Surgical, Ultrasound Guided Drainage, and Medical Management of Tuboovarian Abscesses

Crespo, Frank A.; Ganesh, D; Lo, Kaming; Chin, Kevin M.; Norris, Paul; Chakhtoura, Nahida

doi:10.1155/2014/501729

Cited by 5 publications

(23 citation statements)

References 9 publications

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“…Intrauterine devices are considered to be associated with TOAs . Removal of an intrauterine device or intrauterine system should be considered as it may be associated with better short‐term clinical outcomes . The decision to remove the intrauterine device needs to be balanced against the risk of pregnancy in those who have had intercourse in the preceding five days.…”

Section: Special Circumstances Of Toamentioning

confidence: 99%

“…The incidence of chronic pelvic pain has been shown to be 12% after one episode, 30% after two episodes and 67% after three or more episodes of PID or TOA . Crespo et al . showed that there were no statistical differences observed between those treated with antibiotics and those managed surgically in terms of chronic pelvic pain.…”

Section: Long‐term Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis and management of tubo‐ovarian abscesses

Munro

Gharaibeh

Nagabushanam

et al. 2018

The Obstetric & Gynaecologis

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Key content Tubo‐ovarian abscesses represent a severe form of pelvic inflammatory disease and carry high morbidity. Diagnosis is made by combining the clinical picture (fever, pelvic pain and pelvic adnexal mass) with raised inflammatory markers and radiological findings demonstrating an abscess. Initial management with intravenous antibiotics may not be successful. Surgical intervention may be indicated but the optimal timing is not clear and image‐guided drainage can be a possible alternative to surgery. Surgery may be conservative or involve pelvic clearance and will depend on the clinical situation. Learning objectives To be able to recognise and initiate prompt treatment of pelvic inflammatory disease and tubo‐ovarian abscesses. To understand appropriate antibiotic treatment and/or radiological drainage. To be able to identify indications for timely surgical intervention and explore the optimal surgical approach of laparoscopic versus open surgery. Ethical issues Delays in treatment may have adverse effects on future fertility. Who is appropriate for fertility‐preserving treatment?

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Section: Special Circumstances Of Toamentioning

confidence: 99%

Section: Long‐term Complicationsmentioning

confidence: 99%

Diagnosis and management of tubo‐ovarian abscesses

Munro

Gharaibeh

Nagabushanam

et al. 2018

The Obstetric & Gynaecologis

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“…The incidence of chronic pelvic pain has been shown to be 12%, 30%, 67% after one episode, two episodes, and three or more episodes of PID or tuboovarian abscess, respectively(5). Crespo et al showed that the treatment with antibiotics were no statistical differences observed with those managed surgically regarding chronic pain (6). The imaging study revealed a bilateral ovarian mass in this patient.…”

Section: Discussionmentioning

confidence: 57%

Laparoscopic Resection of An Extensive Tuboovarian Abscess in A Mechanical Valve Replacement Woman

Wasinghon¹,

Huang

2020

Gynecol Obstet Reprod Med

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The case is a 44-year-old-female who presented with right lower abdominal pain without fever or leukocytosis. She had previous mechanical valve replacement with taking warfarin for last ten months from the diagnoses of infective endocarditis. The ultrasonography showed bilateral complex ovarian mass. At laparoscopy, the patient had a right tubo-ovarian abscess and a left mature teratoma with extensive adhesions to the rectum. A case illustrates an uncommon premenopausal age with right tuboovarian abscess and left mature teratoma. The laparoscopic surgery is an excellent benefit for quicker recovery time, smaller incisions, less post-operative pain, and especially of a few infections that will affect to underlying disease of the patient.

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“…with TOA of ≥8 cm were hospitalised longer than those with TOA of <8 cm (7.71 days vs 5.97 days, p<0.029) 9 . In our study, hospitalisation was longer in surgical drainage group than antibiotic group (9.9 days vs 5.2 days, p<0.0001).…”

Section: Discussionmentioning

confidence: 87%

“…TOA of ≥8 cm should receive ultrasound-guided drainage or surgery with concomitant intravenous antibiotics to shorten hospitalisation and decrease hospital costs 9 .…”

Section: A Management Algorithm Proposed That Patients Withmentioning

confidence: 99%

Risk factors for failure of antibiotic therapy for tubo-ovarian abscess

2019

Hong Kong J Gynaecol Obstet Midwifery

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To assess the risk factors for antibiotic therapy failure and to predict which patients will require surgical drainage for tubo-ovarian abscess. Methods: We collected data from patients by ICD-9 codes starting with 614.2. We extracted data regarding background information, clinical presentation, laboratory parameters, and ultrasonographic findings. Patients responded to antibiotics alone were compared with patients required surgical drainage. Relative risk of surgical drainage was estimated with logistic regression model. Result: A total of 126 cases of tubo-ovarian abscess were evaluated, of which 92 were successfully managed with antibiotic therapy alone and 34 required surgical drainage. Age, multiparity, intrauterine device use, fever, maximal white cell count and abscess size were identified to be significant risk factors associated with the need for surgical drainage. The adjusted relative risks of surgical drainage were 2.250 for abscess size ≥8 cm, and 3.162 for fever on admission. The duration of hospitalisation was increased by 23.8% for abscess size ≥8 cm and by 23.7% for fever on admission. Conclusion: Larger abscesses are associated with increased risk of surgical drainage. However, additional research is required to determine the optimal treatment for large abscesses. It is reasonable to try antibiotic therapy in clinically stable patients irrespective of abscess size.

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Surgical, Ultrasound Guided Drainage, and Medical Management of Tuboovarian Abscesses

Cited by 5 publications

References 9 publications

Diagnosis and management of tubo‐ovarian abscesses

Diagnosis and management of tubo‐ovarian abscesses

Laparoscopic Resection of An Extensive Tuboovarian Abscess in A Mechanical Valve Replacement Woman

Risk factors for failure of antibiotic therapy for tubo-ovarian abscess

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