Patients with Pelvic Inflammatory Disease vs. Tuboovarian Abscess: Comparison of Follow-Up and Treatment Processes

Background: Pelvic inflammatory disease (PID) is an infection of the upper vaginal tract in women that can be subclinical or severe, affecting any or all of the uterus, fallopian tubes, and ovaries. Tuboovarian abscess (TOA) is a common consequence of PID. The purpose of this study is to compare the demographic features, symptoms, clinical findings, and treatment techniques of patients hospitalized with the diagnosis of PID and TOA, to assess their response to treatment protocols and therapy, and to evaluate the development of recurrence. Methods: The study, a descriptive retrospective cohort analysis, included 318 patients with PID and TOA who were admitted to the Gynecology Clinic of the University of Health Sciences Etlik Zubeyde Hanim Women’s Health Training and Research Hospital between January 1, 2016 and August 1, 2019. Results: In terms of age, gravida, parity, BMI, educational background, profession, comorbidities, and previous PID attacks, there were no statistically significant differences between the PID and TOA groups. Among birth control techniques, the TOA group had a higher rate of intrauterine device usage, infection indicators (white blood cell, C-reactive protein, and erythrocyte sedimentation rate), and smoking. The PID group had a significantly greater prior history of uterus surgery. While the patients’ symptoms and length of complaints were comparable in both groups, the duration of antibiotherapy was statistically longer in the TOA group. Conclusion: The incidence of active smoking and the mean hospitalization day were found to be considerably higher in the TOA group, which was consistent with the literature in our series. In the literature, the most risky period for the development of PID was stated to be 21 days after the insertion of an intrauterine device, whereas in our study, it was determined that 20.8 percent of the acute PID group and 47.7 percent of the TOA group had an intrauterine device, and that these patients had long-term use of intrauterine devices. Although there is evidence that laparoscopic surgery may be performed successfully in TOA surgery, most surgeons prefer laparotomy. In our series, the rate of minimally invasive surgery was 88 percent. The study’s strength is that it is the biggest single-center cohort investigation of hospitalized PID and TOA patients, comparing demographic and physical features, symptoms and signs, clinical course, treatment procedures, and followup methods. There have been few studies in this area, and the number of cases is fewer than in our series. Our study’s limitations include the fact that it is retrospective, and not all diagnoses can be validated by culture.