Surgical Management of Tubo-Ovarian Abscesses That Failed Percutaneous Drainage

Abstract

<h3>Study Objective</h3> Report outcomes in the management of tubo-ovarian abscesses (TOA) initially managed with percutaneous drainage. <h3>Design</h3> Retrospective chart review. <h3>Setting</h3> Tertiary University-affiliated Medical Center. <h3>Patients or Participants</h3> Patients who underwent percutaneous drain placement for TOA from 2003 to 2020 were included. Percutaneous drainage CPT codes were used to retrieve patient cases. Charts were subsequently reviewed manually. Cases with retrospective diagnoses of: Endometriosis or non-genital etiology of TOA were excluded. <h3>Interventions</h3> percutaneous drainage. <h3>Measurements and Main Results</h3> Sixty-six patients were identified, nine met exclusion criteria, and 57 were analyzed. Percutaneous drainage was successful in 42 patients, while surgery was ultimately required in 15 cases. Of 15 surgical cases only 4 occurred during the initial admission, whereas 11 were delayed and performed due to recurrence of TOA (5), persistence of symptomatic mass (3), or development of chronic pelvic pain (3). Three patients underwent salpingo-oophorectomy. Eight underwent hysterectomy with unilateral or bilateral salpingo-oophorectomy. All but one patient who underwent delayed intervention had it within 1 year of initial presentation. <h3>Conclusion</h3> Percutaneous drainage of TOA is initially successful in 93% of patients, however ultimately 26% of patients ultimately require surgical intervention.