Archives of Gynecology and Obstetrics

, Volume 297, Issue 5, pp 1201–1204 | Cite as

Is intrauterine device a risk factor for failure of conservative management in patients with tubo-ovarian abscess? An observational retrospective study

  • Victoria Kapustian
  • Ahmet Namazov
  • Odeliya Yaakov
  • Michael Volodarsky
  • Eyal Y Anteby
  • Ofer Gemer
General Gynecology



Tubo-ovarian abscess (TOA) is a serious and potentially life-threatening complication of pelvic inflammatory disease (PID). TOA formation may be an uncommon, but serious complication associated with the use of an intrauterine device (IUD). While the majority of TOA respond to antibiotic therapy, in approximately 25% of cases surgery or drainage is indicated. In the present study, we compared the failure rate of conservative management in patients with and without IUD, who were admitted with a diagnosis of TOA.


In this retrospective case–control study, 78 women were diagnosed with TOA. All patients were treated initially by broad-spectrum intravenous antibiotics. The failure of conservative management after 72 h was followed by surgical intervention.


The patients were divided into two groups: 24 patients were IUD-carriers, and 54 did not use IUD. There was no significant difference in surgical intervention rate between IUD group (50%) and no-IUD group (43%), p = 0.32. The WBC count was significantly higher in IUD-carriers diagnosed with TOA than in patients without IUD (16.5 ± 6.6 vs. 13.1 ± 4.6, p = 0.001). The patients with IUD had significantly larger abscesses as revealed by ultrasound than patients without IUD (61.6 ± 21.4 vs. 49.6 ± 20.6 mm, p = 0.02).


The surgical intervention rate in TOA patients with and without IUD was similar.


Intrauterine device Tubo-ovarian abscess Conservative management 


Author contributions

VK: manuscript writing-editing, data analyzing. AN: manuscript editing, data analyzing. OY: data collection. MV: data collection. EA: supervisor. OG: supervisor, project administration, manuscript editing, data analyzing.

Compliance with ethical standards

Conflict of interest

We have no potential conflict of interest to declare.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

The study was designed as a retrospective study. All data were collected anonymously. The Ethical board waived informed consent.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, Faculty of Health Sciences, Barzilai Medical CenterBen-Gurion University of NegevAshkelonIsrael

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