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Objective: The aim of the current study was to report our experience on the use of ultrasonographically guided transvaginal aspiration of tuboovarian abscesses presenting with the clinical picture of acute pelvic inflammatory disease.
Methods: A retrospective analysis of 21 patients with the clinical and radiologic diagnosis of tuboovarian abscess was performed. Tuboovarian abscess were treated by transvaginal ultrasound guided aspiration of the abscess and followed by intracavitary instillation of a combination of antibiotics with intravenous injection therapy.
Results: Among 21 patients, 19 patients were improved clinically and could avoid the need of laparotomy or lapasoscopy. But two patients required the operation because of persistent symptoms. In all 19 patients, laboratory tests were improved and fever was controlled significantly at post aspiration 1 day. The average volume of pus drained was 125 mL (range 20-300, SD ±89.1 mL). The mean time from aspiration to afebrile condition was 1.8 days (range 1-5, SD ±1.4 days) and mean time from aspiration to hospital discharge was 5.2 days (range 1-13, SD ±3.3 days) with mean duration of hospitalization 7.3 days (range 1-14, SD ±3.6 days). No major complications or recurrence were observed. In Two cases, culture positive in asipiration material.
Conclusion: Ultrasonographically guided transvaginal aspiration of tuboovarian abscesses in patients with acute pelvic inflammatory disease and abscess cavity is a simple, safe, effective procedure that avoided the need for laparoscopy or laparotomy.