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A tubo-ovarian abscess (TOA) is one of the late complications of pelvic inflammatory disease (PID) and can be life-threatening if the abscess ruptures and results in sepsis. It consists of an encapsulated or confined pocket of pus with defined boundaries that forms during an infection of a fallopian tube and ovary .
A pyosalpinx is typically seen in a more acute stage of pelvic inflammatory disease and may be part of a tubo-ovarian abscess. Tubal phimosis refers to a situation where the tubal end is partially occluded, in this case fertility is impeded, and the risk of an ectopic pregnancy is increased.
In premenopausal women, adnexal masses include ovarian cysts, ectopic (tubal) pregnancies, benign or malignant tumors, endometriomas, polycystic ovaries, and tubo-ovarian abscess. The most common causes for adnexal masses in premenopausal women include follicular cysts and corpus luteum cysts .
A hematosalpinx from a tubal pregnancy may be associated with pelvic pain and uterine bleeding. A gynecologic ultrasound will show the hematosalpinx. A hematosalpinx from other conditions may be painless but could lead to uterine bleeding.
Treatment is with antibiotics and drainage of the abscess; typically guided by ultrasound or CT, through the skin, via the rectum, or transvaginal routes. [3] Occasionally antibiotics may be used without surgery; if the abscess is at a very stage and small. [2] Until sensitivities are received, a broad spectrum antibiotic is generally required. [2]
Laparoscopic identification is helpful in diagnosing tubal disease; a 65 percent to 90 percent positive predictive value exists in patients with presumed PID. [25] Upon gynecologic ultrasound, a potential finding is tubo-ovarian complex, which is edematous and dilated pelvic structures as evidenced by vague margins, but without abscess ...
Further, using fluoroscopy or hysteroscopy proximal tubal occlusion can be overcome by unilateral or bilateral selective tubal cannulation, a procedure where a thin catheter is advanced through the proximal portion of the fallopian tube os to examine and possibly restore tubal patency [8] salpinostomy (creating an opening for the tube) [9] or ...
Ectopic pregnancy, or tubal ectopic pregnancy, is a condition that occurs when a developing pregnancy implants outside of the uterus, such as in the fallopian tubes. [36] This condition is an emergency and can be fatal to the pregnant person. [36] Treatment usually involves a salpingectomy, or the removal of the affected fallopian tube. [36]