Management of tuboovarian abscesses: percutaneous drainage following failed antibiotic therapy

Abstract

Objective: To look at the short- and long-term outcome of percutaneous drainage of tuboovarian abscesses (TOAs) after failure to respond to initial antibiotic therapy.Methods: A retrospective study of patients with a diagnosis of TOAs admitted to Jackson Memorial Hospital between January 1, 1997 and December 31, 1997.Results: Fifty-four patients with a diagnosis of TOAs were identified. Forty patients (74%) responded to parental antibiotic therapy and 14 patients (26%) did not. Percutaneous drainage was performed under computed tomography or ultrasound guidance in 10 patients who failed antibiotic therapy. Eight patients (80%) responded to percutaneous drainage, and two patients (20%) continued with febrile morbidity and required surgical intervention. Follow-up was possible for seven patients with a median duration of 11 months. Recurrence occurred in two patients, at 2 and 18 months post drainage, and required surgery. Long-term sequelae included infertility in two patients. No patients have developed chronic pelvic pain.Conclusions: In this series of patients, percutaneous drainage of TOAs was successful in avoiding surgery in 6 of 10 patients. Therefore, percutaneous drainage should be considered as the next management strategy for patients admitted with TOAs who do not respond to antibiotic therapy.