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Is Sounding the Uterus Prior to Intrauterine Device Placement Still Relevant?
1Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg Hospital Bellville, Cape Town, South Africa.
International Journal of Women'S Health
|November 12, 2025
Summary
Uterine sounding before intrauterine device (IUD) insertion lacks evidence of benefit and may cause harm. Current guidelines recommend abandoning this practice to simplify procedures and reduce patient discomfort.
Area of Science:
- Gynecology
- Reproductive Health
- Medical Device Technology
Background:
- Uterine sounding has been a gynecological practice for over 200 years.
- Sounding was introduced with thermoplastic intrauterine devices (IUDs).
Purpose of the Study:
- To investigate changes in clinical practice and manufacturer recommendations regarding uterine sounding before IUD placement.
- To evaluate the evidence supporting uterine sounding prior to IUD insertion.
Main Methods:
- A comprehensive literature search was conducted.
- The search focused on changes in clinical practice and manufacturer instructions for IUD insertion.
Main Results:
- Current IUDs still recommend sounding, despite a lack of evidence for objective benefit.
- Potential benefits of sounding are outweighed by disadvantages, especially with ultrasound availability.
- Sounding yields measurements of dubious value and is prone to errors, potentially leading to incorrect IUD placement.
Conclusions:
- Uterine sounding before IUD placement has no supporting evidence and is an outdated practice.
- Abandoning sounding can simplify the IUD insertion procedure.
- Not sounding may reduce pain and the risk of introducing bacteria into the endometrial cavity.
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