Incorporating endovaginal ultrasonography into the overall gynecologic examination

Previously endovaginal ultrasonography was considered an adjunct for use in full-service ultrasound facilities by subspecialists only. The technique, however, has tremendous application for use by the clinician in the examination room for patients at bimanual examination. This is because the procedure is meant to be performed with an empty urinary bladder. It requires very little time once the operator is adequately trained. It provides excellent resolution despite high degrees of magnification. This allows for a distinction between a traditional ultrasound examination and this new concept of examining gynecologic patients with vaginal probe ultrasonography as a part of the routine overall gynecologic examination. Methodology and philosophic issues arising from such a concept are discussed.