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What is a Tubo-Ovarian Abscess?

By H. Colledge
Updated Mar 03, 2024
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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.

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Discussion Comments

By anon974627 — On Oct 19, 2014

I recently was hospitalized for this and was given antibiotics. the pain was tremendous. I didn't finish the medication.

By anon950188 — On May 08, 2014

I was hospitalized and had the pus drained out with antibiotics. The pain was so severe that my stomach started to swell to where I looked pregnant. I am worried now that I am trying to have another baby it is always impossible since I have been trying for almost a year now.

By anon927567 — On Jan 24, 2014

I had this happen to the point I was hospitalized and the only symptom I had was a really strong smell even after a shower. Should've gone to the doc when I noticed that.

By anon340272 — On Jul 01, 2013

I've recently had a recurrence, five years later in the same ovary. I tested negative each time for STDs. It's painful and can escalate quickly. The first time, within a few days, it blew and I went into sepsis and they had to carry me into the hospital. I'm lucky in that I responded to the antibiotics.

Intervention radiology (draining it with a needle) is shifty sometimes because of the proximity to the intestines. This is no joke, and after you come home, you'll be on antibiotics for several weeks. Expect to be lethargic and to not have a fabulous appetite. Following up is important. Pelvic sonograms will assess its demise.

By anon322432 — On Feb 27, 2013

I had one of these when I was fourteen, before I was sexually active. It burst and I was a week from death when I had emergency surgery, where I had my right ovary, right fallopian tube, and appendix removed along with a good two cups of pus.

By ceilingcat — On Jun 26, 2011

@Monika - Glad your friend is OK.

Conditions like this really highlight the usefulness of medical imaging. The symptoms of a tubo-ovarian abscess are so similar to other medical condition that medical imaging is the only way to know for sure what's going on.

By Monika — On Jun 25, 2011

A friend of mine developed a tubal ovarian abscess in high school. She ended up in the hospital for quite awhile because she waited a long time to get treatment. She didn't want her parents to know she was sexually active so she ignored her symptoms for quite awhile until she was in so much pain she her parents noticed.

She's fine now but things were strained between her and her parents for a long time after that.

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