Image-guided transvaginal drainage of pelvic abscesses and fluid collection using a modified seldinger technique

Abstract

Transvaginal drainage using the trocar method is advantageous as a single-step procedure; however, the procedure may occasionally be difficult to perform, due to buckling of the catheter in the elastic vaginal tissues, despite the presence of a stiff stylet. To evaluate the efficacy and the safety of image-guided transvaginal drainage of pelvic abscesses and fluid collection using a modified Seldinger technique. Fifteen patients (mean age 43 years, range 24-82 years) who underwent transvaginal aspiration (n=1) or catheter drainage (n=14) guided by ultrasound and fluoroscopy were enrolled in this retrospective study. A small coronal incision was performed to facilitate puncture using an 18G needle, tract dilatation, and the insertion of a drainage catheter by the Seldinger technique. Outcome was analyzed with respect to clinical success, technical success, and procedure-related complications. The overall clinical success rate was 87% (13/15 cases). The success rate of catheter drainage was 86% (12/14 cases), and the use of aspiration alone was successful in one patient. Technical success was achieved in all patients, without procedure-related complications. Image-guided transvaginal drainage with a modified Seldinger technique can be a safe and effective alternative treatment for pelvic abscesses and fluid collection.