. Interventions for female urinary incontinence can include non-surgical options such as lifestyle modifications, pelvic floor muscle training and drugs Stress incontinence which is voiding when a woman coughs laughs or sneezes is the most common type of female urinary incontinence. Images in this article are applicable for a medical device which improves pelvic floor muscle tone for use in the home without surgery or narcotics to treat female stress urinary incontinence.