A prospective comparison of clinical ultrasound and operative examination of the female pelvis.

The value and accuracy of ultrasound examination in patients with gynecological disease is still controversial. Patients scheduled for elective surgery participated in a "blind" ultrasound examination the day before. Findings at surgery were compared with those of ultrasound and of manual examination. Ultrasound was superior to clinical examination in terms of sensitivity (83% and 67%, respectively), whereas specificity was similar for both methods (96% and 94%, respectively). Neither ultrasound nor clinical exam was reliable in detecting tubal anomalies, whereas small solid lesions were missed by sonography and larger cystic lesions by manual exam. Ultrasound would seem to be superior in overall performance, and a useful complement to palpatory exam.