Assessing use of eau recommendations in diagnostic and therapeutic strategies for chronic pelvic pain syndrome: a case vignette study on dutch pelvic floor physiotherapists practices

Background: Chronic Pelvic Pain Syndrome (CPPS) presents as pain located in the pelvic area lasting for at least six months, often with a multifactorial aetiology. The International Continence Society divides CPPS in multiple domains; one is the musculoskeletal domain. Pelvic floor physiotherapy is a recommended treatment and is advised in the European Association of Urologist (EAU) guidelines. However, in the Netherlands, it is unclear which treatment strategies are used by pelvic floor physiotherapists (PFPs) for CPPS patients due to the lack of a Dutch evidenced-based guideline for physiotherapists. This study provides an overview of the adherence to the EAU guideline by PFPs in managing CPPS patients. Methods: A case vignette study using two case vignettes and a general questionnaire defining contextual data. Participants were PFPs treating patients with CPPS in primary care. We contacted 550 qualified PFPs registered in the Dutch national quality registry for physiotherapy. Main outcome measure: first, adherence to EAU guidelines and second, the adherence compared to level of education and caseload. Results: Of the invited participants, 198 completed the survey. Of these, 29 (14.6%) scored higher than 80% for both case vignettes; fifty-four (27%) scored 80% for the male case vignette and 30 (15%) scored 80% for the female case. Conclusions: Our findings show low adherence to the EAU guideline’s proposed diagnostic and treatment criteria. PFPs should become more familiar with implementation of this guideline.