Abstract
To evaluate the treatment outcome of tubo-ovarian abscesses managed by transvaginal ultrasound-guided aspiration. Descriptive analysis of all patients with tubo-ovarian abscesses treated with a minimally invasive procedure, ultrasound-guided drainage, at the Department of Gynecology, Centro Hospitalar Vila Nova de Gaia/Espinho, during a period of 5 years (from June 2009 to June 2014). Twenty-six cases were included in the study. The mean age of the study group was 42.8 years. All patients were submitted to transvaginal ultrasound-guided aspiration and sclerosis with iodated solution, as well as received broad-spectrum intravenous antibiotics. The mean time from admission to drainage was 2.5 days. Cultures for aerobic and anaerobic pathogens were positive in 14 of the 26 cases. A complete response was noted in 23 of the 26 cases. No complications or morbidity were noted as a consequence of the drainage procedures. Minimally invasive treatment of tubo-ovarian abscesses by transvaginal ultrasound-guided drainage is an effective and safe approach.
Highlights
Tubo-ovarian abscess (TOA) is a consequence of an infectious process and is characterized by a walled-off inflammatory structure involving adnexa
TOA is classified in primary when it occurs in the context of pelvic inflammatory disease (PID) and secondary if it occurs in the consequence of other intra-abdominal processes, like bowel perforation or pelvic malignancy[2,3,4]
Twenty-six cases of TOA were treated with transvaginal aspiration and sclerosis, ultrasound-guided, after the institution of broad-spectrum antibiotics
Summary
Tubo-ovarian abscess (TOA) is a consequence of an infectious process and is characterized by a walled-off inflammatory structure involving adnexa. The infection is, in the majority of cases, caused by a mixed flora composed by anaerobic and gram-negative bacteria that ascend causing pelvic inflammatory disease (PID)[1]. TOA is classified in primary when it occurs in the context of PID (in about 30% of cases) and secondary if it occurs in the consequence of other intra-abdominal processes, like bowel perforation or pelvic malignancy[2,3,4]. The diagnosis of TOA is made by clinical, laboratorial and imaging aspects. The gold standard exam for the diagnosis of TOA is ultrasonography, mainly when executed with vaginal transducer. Ultrasound findings suggestive of TOA include a cystic and complex neo-formation in the pelvic compartment, with heterogeneous compound and irregular margins, surrounded by vascularized tissue, with high resistance index in Doppler study[2,3,4,5]
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