Predictive risk factors for occurrence of tubo-ovarian abscess in patients with ovarian endometriosis: a prospective comparative study

A.M. Abdou, A.M. Fahmy, O.A. Harb, A.R.E.S. Abdel-Razik
In: Italian Journal of Gynaecology and Obstetrics · 2022 · vol. 35(02) , pp. 196 · doi:10.36129/jog.2022.57 · W4294238226
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Spontaneous ovarian cyst rupture, history of pelvic inflammatory disease, and lower genital tract infections are predictive risk factors for tubo-ovarian abscess in patients with ovarian endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This prospective comparative case-control study evaluated 200 surgically treated women with ovarian endometriosis, comparing 80 with ovarian endometriosis complicated by tubo-ovarian abscess (OE-TOA) versus 120 with ovarian endometriosis without TOA, using demographic and clinical variables including prior PID, spontaneous rupture of endometriosis-related ovarian cysts, and lower genital tract infections. The study found significant associations between OE-TOA and spontaneous rupture of ovarian cysts and history of PID, with these factors independently increasing TOA risk (odds ratios reported as 2.819 and 2.547 folds, respectively), and also reported more lower genital tract infections in the OE-TOA group (66.7% vs 33.3%). A key limitation is that the study’s design is case-control within a surgical cohort selected by presence of an adnexal mass and detected pus, which may limit generalizability to all ovarian endometriosis patients. This paper is centrally about endometriosis — it specifically investigates predictive risk factors for tubo-ovarian abscess occurring in patients with ovarian endometriosis.

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Abstract

Objective. To assess demographical and clinical criteria of patients with tubo-ovarian abscesses (TOAs) to evaluate predictive risk factors of occurrence of ovarian endometriosis-tubo-ovarian abscess (OE-TOA). Patients and Methods. In the current case control comparative study, 200 patients with OE were included and divided into the first group (the case) (composed of 80 patients with OE-TOA) and the second group (the control) (composed of 120 patients with OE but no TOA). Then we compared between both groups regarding all parameters. Results. There is statistically significant relation between occurrence of combined OE and TOA and spontaneous rupture of ovarian cyst (p = 0.026), history of PID (p = 0.26) and presence of DM (p = 0.32). Spontaneous rupture of ovarian cyst and history of PID are significantly associated with combined OE and TOA. Lower genital tract infections were diagnosed in 8 (66.7%) of patients in the first group (OE-TOAs) and were diagnosed in only 4 (33.3%) patients with OE without TOAs (p = 0.042). History of spontaneous rupture of OE cyst and PID independently increased risk of TOA+ OE by 2.819 and 2.547 folds, respectively. Conclusions. We found that predictive risk factors of OE-TOA were rupture of OE cysts spontaneously in addition to lower genital tract infections, low immunity and neglected pelvic inflammatory diseases.

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Condition tags

endometriosis

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