Tubo-ovarian abscess: contemporary approach to management.

D. V. Landers, Richard L Sweet

Research output: Contribution to journalArticlepeer-review

150 Scopus citations

Abstract

Two hundred and thirty-two patients with tubo-ovarian abscesses (TOAs) were evaluated. Ruptured TOAs were documented in seven (3%) of the patients. One hundred and seventy-five patients with TOAs were treated with antibiotics alone; for 15 of these patients, TOAs were confirmed by laparoscopy. The remaining 57 patients required surgical intervention: drainage (five patients), unilateral salpingo-oophorectomy (19) and total abdominal hysterectomy and bilateral salpingo-oophorectomy (33). A unilateral TOA was present in 163 patients (70%). Seventy-six patients with TOAs used intrauterine contraceptive devices, and in this group, 54 (71%) patients had unilateral TOAs. The most common microorganisms that were recovered from these TOAs were Escherichia coli, Bacteroides fragilis, Bacteroides species, Peptostreptococcus, Peptococcus, and aerobic streptococci. Sixty-eight percent of the patients treated with an antimicrobial regimen that included clindamycin had a decrease in the size of the TOA, while only 36.5% of those receiving antimicrobial regimens without clindamycin had a decrease in the size of the TOA (P less than .01). Long-term follow-up information (two to 10 years) was available for 58 of the patients treated with antibiotics alone. Eighteen (31%) required subsequent surgery; 12 had persistent TOAs; and six, chronic salpingo-oophoritis. Intrauterine pregnancy was documented in eight (13.8%) patients. Of the 19 patients treated with unilateral adnexectomy, two ultimately required hysterectomy and contralateral adnexectomy, while three patients in this group subsequently became pregnant (one ectopic and two intrauterine).

Original languageEnglish (US)
Pages (from-to)876-884
Number of pages9
JournalReviews of Infectious Diseases
Volume5
Issue number5
StatePublished - Sep 1983
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)

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