Safety of Transrectal or Transvaginal Drainage of Pelvic Abscesses

Abstract

Objective The literature on the safety and long-term sequelae of transrectal and transvaginal drainage of pelvic abscesses is limited. We evaluated the outcomes and safety of pelvic abscess drainage by interventional radiology at our institution. Methods After obtaining institutional review board approval, we retrospectively evaluated the outcomes of transrectal and transvaginal pelvic abscesses drainage using computed tomography, endorectal ultrasound, and or fluoroscopy. Results The study included 26 patients, with an age range of 24 to 88 years old, out of whom 53.8% were men. A total of 46.1% of the participants were African Americans and 26.9% were Caucasians. The average body mass index was 28.4 (range: 15.6 to 41.9). The most common etiology was penetrating abdominal injury (27%), followed by appendectomy (23%), diverticular disease (11.5%), anastomotic leak (11.5%), and disorders of gynecological causes (11.5%). The mean abscess diameter was 6.3 cm (range: 3.3 to 10.0 cm). Transrectal drainage was performed in all except one patient who had a transvaginal drainage. Transrectal ultrasound was used for drainage in 92.3% cases, and fluoroscopy was used as an additional imaging modality in 75% of the cases. An 8- or 10-Fr pigtail catheter was used in > 80% of the patients. Drains were removed between 2 and 7 days in 92.3% of the cases. The average follow-up was 30.4 months (range: 1 to 107 months), and no long-term complications were reported. Only one patient required subsequent operative intervention for an anastomotic leak. Conclusions Pelvic abscess drainage by transrectal route using radiological guidance is a safe and effective procedure.

Assessing the safety and effectiveness of trans-abdominal ultrasound-guided tube drainage for pelvic collections post-obstetrics and gynecological surgery

“…They also found that the only case that required an additional surgical drainage procedure was associated with comorbidity (the patient had a pelvic abscess from a post-ileal pouch-anal anastomosis leak). They also mentioned that the follow-up of this case did not present any significant long-term sequelae [9] . Regarding the number of cases included in our study, it is quite enough to conclude the data when compared to other studies.…”

“…Transvaginal drainage of pelvic collections clinical success rate may reach up to 100% [8] , but these methods are often under-used where expertise in techniques is limited. The availability of radiologists familiar with the technique, concern about the effectiveness, and long-term complication is likely to be reasons for the limited use of these procedures [9] . Our result is comparable to similar trials in literature.…”

Safety and effectiveness of transperineal puncture guided by a biplane intracavitary ultrasonic probe in the treatment of male rectovesical pouch effusion

“…After the puncture, the patient's indicators signi cantly improved. More importantly, to avoid intestinal stula development, ne needle aspiration is often used instead of catheter drainage during transrectal puncture, but for patients with large lesions volumes, multiple procedures are often needed to achieve satisfactory results 21,22 . In this study, catheter drainage through the perineum was used for the treatment of rectovesical pouch effusion.…”