I read with great interest the editorial “Ultrasound screening in gynecological examinations: can we overcome the criticism that it is insufficient and harmful?” in Volume 49, Number 1. This topic deserves full consideration since such efforts may remove the current constraints on ultrasound imaging in gynecology and expand its free use.

On the other hand, it would be a very dangerous choice if we entrust the future development of ultrasound imaging entirely to high-performance equipment and specially trained examiners. This could lead to losing sight of ultrasound imaging as a routine tool. This examination is not only useful when dealing with hard-to-find lesions or delicate findings. Let me share the following example with the readers.

First, in women who have thick abdominal walls and pelvic floors, ultrasound imaging is necessary because bimanual examinations do not provide reliable information for the evaluation of internal genitalia.

Second, when a specimen is taken from the uterine cavity for pathological examination, it is highly recommended that the shape of the cavity be confirmed by ultrasound imaging, regardless of body habitus.

Third, as the number of deliveries with epidural analgesia is sharply increasing, prevention of bladder over-distension is an urgent issue to protect the lower urinary tract function in women. It is a pity that residual urine measurement devices (such as BladderScan®) are not reliable during and after labor, but if the delivery room and ward have ordinary US equipment that midwives can easily and repeatedly use, the risk of bladder over-distension can be greatly reduced.

The value of ultrasound imaging as a routine tool is being rediscovered. It is gratifying to see that the major manufacturers are now sending out a variety of equipment suitable for point-of-care use. However, we do not expect that national health insurance will cover the cost of ultrasound imaging for obese patients. Also, we frequently see cases where the pathological examination of the endometrium is accepted, but the ultrasound imaging to perform the biopsy is rejected. In gynecology and obstetrics, apparently, behind the shadow of the competition for the development of advanced technology and techniques, medical procedures that can be done with ordinary US equipment are not supported and are often forgotten. I would like to ask specialists to make kind efforts to create an environment in which ultrasound imaging can be fully utilized as a daily tool.