What is A Tubo-ovarian Abscess?
Tubo-ovarian abscess is the accumulation of pus in the anatomic space and in this case, the fallopian tubes and/or ovaries. It is also one of the causes that contribute to female infertility.
It is a form of PID (Pelvic Inflammatory Disease) that is caused by many factors, and one of the most common causes is the sexually transmitted disease.
What causes It?
It is important to determine the causes of tubo-ovarian abscess, so the right treatment can be done, including its appropriate preventive measures.
The cause of Tubo-Ovarian Abscess is multifactorial. The following causes vary from one person to the other:
- Microorganisms – one or more microorganisms can cause abscess formation and can spread in the lower genital tract and into the fallopian tubes and/or ovaries. One of the most common microorganisms causing tubo-ovarian abscess is Actinomyces Israelli.
- STD (Sexually Transmitted Disease) – caused by poor sexual practices and multiple partners
- Douching – can lower the pH or acidity of the vagina that can help in fighting infection and other microorganisms.
- IUD (Intrauterine Device) – a form of contraceptive that is secured in the uterus.
- Complication from surgery – 2 – 3 weeks pelvic or genital surgery, a complication may arise.
Signs and Symptoms
- Vaginal discharge – can cause itchiness and irritation in the vaginal opening and can be foul-smelling.
- Bleeding – bleeding may be more than the usual amount of blood during menstruation. Dysmenorrhea or pain in the abdomen during menstruation can be much severe prior to the development of tubo-ovarian abscess. Menstrual cycle may also be altered, resulting to delayed menses. There can also be bleeding even though it is not the menstrual date.
- Pain – acute or chronic pain may be felt in the lower abdomen that can radiate to the back. Pelvic pain may also be present or may be on both or either sides of the fallopian tubes or ovaries.
- Fever and chills – temperature can rise due to the underlying illness. This can indicate severe infection.
- Urinary tract infection – can be from the vaginal discharge. Urination may be frequent, painful and may have a burning sensation.
How is the infection diagnosed?
Thorough physical exam is also performed to women with tubo-ovarian abscess. This includes an internal exam to assess the vagina for any growth or mass. A vaginal speculum may also be inserted to get a clear view of the cervix.
Apart from physical examination, diagnostic tests will also be performed. Due to today’s technology, we are able to discover illnesses and their exact location in the body. The damage or severity they have created can also be seen. Because of these diagnostic tests, an illness like tubo-ovarian abscess is prevented from worsening and affecting other nearby areas.
- Pap smear – done while the vaginal opening is retracted using a speculum, then a specimen (vaginal smear) is obtained using a sterile applicator. This is sent to laboratory to be assessed under the microscope to check for any infection and microorganisms present.
- Ultrasound – may be done as a pelvic ultrasound, or a transvaginal ultrasound. This will provide the image of the reproductive organs like the uterus, cervix, fallopian tubes and ovaries. The sizes of these organs will also be determined. Growths and other masses will be located as well.
- CT (Computed Tomography) scan – another kind of imaging test that provides a cross-sectional photograph of the organs. This test will detect any growth and blockage.
- MRI (Magnetic Resonance Imaging) – also a kind of a test that provides images of the body. The structures and other anatomical features of the body organs will be seen in MRI.
The patient’s medical history will be documented like her sexual practices. The partner may also be assessed. Any presence of IUD will be investigated. IUD is Intrauterine Device, a form of contraceptive that can be a cause of irritation in the uterus and the nearby organs.
What is the Treatment for Tubo-ovarian Abscess?
The usual treatment for tubo-ovarian abscess is oral antibiotics that last for 10 – 12 weeks. However, if there was no progress noted, then some interventions will be performed:
- Ultrasound-guided or CT scan-guided drainage – through the result of the ultrasound, a syringe with appropriate needle size will be inserted in the affected area to drain out the entire abscess.
- Incision and drainage – done under general anesthesia, wherein there is a small incision is made in the pelvic region right above the affected fallopian tube and/or ovary. This may be done in a conventional manner or through laparoscopic procedure (with the aid of small tubes with camera and will enter the incision created). A syringe will be used to drain the abscess or through the use of a suction tube. The abscess will be sent to the laboratory to determine the kinds of microorganisms present in it.
- Salphingo–oophorectomy – surgical removal of the affected fallopian tubes and ovaries.
How is it Prevented?
There are many preventive measures we can do to avoid acquiring tubo-ovarian abscess. One is by regularly visiting your Obstetrician. During the visit, the routine tests will be done such internal exam and pap smear.
The doctor may even prescribe a vaccine for you to prevent sexually transmitted diseases and other reproductive diseases such as cervical cancer.
Immediate action must be done right away once tubo-ovarian is discovered, to prevent it from rupturing and causing complications.
Taking care of ourselves will not only prevent tubo-ovarian abscess, but also other illnesses, and it all starts with awareness. Therefore, health education plays a big role in preventing us from contracting diseases. This includes contraceptives and safe sexual practices.