Table 1 Literature review of tubo-ovarian abscess in post-menopausal women
From: Tubo-ovarian abscess with sepsis in a nonagenarian woman: a case report and literature review
No. | Patient number (Post-menopausal/Total) | Age (year) | Microorganism | Treatment | Treatment outcome | Conclusion | Ref. |
|---|---|---|---|---|---|---|---|
1 | 1/1 | 91 | Escherichia coli | Exploratory laparotomy with antibiotics | Successful and patient survived | TOA could occur in nonagenarian women, especially those who are immunocompromised, which requires timely management for a better prognosis | Our case |
2 | 1/1 | 55 | Clostridium perfringens | Exploratory laparotomy with hysterectomy | Successful and patient survived | Clostridium perfringens can cause adnexal infection in the absence of trauma | 8 |
3 | 1/1 | 71 | N/A | Exploratory laparotomy | Successful and patient survived | Chronic TOA may rupture or fistulize to adjacent organs into the ischiorectal space | 7 |
4 | 9/63 | Pre-menopausal: 26 Post-menopausal: 52 | N/A | Exploratory laparotomy | Successful and patient survived | An attempt at early recognition and surgical management of TOA is vital in post-menopausal women | 2 |
5 | 17/80 | Overall: 42 | Anaerobes; negative results | Exploratory laparotomy | Successful and patient survived | Fewer patients were hospitalized in Oslo for PID during the period of 2000–2002 compared with ten years earlier, but a higher percentage of patients had developed TOA compared with the first period (43% compared with 26%), indicating a changing clinical panorama of PID | 1 |
6 | 17/93 | Pre-menopausal: 34 Post-menopausal: 58 | N/A | Exploratory laparotomy | Successful and patient survived | For post-menopausal women with TOAs, pelvic malignancy should be excluded. Conservative treatment has no place during the menopause | 9 |
7 | 20/20 | N/A | N/A | Total hysterectomy | Successful and patient survived | Early detection and treatment of unruptured TOA had less surgery-related complications and had a shorter mean length of hospitalization | 10 |
8 | 25/296 | Overall: 34.5 ± 10.3 | N/A | Exploratory laparotomy; laparoscopic treatment; broad-spectrum antibiotics | Successful and patient survived | Post-menopausal status on admission were associated with a failed response to conservative treatment | 6 |
9 | 29/64 | Early laparoscopic: 39.0 Conventional: 38.9 | Escherichia coli Peptostreptococci baumanmii | Early laparoscopic treatment; conventional antibiotics | Successful and patient survived | Early laparoscopic treatment is associated with a shorter time of fever resolution, shorter hospitalization, and less blood loss compared with conventional treatment for TOA or pelvic abscess | 4 |
10 | 35/318 | Medical treatment: 35.6 ± 8.1 Medical + Surgical treatment: 37.3 ± 6.2 | N/A | Exploratory laparotomy with drainage tube; conventional antibiotics | Successful and patient survived | The TOA size, complex multi-cystic mass image, CRP, and ESR are useful indicators as to whether surgical treatment is required for the management of TOA | 5 |
11 | 39/144 | Pre-menopausal: 38.5 ± 7.7 Post-menopausal: 54.3 ± 8.1 | Group C Streptococcus | Exploratory laparotomy with antibiotics; drainage for premenopausal women only | One post-menopausal woman of TOA had malignancy, but no other women were diagnosed with cancer during a mean follow-up of 7.6 years | In post-menopausal women with TOA, the prevalence of concurrent pelvic malignancy was 2.6%, which is higher than in the general population, but lower than that reported in the literature; 44% were conservatively managed without any apparent cases of misdiagnoses of cancer | 3 |