Tubo ovarian abscess as the name suggests is formation of abscess in ovary and the connecting fallopian tube. The condition occurs in women mainly during the reproductive age, between 20 to 40 years. It is not a common pelvic disorder. Only ten in one million women are known to suffer from it. There are several factors responsible for development of abscess with manifestation of various signs and symptoms.
Ovarian abscess is a serious condition and it needs immediate treatment. Delay in treating the condition can lead to several complications, some of which are life threatening such as sepsis.With advent of third generation antibiotics, most cases can be treated conservatively, however, large size abscess may require surgical drainage.
Common Causes Of Tubo Ovarian Abscess
Tubo ovarian abscess is a bacterial infection. The common causes associated with it are as follows:
- Bacterial infection moving up from the vagina is predominant cause for development of ovarian abscess. Various bacteria are known to cause pelvic inflammatory disease such as Nisseria gonorrhea, Chlamydia, E. coli etc. Any such organism can cause an abscess in ovary and connecting fallopian tube.
- It occurs in women between the ages of 20 to 40, that is during their reproductive age. Women who are sexually active are at increased risk to develop tubo ovarian abscess.
- Intrauterine device is also suspected causative factor. Often IUDs is associated with pelvic inflammatory disorder which can trigger an infection in the ovary and fallopian tube.
- Pelvic surgery or abdominal surgery for different reasons can increase the risk.
- There is an increased risk among women who are undergoing infertility treatment.
Signs And Symptoms Of Tubo-Ovarian Abscess
Tubo ovarian abscess has several clinical characteristics. With the help of other diagnostic tools such as sonogram, CT scan, blood tests, it becomes easy to differentiate it with other pelvic disorders. In majority of cases only one ovary and tube is affected.
- One of the main presentations of this disease is pain in pelvis and lower abdomen. More than ninety percent of patients complain of pain, which is excruciating, sharp and continuous.
- Pain is associated with systemic symptoms such as high fever, vomiting, malaise, headache etc.
- In most cases a mass can be felt through vaginal examination. An enlarged abscess can be felt even from outer aspect of pelvis.
- The affected area is tender to touch. Often patient does not allow the physician to examine due to pain.
- Bleeding or abnormal discharge from vagina, pain while passing urine and stool are other known symptoms of tubo ovarian abscess.
Complications Of Tubo Ovarian Abscess
Since last few decades complications arising from tubo ovarian abscess has significantly decreased, thanks to new generation antibiotics, good surgical skill, modern diagnostic tools such as CT scan, sonogram etc which can detect the disease at an early stage. However, few women may still remain susceptible to complications.
One of the serious complications is rupture of abscess. It can lead to sepsis which has high mortality rate. Long time complications such as infertility, chronic pain in pelvis, ectopic pregnancy, blood vessel thrombosis are present in some women even after recovering from tubo ovarian abscess.
Majority of small tubo ovarian abscess heal with intravenous antibiotic treatment. Cases of large abscess may require to be drained surgically.