Interdisciplinary S2k Guideline: Sonography in Urogynecology^[*]

1 General Recommendation

Pelvic floor sonography is currently the gold standard in gynecology for the morphological diagnosis of incontinence and of functional disorders of the pelvic floor. X-ray examinations and MRI of the pelvic floor are much less common nowadays, and these examinations are usually only done to investigate more complex issues which cannot be adequately evaluated with ultrasonography.

Diagnostic ultrasonography should be done both perioperatively and after surgery for urinary incontinence or prolapse to evaluate complications. Sonography also provides useful biofeedback and can be used to assess the patientʼs progress after conservative treatment.

A review of recent international literature shows that, in the majority of studies, morphological diagnoses are obtained with sonography. A number of different methods are used for investigation and evaluation, which can make it difficult to compare the findings of different studies. While in previous years introital sonography and perineal ultrasound were the preferred 2D imaging methods used for diagnosis, more recent studies have focused on the use of 3D imaging methods. The basic principle, which applies to both approaches, is that metric assessments are secondary to descriptive evaluations as an important constituent of urogynecological diagnostics. Both methods are useful, particularly to assess complications after surgery for urinary incontinence and prolapse procedures, and both procedures have an important role to play in understanding and managing complications.

^* Principal Author
Prof. Dr. med. Ralf Tunn (Berlin)

Contributing professional societies
1. German Society for Gynecology and Obstetrics
2. Study Group for Urogynecology and Plastic Pelvic Floor Reconstruction of the German Society for Gynecology and Obstetrics
3. Study Group for Urogynecology and Reconstructive Pelvic Floor Surgery, Austria
4. Study Group for Urogynecology and Reconstructive Pelvic Floor Surgery, Switzerland
5. Surgical Study Group for Coloproctology
6. Professional Association of Gynecologists in Germany
7. German Society for Ultrasound in Medicine

Note
The long version, including the complete list of references and the guideline report, can be viewed on the AWMF website (www.awmf.org).

To cite as: National German Guideline (S2K): Sonography and Urology, AWMF Registry No. 015/055. Geburtsh Frauenheilk 2014; 74: 1093–1098