| The Predictive Factors that Determines the Surgical Intervention in Tubo-Ovarian Abscess Patients. |
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Hyeok Heo, Do Gyun Kim |
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Department of Obstetrics and Gynecology, Dongguk University College of Medicine, Kyung-ju, Korea. |
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| Abstract |
OBJECTIVE
To assess what are the predictive factors that differentiate between medical and surgical group and, to determine the group that can be treated more efficiently with early surgical intervention than with conservative medical management. METHODS: Clinical and epidemiologic factors from the medical records of 85 selected patients who had either medical (n=52) or surgical (n=33) treatments for Tubo-ovarian abscess in Dongguk university hospital from February 1998 to May 2003 were evaluated retrospectively. RESULTS: Prognosis was predictable on the basis of response to the medical therapy and the extent of the disease at the time of the diagnosis. There was apparent association with the age, parity factors and CRP values where higher the variables, surgical intervention was needed. Same results were obtained with the large size of the abscess according to the sonography and the usage of the intrauterine devices (p<0.005). No statistical significance was noted, however, with leukocytosis, ESR, previous PID or D and C history, or high body temperatures (all ranging p>0.05). CONCLUSION: Medical therapy in the patients with high parity or old age is most likely to fail if the size of the abscess is more than 6 cm, increased CRP value or using IUD as a contraceptive. These prognostic factors should be considered in the early surgical interventions to prevent the subsequent complications from the delay of treatments and also to reduce the duration. |
| Key Words:
Tubo-ovarian abscess |
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