Abstract
BackgroundThis study aimed to determine the possible prognostic factors correlated with the treatment modalities of tubo-ovarian abscesses (TOAs) and thus to assess whether the need for surgery was predictable at the time of initial admission.Materials and methodsBetween January 2012 and December 2019, patients who were hospitalized with a TOA in our clinic were retrospectively recruited. The age of the patients, clinical and sonographic presentation, pelvic inflammatory risk factors, antibiotic therapy, applied surgical treatment, laboratory infection parameters, and length of hospital stay were recorded.ResultsThe records of 115 patients hospitalized with a prediagnosis of TOA were reviewed for the current study. After hospitalization, TOA was ruled out in 19 patients, and data regarding 96 patients was included for analysis. Twenty-eight (29.2%) patients underwent surgical treatment due to failed antibiotic therapy. Sixty-eight (70.8%) were successfully treated with parenteral antibiotics. Medical treatment failure and need for surgery were more common in patients with a large abscess (volume, > 40 cm3, or diameter, > 5 cm). The group treated by surgical intervention was statistically older than the patients receiving medical treatment (p < 0.05).ConclusionsAlthough the treatment in TOA may vary according to clinical, sonographic, and laboratory findings; age of patients, the abscess size, and volume were seen as the major factors affecting medical treatment failure. Moreover, TOA treatment should be planned on a more individual basis.
Highlights
This study aimed to determine the possible prognostic factors correlated with the treatment modalities of tubo-ovarian abscesses (TOAs) and to assess whether the need for surgery was predictable at the time of initial admission
The duration of hospitalization, abscess size, and abscess volume were significantly higher in patients who underwent surgery compared to those receiving medical treatment alone (p < 0.01)
We found an increased mean abscess volume and abscess size in surgically treated patients, and medical treatment failure and need for surgery were more common in patients with a large abscess
Summary
This study aimed to determine the possible prognostic factors correlated with the treatment modalities of tubo-ovarian abscesses (TOAs) and to assess whether the need for surgery was predictable at the time of initial admission. A tubo-ovarian abscess (TOA) is a common complication of pelvic inflammatory disease (PID), affecting approximately 10–15% of women with PID [1]. It is most commonly seen at the age of 30–40 years in reproductive-age women [2]. In women with an abscess size of less than 9 cm, with no signs of abscess rupture and hemodynamic stability, the clinical guidelines of the Centers for Disease Control and Prevention (CDC) recommend medical management as the first treatment approach for TOAs [7]. Abscess size is predictive in determining treatment success with antibiotics alone and length of hospital stay [8]
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