A tubo-ovarian abscess is an infected, pus-filled lump located in the ovary or Fallopian tube. It is commonly caused by infection moving up the reproductive tract from the vagina, and typically forms part of what is known as pelvic inflammatory disease, where bacteria multiply inside the pelvic cavity affecting structures such as the womb and ovaries. Occasionally this disease can be a result of infection spreading from nearby organs, in an illness such as appendicitis, but more often it is associated with sexual activity. A tubo-ovarian abscess usually appears in the later stages of pelvic inflammatory disease, and although the illness can be life-threatening if it is left untreated, it usually responds to antibiotics, with surgery being used if necessary.
Most often, a tubo-ovarian abscess occurs in young women who are sexually active. An increased risk is also present in women who have been fitted with an intrauterine contraceptive device, or IUD. There are a number of different organisms which can be involved in the infection, with common examples being the bacteria that cause chlamydia and gonorrhea.
Symptoms which may be experienced as a result of this kind of abscess can include pain in the lower abdomen and fever. Sometimes unusual bleeding or discharge from the vagina is seen, and there may be discomfort when urinating or passing stools. The areas around the reproductive organs may feel tender when examined by a doctor. Occasionally there are no symptoms at all and the tubo-ovarian abscess may be found by chance on an ultrasound scan.
Diagnosing a tubo-ovarian abscess is important, in order to distinguish it from other masses such as cancers and cysts. Ultrasound imaging is generally used but MRI, or magnetic resonance imaging, may be useful if the ultrasound findings are unclear. The abscess typically appears on an ultrasound scan as a lump which has thick walls and is filled with fluid and debris.
As is the case for other types of pelvic abscess, the treatment of a tubo-ovarian abscess involves a stay in the hospital while antibiotics are administered intravenously. If the abscess does not respond to antibiotic treatment, or if it is extremely large, it may need to be drained surgically. This can be carried out with a needle, using ultrasound imagery to guide the surgeon to the correct location, or the abscess may need to be cut. Occasionally it might be necessary to treat a Fallopian tube abscess or ovarian abscess by removing all of the affected tube or ovary.