Tubo-ovarian abscesses in postmenopausal women: Clinical presentation and outcomes

Abstract

ObjectivesThis study describes the presentation, clinical characteristics and outcomes of postmenopausal women diagnosed with tubo-ovarian abscesses (TOAs). Study designAll postmenopausal women aged over 50 years presenting to three academic institutions with TOAs between 2007 and 2017 were identified. Patient charts were retrospectively reviewed and clinical variables were extracted. Descriptive statistics were prepared and analyses were performed. Main outcome measuresThe main outcome measures were complications and rate of malignancy. ResultsFrom 2007–2017, 61 postmenopausal women with TOAs were identified. Their median age was 62 years (range 50–87 years). Many of the women presenting with TOAs had co-morbidities; 34.4% had diverticulosis or diverticulitis and 9.8% had diabetes. Among the 61 women, 19 (31.1%) underwent interventional radiology (IR) drainage. Most postmenopausal women presenting with a TOA underwent surgical intervention (n = 47, 77.1%). Thirty-three (54.1%) women underwent early surgery (within 30 days), and 14 (22.9%) underwent late surgery (after 30 days). Overall, 14 (29.8%) women had either an intra-operative or a post-operative complication. Post-operative complications were more common among women who underwent late surgery than among those who underwent early surgery (35.7% vs 9.1%, P = 0.04). However, there was no difference in the readmission rate within 30 days of surgery (P = 1.0) or in the overall complication rate (P = 0.24) between surgery groups. Eight women (13.1%) had malignancy diagnosed either pre-operatively or at the time of their presentation with a TOA. ConclusionsPostmenopausal women presenting with TOAs often undergo surgical procedures that have a high rate of complications and may be associated with malignancy.