Endometriosis is a risk factor for recurrent pelvic inflammatory disease after tubo-ovarian abscess surgery.

Zografou Themeli, Maria; Nirgianakis, Konstantinos; Neumann, Stephanie; Imboden, Sara; Mueller, M D (2023). Endometriosis is a risk factor for recurrent pelvic inflammatory disease after tubo-ovarian abscess surgery. Archives of gynecology and obstetrics, 307(1), pp. 139-148. Springer-Verlag 10.1007/s00404-022-06743-6

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PURPOSE

To evaluate the clinical outcomes and prognosis of patients undergoing laparoscopic surgery for tubo-ovarian abscess (TOA) and identify risk factors for pelvic inflammatory disease (PID) recurrence.

METHODS

We conducted a retrospective cohort analysis including 98 women who underwent laparoscopic surgery for TOA at the Department of Obstetrics and Gynecology at the Bern University Hospital from January 2011 to May 2021. The primary outcome studied was the recurrence of PID after TOA surgery. Clinical, laboratory, imaging, and surgical outcomes were examined as possible risk factors for PID recurrence.

RESULTS

Out of the 98 patients included in the study, 21 (21.4%) presented at least one PID recurrence after surgery. In the univariate regression analysis, the presence of endometriosis, ovarian endometrioma, and the isolation of E. coli in the microbiology cultures correlated with PID recurrence. However, only endometriosis was identified as an independent risk factor in the multivariate analysis (OR (95% CI): 9.62 (1.931, 47.924), p < 0.01). With regard to the time of recurrence after surgery, two distinct recurrence clusters were observed. All patients with early recurrence (≤ 45 days after TOA surgery) were cured after 1 or 2 additional interventions, whereas 40% of the patients with late recurrence (> 45 days after TOA surgery) required 3 or more additional interventions until cured.

CONCLUSION

Endometriosis is a significant risk factor for PID recurrence after TOA surgery. Optimized therapeutic strategies such as closer postsurgical follow-up as well as longer antibiotic and hormonal therapy should be assessed in further studies in this specific patient population.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Zografou Themeli, Maria, Nirgianakis, Konstantinos, Neumann, Stephanie, Imboden, Sara, Mueller, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0932-0067

Publisher:

Springer-Verlag

Language:

English

Submitter:

Pubmed Import

Date Deposited:

31 Aug 2022 10:52

Last Modified:

13 Jan 2023 00:12

Publisher DOI:

10.1007/s00404-022-06743-6

PubMed ID:

36036826

Uncontrolled Keywords:

Chronic pelvic abscess Endometriosis Ovarian endometrioma Pelvic inflammatory disease Recurrence Tubo-ovarian abscess

BORIS DOI:

10.48350/172479

URI:

https://boris.unibe.ch/id/eprint/172479

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