Primary care providers' knowledge about the therapeutic management of refractory pelvic floor dysfunctions in Flanders, Belgium: A cross-sectional study.

Background: Pelvic floor dysfunctions (PFD) are prevalent conditions in primary care practice. Basic knowledge of second-line therapies among primary care providers (PCP's) is indispensable to well-inform refractory patients and improve their access to specialized care. Objectives: Getting insight in the extent of knowledge about second-line therapies for refractory PFD among PCP's in Flanders, Belgium.Methods: From January to March 2019 Flemish PCP's participated on the OptiLUTS trial - Part A (EC/2018/0244), by completion of a 22-item online Dutch questionnaire. Prevalence of PCP's having awareness about sacral neuromodulation (SNM), intradetrusor botulinum toxin injections (BTX) and percutaneous tibial nerve stimulation (PTNS) was explored. Descriptive statistics, univariate analyses and multiple logistic regression analysis were performed.Results: Sixty PCP's, 55% GP's, 45% GP trainees, median age 29 years, participated. Respectively 90%, 73% and 5% had ever heard about BTX, SNM and PTNS. Profession was an independent predictive factor for never having heard of SNM therapy, GP's being more likely to have lack of knowledge than trainees (OR =29, 95%CI [1.9-442.5]). Ninety-three percent wants to learn more about these therapies.Conclusion: There is margin for improvement in the knowledge of PCP's regarding therapies for refractory PFD. The awareness among PCP's should be increased for the optimization of patient care.