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Published online: 2022-10-25

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Tubo-ovarian abscess management in our clinic

Necdet Öncü1, Ali Buhur1, Hüseyin Güray Biçer2

Abstract

Objectives: It is aimed to examine and determine the sociodemographic, clinical parameters and ultrasonographic (USG) findings and to make various predictions about patients who will need tube-ovarian abscess (TOA) surgery.

Material and methods: Within the scope of the study conducted between April 2016 and March 2021, 140 patients diagnosed with TOA were evaluated. The parties in the comparison were compared based on clinical and USG findings of demographic characteristics of the patients who received medical and surgical treatment and those who received only medical treatment.

Results: Ninety-eight (72.05%) patients whose surgical and medical treatment required underwent laparotomy, laparoscopy, and USG-guided drainage. The most important potential hazards for surgical procedures include severe abdominal pain, extent of abscess, and length of hospital stay. Critical threshold for a surgical procedure is when the abscess size becomes 5.5 cm (95% CI: 0.686–0.855, 0.686–0.855, p < 0.05). In the USG-guided drainage group no other complications were noticed.

Conclusion: The size of the abscess is a valuable indicator of whether surgical treatment is required to manage TOAs and the USG-guided drainage led to fewer complications.

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References

  1. Jennings LK, Krywko DM. Pelvic Inflammatory Disease. StatPearls. Treasure Island (FL)2021.
  2. McNeeley SG, Hendrix SL, Mazzoni MM, et al. Medically sound, cost-effective treatment for pelvic inflammatory disease and tuboovarian abscess. Am J Obstet Gynecol. 1998; 178(6): 1272–1278.
  3. Chappell CA, Wiesenfeld HC. Pathogenesis, diagnosis, and management of severe pelvic inflammatory disease and tuboovarian abscess. Clin Obstet Gynecol. 2012; 55(4): 893–903.
  4. Kuo CF, Tsai SY, Liu TC, et al. Clinical characteristics and treatment outcomes of patients with tubo-ovarian abscess at a tertiary care hospital in Northern Taiwan. J Microbiol Immunol Infect. 2012; 45(1): 58–64.
  5. Goharkhay N, Verma U, Maggiorotto F. Comparison of CT- or ultrasound-guided drainage with concomitant intravenous antibiotics vs. intravenous antibiotics alone in the management of tubo-ovarian abscesses. Ultrasound Obstet Gynecol. 2007; 29(1): 65–69.
  6. Reed SD, Landers DV, Sweet RL. Antibiotic treatment of tuboovarian abscess: comparison of broad-spectrum beta-lactam agents versus clindamycin-containing regimens. Am J Obstet Gynecol. 1991;164(6 Pt 1):1556-61; discussion 61-2. .
  7. To J, Aldape D, Frost A, et al. Image-guided drainage versus antibiotic-only treatment of pelvic abscesses: short-term and long-term outcomes. Fertil Steril. 2014; 102(4): 1155–1159.
  8. Kinay T, Unlubilgin E, Cirik DA, et al. The value of ultrasonographic tubo-ovarian abscess morphology in predicting whether patients will require surgical treatment. Int J Gynaecol Obstet. 2016; 135(1): 77–81.
  9. Topçu HO, Kokanalı K, Güzel AI, et al. Risk factors for adverse clinical outcomes in patients with tubo-ovarian abscess. J Obstet Gynaecol. 2015; 35(7): 699–702.
  10. Yildirim M, Turkyilmaz E, Avsar AF. Preoperative Neutrophil-to-Lymphocyte Ratio Has a Better Predictive Capacity in Diagnosing Tubo-Ovarian Abscess. Gynecol Obstet Invest. 2015; 80(4): 234–9.
  11. Halperin R, Levinson O, Yaron M, et al. Tubo-ovarian abscess in older women: is the woman's age a risk factor for failed response to conservative treatment? Gynecol Obstet Invest. 2003; 55(4): 211–215.
  12. Greenstein Y, Shah AJ, Vragovic O, et al. Tuboovarian abscess. Factors associated with operative intervention after failed antibiotic therapy. J Reprod Med. 2013; 58(3-4): 101–106.
  13. Osser S, Gullberg B, Liedholm P, et al. Risk of pelvic inflammatory disease among intrauterine-device users irrespective of previous pregnancy. Lancet. 1980; 1(8165): 386–388.
  14. Lareau SM, Beigi RH. Pelvic inflammatory disease and tubo-ovarian abscess. Infect Dis Clin North Am. 2008; 22(4): 693–708.