Outcomes of antibiotic therapy and transvaginal ultrasound-guided efficacy of transvaginal ultrasound-guided drainage in treating tubo-ovarian abscesses: Three case reports

Zahra Heidar, Tayebeh Esfidani, Atefeh Moridi, Mahtab Anvari
In: International Journal of Reproductive BioMedicine (IJRM) · 2025 · vol. 22(11) , pp. 927–934 · doi:10.18502/ijrm.v22i11.17825 · PMID:39866584 · PMC11757675 · W4406337374
article OA: gold CC0
📄 Open PDF Full text JSON View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This report details three cases of tubo-ovarian abscesses where transvaginal ultrasound-guided drainage, combined with antibiotics, showed superior results compared to antibiotics alone or laparotomy.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This paper presents three case reports of tubo-ovarian abscesses in women with infertility and a history of ovarian endometrioma and/or adnexal procedures related to assisted reproduction, describing antibiotic management and failure of antibiotics alone that led to transvaginal ultrasound-guided drainage, sometimes preceded by laparotomy. Across cases, cultures/clinical courses guided antibiotic changes (e.g., escalation from piperacillin-tazobactam/vancomycin to regimens including meropenem and metronidazole, and addition of agents such as amikacin when indicated), with drainage performed under transvaginal ultrasound guidance until collections resolved and clinical and laboratory parameters improved; the authors report no abscess recurrence during 1-year or 6-month follow-up in the included patients. The main limitation is that the evidence is limited to three individual cases without a comparative control group or standardized treatment pathway, so generalizability is restricted. Relevance to endometriosis: all three cases occur in the context of ovarian endometrioma, and the first case explicitly describes endometriosis stage 4 and endometrioma resection along with abscess drainage, though the paper’s main focus is tubo-ovarian abscess treatment outcomes and drainage techniques.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Background: To introduce minimally invasive methods for the successful treatment of tubo-ovarian abscesses (TOAs), an antibiotic regimen was considered the first line of treatment. However, in some cases, this approach fails, and another intervention (laparotomy or minimally guidance drainage) is required. Case Presentations: 3 women with a history of long-time infertility, all of them were candidates for in vitro fertilization referred to the obstetrics and gynecology department with similar manifestations. For these 3 cases (30-40 yr) the first approach was a broad-spectrum antibiotic therapy. In 2 cases the last step in treatment was transvaginal ultrasound guidance drainage, and in one case laparotomy was done after antibiotic regimen failure; however, in all of 3 cases the best results were seen in transvaginal ultrasound guidance drainage. Conclusion: Patients who have ovarian endometrioma and undergo an assisted reproductive technology cycle, as well as ovum pick up, increase the possibility of TOA occurrence in them. The use of transvaginal ultrasound guidance drainage approach for the treatment of TOA in selective cases, in addition to broad-spectrum antibiotics in patients might reduce their need for invasive treatment with laparotomy.
Full text 16,302 characters · extracted from pmc-nxml · 2 sections · click to expand

Section

Z. Heidar: Design and conduct the study. T. Esfidani and A. Moridi: Critically revised the manuscript. M. Anvari: Interpreted the findings and drafted the manuscript. All authors approved the final version of the manuscript.

Coi Statement

The authors declare that there is no conflict of interest.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: pmc-nxml ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriomainfertility

Citation neighborhood (sparse)

Too few in-corpus citations on either side for a chart; here are the lists.

Cites (3)

References (17)

Source provenance

europepmc
last seen: 2026-06-12T06:13:51.797165+00:00
openalex
last seen: 2026-05-11T05:27:14.892522+00:00
License: CC0 · commercial use OK