Kemal Güngördük1, Esra Guzel2, Osman Asicioğlu3, Gokhan Yildirim4, Guler Ataser2, Cemal Ark4, Sıdıka S Gulova3, Cihangir Uzuncakmak2. 1. Department of Obstetrics and Gynecology, Istanbul Training and Research Hospital, Istanbul, Turkey. Electronic address: maidenkemal@yahoo.com. 2. Department of Obstetrics and Gynecology, Istanbul Training and Research Hospital, Istanbul, Turkey. 3. Department of Obstetrics and Gynecology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey. 4. Department of Obstetrics and Gynecology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
Abstract
OBJECTIVE: To investigate the clinical and laboratory parameters, treatments, and complications of patient with tubo-ovarian abscess (TOA). METHODS: Data for 296 patients diagnosed with TOA (clinically and sonographically) between January 2005 and December 2012 were retrospectively reviewed at 3 tertiary referral hospitals in Turkey. Patients were compared on the basis of TOA size, demographic characteristics, clinical and sonographic presentation, and laboratory findings. RESULTS: Seventy-six patients (25.7%) underwent surgery because antibiotic treatment was unsuccessful. The mean abscess size was larger and the mean C-reactive protein (CRP) level and the erythrocyte sedimentation rate (ESR) were higher among patients who required surgery. The ESR had a diagnostic value of 83.6%, and a specificity and sensitivity of 73.7% and 82.7%, respectively, for the need for surgical intervention, based on a cut-off value of 63.0mm/hour. The CRP level had a diagnostic value of 80.4%, a specificity of 82.3%, and a sensitivity of 65.8% based on a cut-off value of 21.0mg/L. CONCLUSION: The combined use of the sonographic TOA diameter and laboratory parameters (ESR and CRP level) can aid clinical treatment decisions and improve the prediction of the outcome of medical TOA treatment.
OBJECTIVE: To investigate the clinical and laboratory parameters, treatments, and complications of patient with tubo-ovarian abscess (TOA). METHODS: Data for 296 patients diagnosed with TOA (clinically and sonographically) between January 2005 and December 2012 were retrospectively reviewed at 3 tertiary referral hospitals in Turkey. Patients were compared on the basis of TOA size, demographic characteristics, clinical and sonographic presentation, and laboratory findings. RESULTS: Seventy-six patients (25.7%) underwent surgery because antibiotic treatment was unsuccessful. The mean abscess size was larger and the mean C-reactive protein (CRP) level and the erythrocyte sedimentation rate (ESR) were higher among patients who required surgery. The ESR had a diagnostic value of 83.6%, and a specificity and sensitivity of 73.7% and 82.7%, respectively, for the need for surgical intervention, based on a cut-off value of 63.0mm/hour. The CRP level had a diagnostic value of 80.4%, a specificity of 82.3%, and a sensitivity of 65.8% based on a cut-off value of 21.0mg/L. CONCLUSION: The combined use of the sonographic TOA diameter and laboratory parameters (ESR and CRP level) can aid clinical treatment decisions and improve the prediction of the outcome of medical TOA treatment.