Surgical management of acute pelvic infection refractory to conservative therapy

Tubo‐ovarian abscess in the postmenopausal woman

“…In the last century there have been numerous reports on the treatment of tubo-ovarian abscesses, most of them published in the last 30 years [1,[3][4][5][6][7][8][9][10][11][12][13][14]. The latter reflect the changes in management from conservative medical treatment to aggressive operative intervention in women with ruptured TOA or pelvic abscesses unresponsive to antibiotics [1,[3][4][5][6][7][8][9][10][11][12][13][14][15]. Ten of 587 (1.7%) patients with TOA, described in 12 articles, were postmenopausal [3][4][5][6][7][8][9][10][11][12][13][14].In the past, the classical management of pelvic abscess was one of conservatism [15].…”

“…The latter reflect the changes in management from conservative medical treatment to aggressive operative intervention in women with ruptured TOA or pelvic abscesses unresponsive to antibiotics [1,[3][4][5][6][7][8][9][10][11][12][13][14][15]. Ten of 587 (1.7%) patients with TOA, described in 12 articles, were postmenopausal [3][4][5][6][7][8][9][10][11][12][13][14].In the past, the classical management of pelvic abscess was one of conservatism [15]. The indications for surgical intervention with an acute pelvic abscess were formerly quite limited [1]: (a) failure to respond to medical therapy; (b) a questionable diagnosis; (c) rupture; (d) evidence of an intraabdominal catastrophe; (e) associated suppurative…”

“…Therefore, the gynecologist and surgeon should be alert to this uncommon diagnosis in the elderly woman and be prepared for early surgical intervention.Tubo-ovarian abscesses (TOA) are considered a problem only during the childbearing years [1,2]. In the last century there have been numerous reports on the treatment of tubo-ovarian abscesses, most of them published in the last 30 years [1,[3][4][5][6][7][8][9][10][11][12][13][14]. The latter reflect the changes in management from conservative medical treatment to aggressive operative intervention in women with ruptured TOA or pelvic abscesses unresponsive to antibiotics [1,[3][4][5][6][7][8][9][10][11][12][13][14][15].…”

“…The latter reflect the changes in management from conservative medical treatment to aggressive operative intervention in women with ruptured TOA or pelvic abscesses unresponsive to antibiotics [1,[3][4][5][6][7][8][9][10][11][12][13][14][15]. Ten of 587 (1.7%) patients with TOA, described in 12 articles, were postmenopausal [3][4][5][6][7][8][9][10][11][12][13][14].…”