Pyometra. What is its clinical significance?
OBJECTIVE
To evaluate the clinical outcomes of pyometra.


METHODS
Retrospective study conducted between 1993 and 1999 in two regional hospitals.


RESULTS
Pyometra represented 0.038% of gynecologic admissions. Of the 27 women with pyometra, 6 (22.2%) cases were associated with malignancy, 1 (3.7%) was associated with genital tract abnormality, and 20 (74.1%) were idiopathic. Patients with idiopathic pyometra tended to be older and had a higher incidence of concurrent medical conditions. Five (18.5%) women experienced spontaneous perforation of pyometra. A preoperative diagnosis was correctly made in 17 of 22 (77.3%) patients without spontaneous perforation. Most women were treated with dilatation of the cervix and drainage. Nine women (33.3%) had persistent or recurrent pyometra; three of them were asymptomatic.


CONCLUSIONS
Pyometra is an uncommon condition, but the incidence of associated malignancy is considerable, and the risk of spontaneous perforation is higher than previously thought. Dilatation and drainage is the treatment of choice, and regular monitoring after initial treatment is warranted to detect persistent and recurrent disease.
Chan
L Y
LY
Department of Obstetrics and Gynaecology, Princes of Wales Hospital, Chinese University of Hong Kong, Princess Margaret Hospital, Shatin, Hong Kong. lyschan@netvigator.com
Lau
T K
TK
Wong
S F
SF
Yuen
P M
PM
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004107:Dilatation and Curettage; D004322:Drainage; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D014594:Uterine Neoplasms / Q000209:etiology* / Q000503:physiopathology; D014597:Uterine Rupture / Q000209:etiology* / Q000503:physiopathology