The most serious complication of pelvic inflammatory disease (PID) is tuboovarian abscess (TOA). The trend of fertility conserving surgery in TOA cases is due to widespread use of newer broad spectrum antibiotics and modern diagnostic possibilities. The authors present their experiences of the past 15 years (Semmelweis University Ist. Department of Obstetrics and Gynecology) regarding severe TOA cases. The study summarizes 182 cases, where conservative therapy had failed and laparotomy was performed. In 32% of the cases TOA was bilateral, in 68% unilateral. In 54% of the cases an abdominal hysterectomy with a unilateral salpingooophorectomy, whereas in 18% a panhysterectomy (including both the ad-nexa) was performed. 17% of the patients had IUD at the time of the TOA development. The IUD wearing has definitely increased the extent of the performed surgery, hysterectomy (p<0.02), bilateral salpingooophorectomy (p<0.02). The culture/sensitivity (from the abscess) reports yielded positive results in 86% of the cases. In 27,5% of the microbiologically positive cases there were minimum two types of bacteria detected. Most frequently Streptococcus species. E. coli. anaerobic species of Peptostreptococci were detected. In 4 cases histological findings confirmed Actinomycosis. The authors concluded that TOA treatment mainly depends on the age and parity of the patient, and also on the severity of the disease and stage of pelvic structure involvement. The extent/radicality of the performed surgery should always be determined individually for each case.
|Translated title of the contribution||Laparotomy in cases of severe tuboovarian abscess. 15 Years' experience at the Semmelweis University 1st. Department of Obstetrics and Gynecology|
|Number of pages||10|
|Journal||Magyar Noorvosok Lapja|
|Publication status||Published - ápr. 19 2007|
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynaecology