Image-Guided Percutaneous Drainage Reduces the Need for Surgical Interventions in Patients with Tubo-Ovarian Abscess: A Cohort Study

Abstract

Objective: Management of tubo-ovarian abscess (TOA) is a challenging healthcare problem especially in reproductive age women. The aim of this study is to determine the current role of image-guided primary percutaneous drainage in avoidance of surgical intervention in the management of TOA. Material and Methods: A total of 76 patients hospitalized in our tertiary care center with the diagnosis of TOA were retrospectively evaluated. The study population was divided into 2 groups based on the treatment modalities as antibiotic treatment (n=48) and image-guided percutaneous drainage (n=28) and evaluated in terms of clinical and laboratory characteristics and the requirement for surgical intervention. Results: Surgical intervention was required in 1 (3.6%) patient treated with percutaneous drainage and in 10 (20.8%) patients treated with antibiotics (p=0.036). The choice of treatment modality was independent of demographic characteristics, clinical and laboratory findings. The size of TOA in percutaneous drainage group was significantly larger compared to the antibiotic treatment group (mean 6.75±1.886 cm versus 5.92±5.88 cm, respectively, p=0.047). Rehospitalization during follow-up was higher among patients treated with antibiotics only compared to percutaneous drainage group (p=0.06). Conclusion: Percutaneous drainage is an acceptable treatment option including large-sized TOA and decreases the requirement of surgical intervention in selected cases.