Transrectal versus transvaginal abscess drainage: survey of patient tolerance and effect on activities of daily living.
OBJECTIVE
To evaluate patient perception of pain related to transrectal and transvaginal drainage and the catheter's effect on activities of daily living.


METHODS
From July 1993 to August 1997, 22 male and 40 female patients (mean age, 41 years; age range, 4-80 years) underwent transrectal or transvaginal aspiration or drainage. Fifty-seven drainages were performed. In a follow-up survey, patients were asked to score pain experienced during the procedure and afterward on a scale of 1-10 and to rate the effect of the catheter on their activities of daily living.


RESULTS
Twenty-two patients participated in the telephone survey. For those able to recall the insertion procedure, the mean pain score was 3.2 for transrectal and 5.9 for transvaginal drainage. Mean indwelling catheter pain was 1.6 for transrectal and 4.8 for transvaginal drainage. Pain after removal was 1.4 for transrectal and 2.3 for transvaginal drainage. Only one patient with a transrectal catheter reported severe limitation (bowel movement), with no reports of any serious effect on urinating, bathing, sitting, or walking. Transvaginally placed catheters caused marked limitation in all categories and were more painful than transrectal catheters (P < .05).


CONCLUSIONS
Of the transrectal and transvaginal approaches, transrectal is better tolerated.
Department of Radiology, Washington University Medical Center, Mallinckrodt Institute of Radiology, St Louis, MO 63110, USA. hovsepian@mirlink.wustl.edu
D M
DM
Hovsepian
J R
JR
Steele
C S
CS
Skinner
E S
ES
Malden
D018784:Abdominal Abscess / Q000523:psychology / Q000628:therapy*; D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000295:instrumentation* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010388:Pelvis; D012007:Rectum; D012189:Retrospective Studies; D018434:Sickness Impact Profile; D014621:Vagina