632 - Percutaneous Drainage for Management of Tubo-Ovarian Abscesses – a Multi-Center Retrospective Review

Monday, April 13, 2026

12:10 PM - 1:10 PM ET

Poster Presenter(s)

CF

Christopher Fan, BS

Medical Student
University of Texas Southwestern, United States

Author/Co-author(s)

SB

Shadae Beale, MD

Minimally Invasive Gynecologic Surgery Fellow
University of Texas Southwestern, United States
EM

Enzo Mesarick, BS

Medical Student
University of Texas Southwestern, United States
RP

Rithvik Pakala, BS

Medical Student
University of Texas Southwestern, United States
AS

Anika Srinath, BS

Medical Student
University of Texas Southwestern, United States
KS

Katherine Smith, MD

Assistant Professor in Obstetrics and Gynecology
University of Texas Southwestern, United States
JB

Jamaal Benjamin, MD

Assistant Professor
UT Southwestern, United States

Purpose: Tubo-ovarian abscess (TOA) is a complication of pelvic inflammatory disease. In the event of failure of medical management, image-guided drainage is a minimally invasive treatment option {1}. This study aims to compare clinical outcomes of image-guided drainage, surgical, and medical management in the treatment of TOA at three tertiary hospitals.

Materials and Methods: A retrospective study between January 2022 and November 2024 was conducted of patients with TOA, confirmed by imaging and PID criteria. Primary outcomes were hospital admission length and 30-day readmission rate from partial treatment or relapse. Secondary outcomes were days of antibiotic usage before image-guided or surgical drainage and size of TOA at admission. Baseline demographics, intrauterine device (IUD) presence, and image modality of drainage were also analyzed.

Results: Out of 116 patients (median age = 38.5 years) who underwent treatment for TOA, 35 had image-guided drainage, 17 had surgical drainage, and 64 were treated with medical management alone. The majority of image-guided drainage was done with CT (83%). Around half the time (49.1%), interventional radiology (IR) was consulted. The majority of these consults led to drainage (63.2%) with an “unsafe window” being the most common reason it was unsuccessful (11.2%) Mean hospital length was significant between surgical drainage (12 days), image-guided drainage (7.2 days), and medical management (3.9 days). While there was no significance in 30-day readmission, surgical drainage showed the highest rate (11.8%), followed by image-guided drainage (3%) and medical management (1.5%). Mean TOA size was largest in IR drainage (8.1 cm) vs surgery (6.9 cm) and medical therapy (6.0 cm); p >0.05. Bilateral TOAs were most common in surgery (57.9%) versus IR (34.3%) and medical therapy (26.6%). There was no significant difference in presence of an IUD between groups.

Conclusion: Interventional drainage managed larger TOAs, with shorter length of stay than surgery, and low readmission rates when medical management failed in our multi-center retrospective review. Furthermore, the benefits of drainage versus surgery include decreased invasiveness, increased potential to preserve fertility, and faster recovery times {2}. This research adds to the growing literature that after first-line treatment with medical management, IR drainage should be highly considered and utilized for TOAs {3,4}.