Transvaginal ultrasound-guided aspiration of pelvic abscesses.
OBJECTIVE
To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.


METHODS
A retrospective analysis of 27 pelvic abscesses in 22 consecutive women undergoing transvaginal drainage, including 13 tuboovarian abscesses (TOAs) and 14 postoperative abscesses (POAs). All patients received broad-spectrum intravenous antibiotics from the time infection was diagnosed to resolution of signs and symptoms. Chart review and examination of ultrasound files were utilized to extract demographic clinical, laboratory, and outcome data.


RESULTS
The mean age for the study group was 30 years old. Mean duration from diagnosis to drainage was 5.6 days (TOA) and 2.0 days (POA), P < 0.01. The mean diameter of the abscesses was 86 mm. The volume of purulent material drained ranged from 70-750 mL. Perceived adequacy of drainage was correlated with lack of abscess septation. Cultures for aerobic and anaerobic pathogens were positive in 51% of cases (79% POA versus 23% TOA, P < 0.05) with 1.9 organisms/ positive culture. Transvaginal drainage was successful in 25 of 27 abscesses. No complications were reported.


CONCLUSIONS
In skilled hands, transvaginal guided aspiration of pelvic abscess is a highly successful technique with minimal risk to the patient. Follow-up studies are needed to assess the long-term sequelae, such as frequency of infertility, ectopic pregnancy, and chronic pelvic pain.
Corsi
P J
PJ
Department of Obstetrics and Gynecology, Wayne State University School of Medicine and the Detroit Medical Center, MI, USA.
Johnson
S C
SC
Gonik
B
B
Hendrix
S L
SL
McNeeley
S G
SG
Diamond
M P
MP
D000038:Abscess / Q000000981:diagnostic imaging / Q000628:therapy*; D000328:Adult; D000368:Aged; D019160:Endosonography; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010049:Ovarian Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D000292:Pelvic Inflammatory Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D013396:Suction / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome