Conservative management for postmenopausal women with tubo-ovarian abscess

Menopause. 2019 Jul;26(7):793-796. doi: 10.1097/GME.0000000000001317.

Abstract

Objectives: The aim of the study was to describe the experience of one institution in management and outcome of tubo-ovarian abscess (TOA) in pre- and postmenopausal women and to reassess the optimal approach for TOA in postmenopausal women.

Methods: A retrospective cohort study included women diagnosed with TOA between 2003 and 2017 in a tertiary referral center. TOA was diagnosed by sonography or computerized tomography and at least one of the following criteria: temperature more than 38°C, leukocytosis more than 15,000 mm, or surgically proven disease. Women were followed up for a mean of 7.6 years (range 6 mo to 14 y). The rates of conservative management and pelvic malignancy were evaluated.

Results: The study cohort included 144 (69.23%) women who met the inclusion criteria, of which 105 (72.92%) were premenopausal and 39 (27.08%) were postmenopausal. Univariate analysis found no differences in risk factors and disease characteristics between the two groups. Among the study sample, 22 (56.4%) postmenopausal women and 48 (45.7%) premenopausal women were treated surgically (P = 0.5). None of the premenopausal women and 1 (2.6%) postmenopausal woman were diagnosed with pelvic malignancy.

Conclusion: In postmenopausal women with TOA, the prevalence of concurrent pelvic malignancy was 2.6%, which is higher than in the general population, but lower than that reported in the literature; 44% were conservatively managed without any apparent cases of misdiagnoses of cancer.

MeSH terms

  • Abscess / diagnosis
  • Abscess / therapy*
  • Adult
  • Cohort Studies
  • Conservative Treatment / methods*
  • Fallopian Tube Diseases / diagnosis
  • Fallopian Tube Diseases / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Ovarian Diseases / diagnosis
  • Ovarian Diseases / therapy*
  • Pelvic Neoplasms / epidemiology
  • Postmenopause*
  • Premenopause
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome