Risk factors for the development of tubo-ovarian abscesses in women with ovarian endometriosis: a retrospective matched case–control study

Yang Gao, Pengpeng Qu, Yang Zhou, Wei Ding
BMC women's health · 2021 · vol. 21(1) , pp. 43 · doi:10.1186/s12905-021-01188-6 · PMID:33516203 · PMC7847172 · W3128460401
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Lower genital tract infections and spontaneous rupture of ovarian endometriosis cysts were identified as significant risk factors for developing tubo-ovarian abscesses in women with ovarian endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This retrospective single-center matched case–control study examined risk factors for tubo-ovarian abscesses associated with ovarian endometriosis (OE-TOA) using 44 surgically and pathologically confirmed OE-TOA cases and 132 age-matched OE controls without TOA. Data from 2010–2019 records were analyzed with univariate testing and multivariate conditional logistic regression, with diagnoses relying on intraoperative pus observation and pathological criteria. Lower genital tract infection (OR 5.462) and spontaneous rupture of ovarian endometriotic cysts (OR 2.572) were significantly associated with OE-TOA, while IVF was not significantly linked to OE-TOA (p = 0.130); the authors also acknowledge key caveats implicit to their design, including reliance on retrospective single-center data and measured variables recorded in charts. This paper is centrally about endometriosis — specifically identifying risk factors for OE-associated tubo-ovarian abscesses, including infection and cyst rupture.

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Abstract

BACKGROUND: The purpose of this study was to assess the risk factors associated with the development of tubo-ovarian abscesses in women with ovarian endometriosis cysts. METHODS: This retrospective single-center study included 176 women: 44 with tubo-ovarian abscesses associated with ovarian endometriosis and 132 age-matched (1:3) patients with ovarian endometriosis but without tubo-ovarian abscesses. Diagnoses were made via surgical exploration and pathological examination. The potential risk factors of tubo-ovarian abscesses associated with ovarian endometriosis were evaluated using univariate analysis. The results (p ≤ 0.05) of these parameters were analyzed using a multivariate model. RESULTS: Five factors were included in the multivariate conditional logistic regression model, including in vitro fertilization, presence of an intrauterine device, lower genital tract infection, spontaneous rupture of ovarian endometriosis cysts, and diabetes mellitus. The presence of a lower genital tract infection (odds ratio 5.462, 95% CI 1.772-16.839) and spontaneous rupture of ovarian endometriosis cysts (odds ratio 2.572, 95% CI 1.071-6.174) were found to be statistically significant risk factors for tubo-ovarian abscesses associated with ovarian endometriosis. CONCLUSIONS: Among the factors investigated, genital tract infections and spontaneous rupture of ovarian endometriosis cysts were found to be involved in the occurrence of tubo-ovarian abscesses associated with ovarian endometriosis. Our findings indicate that tubo-ovarian abscesses associated with ovarian endometriosis may not be linked to in vitro fertilization as previously thought.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Ovarian Diseases Ovarian Diseases Ovarian Diseases Abscess Abscess Abscess Case-Control Studies Female Humans Retrospective Studies Risk Factors

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