Treatment approaches in tubo-ovarian abscesses according to scoring system

The aim of this study was to define treatment modalities in tubo-ovarian abscesses (TOA) using a scoring system. As there is no scoring system for TAO there is still a controversy on the management. In our opinion, as there is no evidence based TAO management strategy, a scoring system is needed in the management of these patients. For this purpose we prospectively tried to define that may be useful for favoring a treatment modality and the effects of the parameters on the outcome.

The study group comprised of hundred and eighty-four patients hospitalized between May 2001 and June 2008. Patients were divided in three groups according to the treatment modality--laparotomy (group 1, n: 122), medical treatment, (group 2, n: 34), and laparoscopic surgery (group 3, n: 28). Antibiotic regimens or other means of treatment strategies were directed according to our scoring system.

Of the patients, 122 underwent laparatomy, 34 received medical treatment and 28 had operative laparoscopy. Intraoperative complications in the group of 122 patients who underwent laparatomy were bowel injury in 8 patients (6.5%) and ureteral injury in six (4.9 %). Fourteen patients (11.4 %) in the laparatomy group suffered from morbidity related to abdominal incision. In the laparoscopy group two patients (7.1 %) had bowel injury.

With this study, we propose a scoring system in TOA cases and define treatment strategies accordingly. According to the results of our study, laparoscopy serves the best treatment option. Medical treatment, despite longer follow up, may be suitable in well-selected cases (Tab. 3, Ref. 39). Full Text in free PDF www.bmj.sk.