From the Guidelines
A gynecologist or an obstetrician-gynecologist (OB-GYN) is the primary doctor who treats a tubo-ovarian abscess. These specialists have specific training in female reproductive health and are experienced in diagnosing and managing pelvic infections. In some cases, an infectious disease specialist may also be involved in the treatment, particularly for complex cases requiring specialized antibiotic management.
Key Considerations
- The decision to hospitalize a patient with a tubo-ovarian abscess should be based on the discretion of the healthcare provider, considering factors such as the severity of the illness, the patient's ability to tolerate oral antibiotics, and the presence of any complications 1.
- Treatment typically involves intravenous antibiotics, such as a combination of cefoxitin or cefotetan plus doxycycline, or clindamycin plus gentamicin, usually administered for 24-48 hours after clinical improvement, followed by oral antibiotics to complete a 14-day course 1.
- If the abscess is large (greater than 8-10 cm) or if antibiotic therapy fails, surgical drainage or removal of the affected structures may be necessary, which might involve consultation with a gynecological surgeon 1.
Management of Tubo-Ovarian Abscess
- Patients with tubo-ovarian abscess that does not respond to antibiotics should undergo surgical drainage, as recommended by the 2017 WSES guidelines for management of intra-abdominal infections 1.
- The global epidemiologic profile of pelvic inflammatory disease, which can lead to tubo-ovarian abscess, has not been well defined, and prevention programs are often unavailable in many countries 1.
From the Research
Type of Doctor
The type of doctor that treats a tubo-ovarian abscess includes:
- Obstetrician/gynecologists, as they are often involved in the management of pelvic inflammatory disease and its complications, including tubo-ovarian abscesses 2, 3
- Surgeons, as surgical intervention may be required in some cases, such as drainage or removal of the affected ovary and fallopian tube 4, 3
- Infectious disease specialists, as they may be consulted to help manage the infection and choose the appropriate antibiotic regimen 3, 5
Treatment Approach
The treatment approach for a tubo-ovarian abscess may involve:
- Antibiotic therapy, which is often the first line of treatment, with the goal of reducing the size of the abscess and managing the infection 3, 5
- Surgical intervention, which may be necessary in cases where the abscess is large, ruptured, or not responding to antibiotic therapy 4, 3
- Minimally invasive procedures, such as laparoscopy or interventional radiology, which may be used to drain the abscess or remove the affected tissue 6