Skip to main content
SpringerLink
Log in

Is intrauterine device a risk factor for failure of conservative management in patients with tubo-ovarian abscess? An observational retrospective study

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Tubo-ovarian abscess (TOA) is a serious and potentially life-threatening complication of pelvic inflammatory disease (PID). TOA formation may be an uncommon, but serious complication associated with the use of an intrauterine device (IUD). While the majority of TOA respond to antibiotic therapy, in approximately 25% of cases surgery or drainage is indicated. In the present study, we compared the failure rate of conservative management in patients with and without IUD, who were admitted with a diagnosis of TOA.

Methods

In this retrospective case–control study, 78 women were diagnosed with TOA. All patients were treated initially by broad-spectrum intravenous antibiotics. The failure of conservative management after 72 h was followed by surgical intervention.

Results

The patients were divided into two groups: 24 patients were IUD-carriers, and 54 did not use IUD. There was no significant difference in surgical intervention rate between IUD group (50%) and no-IUD group (43%), p = 0.32. The WBC count was significantly higher in IUD-carriers diagnosed with TOA than in patients without IUD (16.5 ± 6.6 vs. 13.1 ± 4.6, p = 0.001). The patients with IUD had significantly larger abscesses as revealed by ultrasound than patients without IUD (61.6 ± 21.4 vs. 49.6 ± 20.6 mm, p = 0.02).

Conclusion

The surgical intervention rate in TOA patients with and without IUD was similar.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Granberg S, Gjelland K, Ekerhovd E (2009) The management of pelvic abscess. Best Res Clin Obstet Gynaecol 23(5):667

    Article  Google Scholar 

  2. Sorbiye IK, Jerve F, Staff AC (2005) Reduction in hospitalized women with pelvic inflammatory disease in Oslo over the past decade. Acta Obstet Gynecol Scand 84(3):290

    Article  Google Scholar 

  3. Pedowitz P, Bloomfield RD (1964) Ruptured adnexal abscess with generalized peritonitis. Am J Obstet Gynecol 88:721

    Article  CAS  PubMed  Google Scholar 

  4. Rosen M, Breitkopf D, Waud K (2009) Tubo-ovarian abscess management options for women who desire fertility. Obstet Gynecol Surv 64(10):681

    Article  PubMed  Google Scholar 

  5. Wiesenfeld HC, Sweet RL (1993) Progress in the management of tubo-ovarian abscesses. Clin Obstet Gynecol 36(2):433

    Article  CAS  PubMed  Google Scholar 

  6. Landers DV, Sweet RL (1983) Tubo-ovarian abscess: a contemporary approach to management. Rev Infect Dis 5:876–884

    Article  CAS  PubMed  Google Scholar 

  7. Chappell C, Wiesenfeld HC (2012) Pathogenesis, diagnosis, and management of severe pelvic inflammatory disease and tubo-ovarian abscess. Clin Obstet Gynecol 55(4):893–903

    Article  PubMed  Google Scholar 

  8. Scott WC (1978) Pelvic abscess in association with intrauterine contraceptive device. Am J Obstet Gynecol 131(2):149

    Article  CAS  PubMed  Google Scholar 

  9. Toglia MR, Schaffer JI (1996) Tubo-ovarian abscess formation in users of intrauterine device remote from insertion: a report of three cases. Infect Dis Obstet Gynecol 4:85–88

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Levenson RB, Pearson KM, Saokar A, Lee SI, Mueller PR, Hahn PF (2011) Image-guided drainage of tuboovarian abscesses of gastrointestinal or genitourinary origin: a retrospective analysis. J Vasc Interv Radiol 22:678–686

    Article  PubMed  Google Scholar 

  11. Granberg S, Gjelland K, Ekerhovd E (2009) Best practice and research. Clin Obstet Gynecol 23(5):667–678

    Google Scholar 

  12. Kuo CF, Tsai SY, Liu TC, Lin CC, Liu CP, Lee CM (2012) Clinical characteristics and treatment outcomes of patients with tubo-ovarian abscess at a tertiary care hospital in Northern Taiwan. J Microb Immun Infect 45:58–64

    Article  Google Scholar 

  13. Greenstein Y, Shah AJ, Vragovic O, Cabral H, Soto-Wright V, Borgatta L, Kuohung W (2013) Tuboovarian abscess. Factors associated with operative intervention after failed antibiotic therapy. J Reprod Med 58(3–4):101–106

    CAS  PubMed  Google Scholar 

  14. Halperin R, Levinson O, Yaron M, Bukovsky I, Schneider D (2003) Tubo-ovarian abscess in older women: is the women’s age a risk factor for failed response to conservative treatment? Gynecol Obstet Invest 55(4):211–215

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Health Sciences, Barzilai Medical Center, Ben-Gurion University of Negev, HaHistadrut Street 2, Ashkelon, Israel

    Victoria Kapustian, Ahmet Namazov, Odeliya Yaakov, Michael Volodarsky, Eyal Y Anteby & Ofer Gemer

Authors
  1. Victoria Kapustian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmet Namazov
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Odeliya Yaakov
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Volodarsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eyal Y Anteby
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ofer Gemer
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

VK: manuscript writing-editing, data analyzing. AN: manuscript editing, data analyzing. OY: data collection. MV: data collection. EA: supervisor. OG: supervisor, project administration, manuscript editing, data analyzing.

Corresponding author

Correspondence to Ahmet Namazov.

Ethics declarations

Conflict of interest

We have no potential conflict of interest to declare.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

The study was designed as a retrospective study. All data were collected anonymously. The Ethical board waived informed consent.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kapustian, V., Namazov, A., Yaakov, O. et al. Is intrauterine device a risk factor for failure of conservative management in patients with tubo-ovarian abscess? An observational retrospective study. Arch Gynecol Obstet 297, 1201–1204 (2018). https://doi.org/10.1007/s00404-018-4690-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-018-4690-z

Keywords

Search

Navigation