Take anti-inflammatory medicines to reduce pain. These include ibuprofen (Advil, Motrin) and naproxen (Aleve). Be safe with medicines.
Full Answer
What causes an ovarian abscess?
What increases my risk for an ovarian abscess?
- Pelvic inflammatory disease (PID)
- Unprotected sex, sex with more than one partner, or sex during adolescence
- Anything that weakens your immune system, such as diabetes, HIV/AIDS, or chemotherapy
- Infertility treatment that involved stimulating your ovaries
- Diverticulitis, appendicitis, or inflammatory bowel disease
What to expect with ovarian cancer treatment?
You are likely to have several tubes in place, which will be removed as you recover:
- a drip inserted into a vein in your arm (intravenous drip) will give you fluid, medicines and pain relief
- a small plastic tube (catheter) may be inserted into your bladder to collect urine in a bag
- a tube may be inserted down your nose into your stomach (nasogastric tube) to drain stomach fluid and prevent vomiting
What is the treatment for most ovarian cysts?
Your treatment may include:
- IV (intravenous) fluids to replace lost fluid
- Careful monitoring of your heart rate and other vital signs
- Monitoring of your red blood cell level (hematocrit) to check the blood’s ability to carry oxygen
- Repeated ultrasounds to check for bleeding into your belly
- Surgery for a worsening medical condition or to check for cancer
What is treatment for abdominal abscess?
- Blood tests. Blood may be drawn to look for signs of infection or an intra-abdominal abscess. ...
- Imaging tests. The best imaging test to check for an abscess is typically a computerized tomography or CT scan to see inside the belly. ...
- Physical exam. ...
How many women have TOA?
Around 15–35% of women being treated for proven PID will be diagnosed with a TOA. 2, 10, 11 It is not clear why there is a progression from PID to a TOA; a delay in treatment of PID is highly likely but virulence of the causative pathogen might make a TOA more likely. 2 Halperin et al. 12 demonstrated that women aged around 45 years are more likely to have a larger abscess with higher inflammatory markers than younger women who paradoxically have more risk factors. Women with co-existing endometriosis are more likely to have more severe PID and TOA. Kubota et al. 13 found that the incidence of a TOA was 2.3% in women with co-existing PID and endometriomas compared with 0.2% in women without endometriomas. The aetiology of endometriosis may be in part immune dysfunction; this could explain the association between TOAs and endometriosis. Alternatively, it could be possible that the walls of endometriomas are more susceptible to bacterial invasion than healthy ovarian cortex or that the presence of blood in an endometrioma acts a good culture medium for pathogens. There is a risk of a TOA secondary to oocyte retrieval in women with endometriomas undergoing in vitro fertilisation but the European Society of Human Reproduction and Embryology suggests that this risk is low and that antibiotic prophylaxis is not essential. 14
What is tubo ovarian abscess?
Tubo-ovarian abscess (TOA) is a recognised and serious complication of untreated pelvic inflammatory disease (PID). It most commonly affects women of reproductive age and nearly 60% of women with TOA are nulliparous. 1 TOA is defined as an inflammatory mass involving the tube and/or ovary characterised by the presence of pus. The most common cause is ascending/upper genital tract infection when purulent material can discharge through the tube directly into the peritoneal cavity causing initial PID and progression to form a TOA. 2 The infection can occasionally involve other adjacent organs such as the bowel and bladder. TOA carries a high morbidity and can be life threatening. When associated with severe systemic sepsis, the mortality rate is reported to be as high as 5–10%. 3 The diagnosis is made when the clinical findings are associated with raised inflammatory markers and radiological findings demonstrating a mass. Surgical intervention may be indicated but optimal timing and the most appropriate procedure is unclear. Techniques include laparoscopic versus open surgery and drainage of abscess versus radical excision. Potential long-term consequences of a TOA include infertility, an increased risk of ectopic pregnancy and chronic pelvic pain. 4, 5
How effective is TOA treatment?
Medical treatment. Medical treatment of a TOA with antibiotics (Box 1) can be effective in up to 70% of patients but is associated with a high recurrence rate. 26 Initially, intravenous broad-spectrum antibiotics that cover the commonest causative pathogens are required.
What are the long term consequences of TOA?
Potential long-term consequences of a TOA include infertility, an increased risk of ectopic pregnancy and chronic pelvic pain. 4, 5.
How to treat a woman with a suspected TOA?
Initial management of the woman with a suspected TOA is dictated by clinical findings and ultrasound. In the presence of systemic sepsis (Table 2 ), appropriate resuscitation and prompt surgery, with concurrent commencement of broad-spectrum intravenous antibiotics, may be considered. The ‘sepsis six’ protocol should be followed: administer oxygen, take blood cultures prior to commencing antibiotics, commence intravenous antibiotics, measure serum lactate, commence intravenous fluids and accurately measure urine output. 25 In the event of an acute abdomen where rupture of an abscess is suspected, surgery may be necessary. If the woman is systemically well and/or clinically stable then consideration can be given to initial treatment with antibiotic therapy with delayed or possible avoidance of any surgical intervention. Figure 3 shows a flowchart with a suggested approach to the management of a woman with a TOA.
What causes a TOA in the peritoneal cavity?
The most common cause is ascending/upper genital tract infection when purulent material can discharge through the tube directly into the peritoneal cavity causing initial PID and progression to form a TOA. 2 The infection can occasionally involve other adjacent organs such as the bowel and bladder.
Why should there be a lower threshold for surgical intervention in postmenopausal women?
There should be a lower threshold for consideration of surgical intervention in postmenopausal women because of the risk of underlying malignancy. Protopapas et al. 36 showed that the incidence of associated malignancies was 47%; these included cervical, endometrial, ovarian and fallopian tube malignancies. TOAs in postmenopausal women are rare, with an incidence of 1.7% of all TOAs.
What is the treatment for tubo-ovarian abscesses?
The antibiotic treatment is indispensable for the treatment of the tubo-ovarian abscesses (TOA). It has to have a wide spectre and would be secondarily adapted in case of a sexually transmitted infection. The surgery remains indicated in first intention in case of vital threat (generalized peritonitis, toxic shock). In the not complicated TOA, the evacuation of abscesses (by draining under imaging or laparoscopy) with the antibiotic treatment gives better rates of cure than the antibiotic treatment alone. For the surgery, several entrys are possible. The laparoscopy allows a shorter hospitalization with fewer complications and a faster resolution of the fever than the laparotomy. The conservative surgery, realized by laparoscopy, has hight rates of successes with few complications. The radical surgery, by coelioscopy or by laparotomy, has high rates of complications. Transvaginal ultrasound guided aspiration is an alternative in the drainage by laparscopy with identical succes. It has been well evaluated. It has low morbidity and can be proposed in first intention in not complicated TOA.
Is antibiotic treatment necessary for tubo-ovarian abscesses?
The antibiotic treatment is indispensable for the treatment of the tubo-ovarian abscesses (TOA). It has to have a wide spectre and would be secondarily adapted in case of a sexually transmitted infection. The surgery remains indicated in first intention in case of vital threat (generalized peritonit …
What is the abscess in the fallopian tube?
An abscess that starts in a fallopian tube and spreads to the ovary is called a tuboovarian abscess (TOA). Less commonly, the abscess can start in the ovary and not involve the fallopian tube.
What is an ovarian abscess?
WHAT YOU NEED TO KNOW: An ovarian abscess is a pus-filled pocket in an ovary. An ovarian abscess is usually caused by bacteria that travel from another part of your body. The bacteria can also travel up your vagina and move into your uterus through your cervix. Bacteria infect the ovary or part of the fallopian tube next to the ovary.
Why do we give medicine?
Medicines may be given to prevent or fight a bacterial infection or to reduce pain. Ask your healthcare provider how to take pain medicine safely. Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects.
Diagnostic Considerations
Acute PID is difficult to diagnose because of the considerable variation in symptoms and signs associated with this condition. Women with PID often have subtle or nonspecific symptoms or are asymptomatic. Delay in diagnosis and treatment probably contributes to inflammatory sequelae in the upper genital tract.
Treatment
PID treatment regimens should provide empiric, broad-spectrum coverage of likely pathogens. Multiple parenteral and oral antimicrobial regimens have been effective in achieving clinical and microbiologic cure in randomized clinical trials with short-term follow-up ( 1171 – 1173 ).
Intramuscular or Oral Treatment
IM or oral therapy can be considered for women with mild-to-moderate acute PID because the clinical outcomes among women treated with these regimens are similar to those treated with IV therapy ( 1158 ). Women who do not respond to IM or oral therapy within 72 hours should be reevaluated to confirm the diagnosis and be administered therapy IV.
Other Management Considerations
To minimize disease transmission, women should be instructed to abstain from sexual intercourse until therapy is complete, symptoms have resolved, and sex partners have been treated (see Chlamydial Infections; Gonococcal Infections). All women who receive a diagnosis of PID should be tested for gonorrhea, chlamydia, HIV, and syphilis.
Follow-Up
Women should demonstrate clinical improvement (e.g., defervescence; reduction in direct or rebound abdominal tenderness; and reduction in uterine, adnexal, and cervical motion tenderness) <3 days after therapy initiation.
Management of Sex Partners
Persons who have had sexual contact with a partner with PID during the 60 days preceding symptom onset should be evaluated, tested, and presumptively treated for chlamydia and gonorrhea, regardless of the PID etiology or pathogens isolated.
Special Considerations
The risk for penicillin cross-reactivity is highest with first-generation cephalosporins but is negligible between the majority of second-generation (e.g., cefoxitin) and all third-generation (e.g., ceftriaxone) cephalosporins ( 619, 631, 653, 656) (see Management of Persons Who Have a History of Penicillin Allergy).