Outcomes of antibiotic therapy and transvaginal ultrasound-guided efficacy of transvaginal ultrasound-guided drainage in treating tubo-ovarian abscesses: Three case reports

Abstract

Background: To introduce minimally invasive methods for the successful treatment of tubo-ovarian abscesses (TOAs), an antibiotic regimen was considered the first line of treatment. However, in some cases, this approach fails, and another intervention (laparotomy or minimally guidance drainage) is required. Case Presentations: 3 women with a history of long-time infertility, all of them were candidates for in vitro fertilization referred to the obstetrics and gynecology department with similar manifestations. For these 3 cases (30–40 yr) the first approach was a broad-spectrum antibiotic therapy. In 2 cases the last step in treatment was transvaginal ultrasound guidance drainage, and in one case laparotomy was done after antibiotic regimen failure; however, in all of 3 cases the best results were seen in transvaginal ultrasound guidance drainage. Conclusion: Patients who have ovarian endometrioma and undergo an assisted reproductive technology cycle, as well as ovum pick up, increase the possibility of TOA occurrence in them. The use of transvaginal ultrasound guidance drainage approach for the treatment of TOA in selective cases, in addition to broad-spectrum antibiotics in patients might reduce their need for invasive treatment with laparotomy.

Keywords

• Abscess, Ovarian, Drainage, Ultrasonography, Endometrioma.