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评估《慢性盆腔疼痛综合征诊断和治疗策略中的欧洲泌尿外科学会(EAU)指南》在荷兰盆底物理治疗师实践中的应用:一项病例 vignette 研究

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.

作者信息

Wissing Myrthe, Rombouts Marian, Steegers Monique, Vissers Kris, van der Wal Selina, Notten Kim

机构信息

Department of Obstetrics and Gynaecology, Radboudumc Nijmegen, Geert Grooteplein Zuid 10, Nijmegen, GA, 6525, The Netherlands.

Department of Anesthesiology Chronic Pain and Palliative Medicine, Radboudumc, Nijmegen, The Netherlands.

出版信息

BMC Womens Health. 2025 May 31;25(1):272. doi: 10.1186/s12905-025-03782-4.

Abstract

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.

摘要

背景

慢性盆腔疼痛综合征(CPPS)表现为盆腔区域疼痛持续至少六个月,病因通常是多因素的。国际尿控协会将CPPS分为多个领域;其中一个是肌肉骨骼领域。盆底物理治疗是一种推荐的治疗方法,欧洲泌尿外科学会(EAU)指南中也建议采用。然而,在荷兰,由于缺乏针对物理治疗师的荷兰循证指南,尚不清楚盆底物理治疗师(PFP)对CPPSCPPS患者采用哪些治疗策略。本研究概述了PFP在管理CPPS患者时对EAU指南的遵循情况。

方法

采用两个病例 vignette 和一份定义背景数据的一般问卷进行病例 vignette 研究。参与者是在初级保健中治疗 CPPS 患者的 PFP。我们联系了在荷兰国家物理治疗质量登记处注册的550名合格PFP。

主要观察指标

第一,对EAU指南的遵循情况;第二,与教育水平和病例量相比的遵循情况。

结果

在受邀参与者中,198人完成了调查。其中,29人(14.6%)在两个病例 vignette 中的得分均高于80%;54人(27%)在男性病例 vignette 中的得分达到80%,30人(15%)在女性病例中的得分达到80%。

结论

我们的研究结果表明,对EAU指南提出的诊断和治疗标准的遵循程度较低。PFP应更熟悉该指南的实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35b2/12125937/a4ac58eb8b9f/12905_2025_3782_Fig1_HTML.jpg

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