Routine use of vaginal ultrasonography in the preoperative evaluation of gynecologic patients. An adjunct to resident education

To determine the clinical utility of routine vaginal ultrasound in evaluating gynecologic patients, we prospectively studied 133 women scheduled to undergo elective surgery based upon abnormal clinical findings as determined by residents and faculty in a large, county-based teaching hospital. Patients were examined bimanually by the surgeons and then examined ultrasonographically using a 5.0-MHz vaginal probe. Surgery was scheduled within 48 hours of the clinical examinations. Vaginosonography demonstrated enhanced sensitivity, specificity and predictive value as compared to bimanual pelvic examination. The technique was quickly mastered by resident physicians, with discrepancies between preoperative ultrasound observations and actual surgical findings present in but 15 of 532 instances. Vaginal ultrasonography is an effective routine adjunct to physical examination in the preoperative evaluation of surgical patients. Furthermore, it has diagnostic capabilities superior to those of the bimanual pelvic examination and increases the accuracy of preoperative diagnoses in gynecologic patients.