Analysis of risk factors predicting surgery in cases with tubo-ovarian abscess

Abstract

AimThis study aimed to evaluate the success rate of medical treatment and to determine the risk factors predicting the need for surgery in cases diagnosed with tubo-ovarian abscess (TOA).MethodA total of 62 patients diagnosed with TOA at a tertiary referral hospital were involved in this case-control study. Two groups were formed: Patients who received medical treatment only (Group 1, n=53) and those who underwent surgery while receiving medical treatment (Group 2, n=9). Multiple logistic regres-sion analysis was performed to determine the risk factors predicting the need for surgical treatment.ResultsThe success rate of the medical treat-ment without surgery was determined as 85.5%. The following risk factors on admission were found to be statistically significantly associated with a need for surgical treatment: presence of fever (>38.0 ̊C) (OR:2.9; 95% CI 1.6-5.2; p=0.001), WBC count ≥ 18.000 cells/mm³ (OR: 20.1; 95% CI 3.4-66.5; p=0.000), abscess diameter ≥ 7 cm (OR:9.4; 95% CI 5.1-17.3; p=0.001), and CRP level ≥ 70 mg/dL (OR: 3.8; 95% CI 2.2-9.8; p=0.003).ConclusionIn the present study, the success of medical treatment in cases with TOA was found to be fairly high. Therefore, except in cases of acute abdomen findings, medical treatment without surgery can be preferred as the initial treatment choice in TOA. In TOA cases with high WBC count and high abscess diameter on admission, surgical treatment can be the preferred first choice as these were found to be the major risk factors associated with the requirement for surgery.

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