S2k guideline on assistive device consultation for urinary incontinence from the German Society for Urology (DGU) – red flags, qualifications of consultants, costs

Abstract

Background

Counseling regarding a planned provision of medical aids is currently neither reimbursed nor regulated in Germany. It is offered by a range of providers with employees with varying levels of qualification and may be provided in a personal conversation, by phone, or remotely. In many cases, counseling is omitted entirely between the prescription and trial use or delivery of the product. The quality of medical aids counseling, which plays a key role in temporary, supportive or palliative care for urinary incontinence, is therefore considered problematic.

Objective

In 2019, the working group “Geriatric Urology” of the German Society for Urology published the first guideline on the counseling process related to the provision of medical aids. An updated version is currently available and has been listed by the Association of the Scientific Medical Societies. The underlying idea was to define quality standard in Germany for the individual components of the counseling process – from identifying the type of incontinence and its severity to product trial use, the counseling setting, the counseling itself, the qualification of the counseling personnel, and the communication between prescribing doctors, service providers, and patients.

Material and Method

This article presents the guideline sections regarding “red flags” – clinical conditions/symptoms, for which medical consultation should take precedence over medical aids counseling – as well as the qualifications required of the counseling personnel, and counseling costs.

Discussion

As medical aids counseling is expected to be financed from the low reimbursement rates provided by statutory health insurers for what is defined as an “appropriate and sufficient” supply – typically amounting to less than EUR 15 a month – more and more providers are withdrawing entirely from the sector of medical aids provision. Others continue to supply medical aids but offer no counseling at all or only to a very limited extent. The guideline “Medical Aids Counseling for Urinary Incontinence” developed by the working group “Geriatric Urology” of the German Society for Urology is meant to define quality standards, also with a view to a political discussion on reimbursement rates.

Wiedemann, A., Manseck, A., Stein, J., Kirschner-Hermanns, R., Froehner, M., Butea-Bocu, M., Fiebig, C., Piotrowski, A., Gleißner, J., Linne, C., Liebald, T., Schorn, H., Wagner, A., & Moll, V. (2026). S2k-Leitlinie Hilfsmittelberatung bei Harninkontinenz der DGU – red flags, Qualifikation Beratender, Kosten. Aktuelle Urologie, 57(01), 108–112. https://doi.org/10.1055/a-2607-5293