A study of tubo-ovarian and ovarian abscesses, with a focus on cases with endometrioma

OBJECTIVE: To determine the incidence and causes of endometrioma-associated tubo-ovarian abscesses (TOAs) and ovarian abscesses. METHODS: The medical records of 6,557 gynecologic inpatients were reviewed, and the data were analyzed using the median test and chi 2 test. RESULTS: The incidence of TOAs was 2.3% (5/218) in patients with endometrioma, and 0.2% (11/6,339) in patients without endometrioma (p = 0.0001). Among the TOA cases (n = 16), no significant differences in age, parity, history of pelvic surgery, or isolated organisms were observed between the subgroups with (n = 5) and without endometrioma (n = 11). There were only 2 cases of ovarian abscess, and both were associated with endometrioma. The causes of the abscesses in the 7 cases with endometrioma were contamination during surgery (1 case), contamination during a transvaginal endometrioma aspiration (1 case), and ascending infection (1 case), and unknown in 4 cases. CONCLUSIONS: The presence of endometrioma is a risk factor for the development of a TOA or an ovarian abscess.