US-guided transvaginal drainage of pelvic abscesses and fluid collections

Ultrasound (US)-guided transvaginal needle or catheter drainage was performed in 14 women for a variety of pelvic abscesses and fluid collections; tubo-ovarian abscesses and postoperative collections were most common. Diagnosis was achieved in all 14 patients (100%), including one patient with suspected ovarian carcinoma who underwent only diagnostic needle aspiration and no therapeutic drainage. Abscesses or fluid collections were evacuated in 13 of 13 patients (100%) with either needle (n = 7) or catheter (n = 6) drainage (with appropriate antibiotics). Twelve of the 14 patients (86%) were spared an operation; surgery was undertaken in two patients for a persistent tubo-ovarian phlegmon. No major complications were associated with drainage. Catheters were removed an average of 6.7 days after insertion. The success, safety, and advantages of US-guided transvaginal drainage in our early experience suggest its use as an alternative to standard percutaneous catheter procedures to diagnose and drain certain pelvic abscesses and fluid collections.