Clinical characteristics and treatment outcomes of patients with tubo-ovarian abscess at a tertiary care hospital in Northern Taiwan

Kuo, Chien-Feng; Tsai, Shin‐Yi; Liu, Te-Chu; Lin, Cheng-Chih; Liu, Chang-Pan; Lee, Chun-Ming

doi:10.1016/j.jmii.2011.09.021

Cited by 19 publications

(20 citation statements)

References 14 publications

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“…Our data also indicate an association rate of 59%, which is compatible with that reported in the literature. Previous studies reported that the prolonged duration of hospitalization was required in patients with TOA who underwent drainage or surgery (12,13,17). Similarly, we found that the mean duration of hospitalization was significantly longer in patients who were surgically treated.…”

Section: Discussionsupporting

confidence: 78%

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The evaluation of risk factors for failed response to conservative treatment in tubo-ovarian abscesses

Akkurt¹,

Yalçın²,

Akkurt³

et al. 2015

J Turkish German Gynecol Assoc

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Objective:The aim of our study is to assess the risk factors for medical treatment failure and to predict the patients who will require the surgical therapy as well as to predict the factors affecting treatment success. Material and Methods:This was a cross-sectional study including 76 women with tubo-ovarian abscesses (TOA) who were either conservatively or surgically treated and were admitted to two gynecology units over a 4-year period. The demographic characteristics of the patients, gynecologic and obstetric histories, size and localization of abscesses were recorded. Gentamicin plus clindamycin treatment protocol was implemented for all patients. Ampicillin treatment was added in three patients with the positive culture of Actinomyces. Response to treatment was evaluated after 48-72 h. Patients who fail to respond to medical treatment required surgery or percutaneous drainage. We compared clinical and laboratory factors between the groups. Results:In surgery group, patients were significantly older than the others (44.9±5.4 versus 39.1±7.6 years). Fifty-six patients (74%) responded to antibiotics and 20 of the patients required surgical intervention. Patients treated with antibiotics were hospitalized for an average of 6.32±2.8 days versus 12.75±5.6 days for those who required surgery (p=0.021). Patients who were surgically treated had a mean size of TOA of 67.9±11.2 mm versus 53.6±9.4 mm for those treated with antibiotics alone (p=0.036). There were no significant differences between groups in laboratory parameters, except for initial white blood cell (WBC) counts. The complications of surgery included in descending order of frequency blood transfusions, surgical wound infections, bowel injury, and bladder injury. Conclusion:An increased size of pelvic mass, higher initial WBC counts, advanced age, and smoking were all associated with failed response to conservative treatment. It is important to identify the risk factors to distinguish patients who will respond to antibiotic therapy and those who will need a surgical treatment. Thus, the required early intervention can result in a reduction in the morbidity associated with TOA. (J Turk Ger Gynecol Assoc 2015; 16: 226-30) Keywords: Antibiotic therapy, pelvic abscess, surgery, tubo-ovarian abscesses Received: 01 July, 2015 Accepted: 06 August, 2015 Available Online Date: 02 November, 2015 The evaluation of risk factors for failed response to conservative treatment in tubo-ovarian abscesses Material and MethodsThis was a cross-sectional study including 76 women with TOA who were either treated conservatively (group 1) and surgically (group 2) and were admitted to two gynecology units over a 4-year period. The study was subject to local ethics committee's approval, and written informed consent was obtained from patients who participated in this study. All authors and the study protocol have complied with the World Medical Association Declaration of Helsinki regarding the ethical conduct of research involving human subjects. In this study, some of t...

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Section: Discussionsupporting

confidence: 78%

“…In a study, a higher CRP level was identified as an important indicator for surgery. However, the lymphocyte and WBC counts in the same study were not significantly elevated (17). Güngördük et al (18) showed that CRP and ESR levels were higher in surgically treated patients.…”

Section: Discussionmentioning

confidence: 72%

The evaluation of risk factors for failed response to conservative treatment in tubo-ovarian abscesses

Akkurt¹,

Yalçın²,

Akkurt³

et al. 2015

J Turkish German Gynecol Assoc

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show abstract

“…6,7 In the present study, 46% patients had undergone a surgery within six months and 30% patients had undergone a surgery over six months before TOA development, which was consistent with that reported in previous studies.…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies reported leukocyte counts and CRP levels of 11.500-16.000/mm 3 and 7.6-14 mg/dL, respectively, in patients undergoing medical treatment, and 14000-16700/mm 3 and 16.1-53.8 mg/dL, respectively, in patients undergoing surgical treatment, indicating that leukocyte counts and CRP levels of patients undergoing surgical treatment were higher than those of patients undergoing medical treatment. 7,12,[14][15][16] In the present study, the mean leukocyte count and CRP level of patients undergoing medical treatment were 11.850/mm 3 and 11.1 mg/dL, respectively, while those of patients undergoing surgical treatment were 13.780/mm 3 and 14.1 mg/dL, respectively, and those of patients undergoing USG-guided drainage were 14.870/mm 3 and 16.2 mg/dL, respectively. These findings indicated that leucocyte counts and CRP levels of patients undergoing surgical treatment were higher than those of patients undergoing medical treatment, which was consistent with that reported in previ- ous studies.…”

Section: Discussionsupporting

confidence: 46%

“…In the present study, the average age of patients with TOA compared with that reported in previous studies was 36.46 ±11.6 years. 6,7 An analysis of the history of IUD use and PID in patients with TOA showed that 29% patients had a history of PID and 7% had a history of IUD use. However, the percentage of patients with a history of IUD use was lower than that reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Ultrasound-Guided Drainage with Other Available Treatment Modalities for, Treatment of Tubo-Ovarian Abscess

Aydın¹,

Peker²,

Bademkıran³

et al. 2018

JCOG

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Complicated Pelvic Inflammatory Disease

Augustin

2023

Acute Abdomen During Pregnancy

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Clinical characteristics and treatment outcomes of patients with tubo-ovarian abscess at a tertiary care hospital in Northern Taiwan

Abstract: Patients with TOA who underwent surgery had a longer duration of hospitalization. Among the patients who underwent surgical intervention, those admitted to the emergency room had higher CRP levels and were more likely to be multiparous.

Cited by 19 publications

References 14 publications

The evaluation of risk factors for failed response to conservative treatment in tubo-ovarian abscesses

The evaluation of risk factors for failed response to conservative treatment in tubo-ovarian abscesses

Comparison of Ultrasound-Guided Drainage with Other Available Treatment Modalities for, Treatment of Tubo-Ovarian Abscess

Complicated Pelvic Inflammatory Disease

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