Association Between Endometriosis and Tubo-Ovarian Abscess

Background: Tubo-ovarian abcesses (TOAs) are complicating factors in approximately one-fourth of hospitalized cases of acute pelvic inflammatory disease (PID). However, many women with TOAs have no antecedent history of PID or sexually transmitted diseases. Moreover, it has not been fully elucidated that which risk factors are associated with TOA and TOAs will develop at whom. In recent studies, it has been questioned whether endometriosis is a risk factor for TOA. The purpose of the study was to identify the incidence of endometriosis in patients who have been surgically treated due to TOA and to search clinical-demographical differences among the groups with and without endometriosis. Methods: A total of 118 patients were divided into two groups according to pathologic results, whether endometriosis with TOAs was confirmed histologically, or not, and demographical-clinical characteristics were investigated. Results: The mean age of patients was 40.9 ± 8.5 years and 21 (17.8%) were postmenopausal. The intrauterine device was  in situ at the time of TOA diagnosis in 49 (41.5%) patients. Concomitant disease and previous pelvic surgery history were identified in 16 (13.6%) and 43 (36.4%) patients, respectively. Final histopathological analyses revealed endometriosis with TOA in 21 (17.8%) patients. When all patients were divided into two groups with and without endometriosis and compared according to clinical and demographical characteristics, there were not any significant differences identified (P > 0.05), except hemoglobin values (P = 0.039). Conclusion: Endometriosis with TOA is not only in reproductive period but also in menopause, more prevalent than expected for normal population. J Clin Gynecol Obstet. 2016;5(1):17-22 doi: http://dx.doi.org/10.14740/jcgo388w