Pelvic Inflammatory Disease in Virgin Women With Tubo-ovarian Abscess: A Single-Center Experience and Literature Review

Hyun-Woong Cho, Hyun‐Woong Cho, Yu‐Jin Koo, Yu-Jin Koo, Kyung-Jin Min, Kyung‐Jin Min, Jin Hwa Hong, Jin-Hwa Hong, Jae Kwan Lee, Jae-Kwan Lee
Journal of Pediatric and Adolescent Gynecology · 2015 · vol. 30(2) , pp. 203–208 · doi:10.1016/j.jpag.2015.08.001 · PMID:26260586 · W2200406743
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This single-center study reviewed cases of pelvic inflammatory disease in virgin women with tubo-ovarian abscess to describe their clinical characteristics and management.

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Abstract

STUDY OBJECTIVE: To evaluate the incidence of pelvic inflammatory disease (PID) in virgin women and investigate the clinical characteristics of the patients. DESIGN: Retrospective chart review and literature review. SETTING: Tertiary academic center. PARTICIPANTS: Virgin women who were confirmed to have PID via surgery from 2002 to 2014. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The evaluation of medicosurgical history, clinical progress, surgical record, and pathologic reports. RESULTS: Of 122 patients diagnosed with PID via surgery, 5 women were virgins (4.1%). The median age was 21 years (range, 14-24 years), and all patients presented with abdominal pain. The median diameter of the pelvic abscess pocket on preoperative imaging was 4.5 cm (range, 2.6-15 cm). Only 1 case was preoperatively diagnosed as a tubo-ovarian abscess; the others were expected to be benign ovarian tumors, such as endometrioma and dermoid cysts. No possible source of infection was identified for any patient, except 1 who had a history of an appendectomy because of a ruptured appendix. The results of the histopathological analysis of the excisional biopsy performed during surgery in 4 cases were consistent with acute suppurative inflammation. After postoperative antibiotic use, the conditions of all patients stabilized, and they were discharged from the hospital on median postoperative day 9. CONCLUSION: PID in virgin women is rare, but it should be considered in all women with abdominal pain, regardless of sexual history.

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MeSH descriptors

Abscess Fallopian Tube Diseases Ovarian Diseases Pelvic Inflammatory Disease Postoperative Complications Abdominal Pain Abdominal Pain Abdominal Pain Abscess Abscess Adolescent Anti-Bacterial Agents Anti-Bacterial Agents Fallopian Tube Diseases Fallopian Tube Diseases Female Humans Ovarian Diseases Ovarian Diseases Ovarian Neoplasms

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