A Clinical and Risk Factor Profile of Patients With Tubo-Ovarian Abscesses: A Retrospective Study From Two District...

A tubo-ovarian abscess (TOA) represents a severe complication of pelvic inflammatory disease requiring prompt recognition and appropriate management. The decision between medical and surgical intervention remains complex, with various factors influencing treatment outcomes. This study aimed to describe the demographic and clinical characteristics of patients presenting with tubo-ovarian masses and identify predictors for surgical intervention while recording treatment outcomes.

This retrospective observational study analyzed 69 patients with tubo-ovarian masses treated at two district hospitals in the United Kingdom. All patients initially received broad-spectrum intravenous antibiotics, with surgical intervention reserved for those who failed to respond after 72 hours. Demographic characteristics, clinical parameters, laboratory findings, and treatment outcomes were extracted from electronic medical records. Statistical analysis was performed using Statistical Product and Service Solutions (SPSS, version 25.0; IBM SPSS Statistics for Windows, Armonk, NY), with chi-square tests for categorical variables and Mann-Whitney U tests for continuous data.

The mean age was 42.1±11.1 years, with 39 patients being obese (56.5%). Risk factors included smoking (n=8, 11.6%), intrauterine device (IUD) use (n=12, 17.4%), and diabetes (n=4, 5.8%). Eighteen patients (26.1%) required surgical intervention after failed medical management. Patients requiring surgery had significantly larger abscess size (p=0.036), higher fever prevalence (p=0.045), elevated C-reactive protein (CRP) levels (p=0.004), and longer hospital stays (p<0.001). There were six patients with an early recurrence rate within 45 days (8.7%), with no significant difference between management groups (p=0.647).

Larger abscess size, presence of fever, and elevated CRP levels are significant predictors of surgical intervention in TOA management. The study population demonstrated an older age profile and high obesity prevalence. These findings provide objective clinical indicators to guide treatment decision-making and optimize patient outcomes in TOA management.