Postmenopozal hastalarda tubaovaryan apse: üçüncü basamak bir merkezde deneyimi

Abstract

Amaç: Çalışmanın amacı, üçüncü basamak bir merkezde postmenopozal kadınlarda tubaovaryan apse (TOA) yönetimi ve sonuçları ilgili deneyimi ortaya koymaktır. Gereç ve Yöntem: Bu çalışma Ocak 2012 ile Haziran 2021 arasında yapılmıştır. Hastanede yatmış olan 127 TOA olgusu tıbbi kayıtlardan belirlendi ve geriye dönük olarak incelendi. Toplanan veriler yaş, doğum sayısı, menopoz durumu, rahim içi araç (RİA) kullanımı, sigara öyküsü, geçirilmiş cerrahi işlem, radyolojik bulgular, tıbbi ve cerrahi tedaviler, laboratuvar bulguları, patoloji ve hastanede kalış süresini içermektedir. Bulgular: Tüm hastaların ortalama yaşı 39.2 ± 9.8 yıldı ve 22 (%17.3) hasta postmenopozal idi. Postmenopozal hastalarda cerrahi müdahale ihtiyacı, RİA kullanımı, hastanede kalış süresi ve nihayi patolojide malignite tanısı anlamlı olarak daha yüksek bulundu (p < 0.05). Postmenopozal hastalarda cerrahi kararı için geçen sürenin daha kısa olduğu görüldü (p < 0.05). Hastaların menopoz durumlarına göre radyolojik ve laboratuvar bulguları benzerdi. Postmenopozal hastalarda, ortalama tanı yaşı, hastanede kalış süresi, apse boyut ve hacmi cerrahi uygulanan hastalarda sadece medikal tedavi alanlara göre anlamlı olarak daha yüksek bulunmuştur (p < 0.05). Sonuç: Postmenopozal TOA'lı hastalar, daha fazla komorbiditeye sahip olma, uzamış RİA kullanım öyküsü ve daha yüksek gizli malignite olasılığı açısından premenapozal dönemdeki hastalardan farklıdır. Menapoz sonrası hastalar daha çok ameliyat olma eğilimindedir, ancak klinik uygulamada bireyselleştirilmiş tedavi stratejileri gerekebilir.

Keywords

• Tubaovaryan apse
• pelvik inflamatuar hastalık
• menopoz

Tubo-ovarian abscess in postmenopausal patients: a tertiary single center experience

Abstract

Objective: The purpose of the present study was to reveal the experience of a single tertiary center in management and outcomes of tubo ovarian abscess (TOA) in postmenopausal patients. Materials and Methods: The present study was conducted between January 2012 and June 2021. One hundred and twenty-seven hospitalized cases of TOA were identified from the medical records and retrospectively reviewed. Collected data included age, parity, menopausal status, intrauterin device (IUD) usage, smoking history, prior procedure, radiological findings, medical and surgical treatments, laboratory findings, pathology and length of hospital stay. Results: The mean age of all patients were 39.2 ± 9.8 years, and 22 (17.3%) patients were postmenopausal. The need for surgical intervention, the intrauterine device usage, duration of hospitalization, and malignancy at final pathology were significantly higher in postmenopausal patients (p < 0.05). The mean day for surgery was earlier in postmenopausal patients (p < 0.05). The radiological and laboratory findings were similar according to the menopausal status of patients. Among postmenopausal patients, the mean age at diagnosis, the duration of hospitalization, abscess size, and abscess volume were significantly higher in patients who also underwent surgery compared to those receiving only medical treatment (p < 0.05). Conclusion: Postmenopausal patients with TOA differ from traditional abscesses regarding having more comorbidities, a history of extended IUD usage, and a higher possibility of occult malignancies. Postmenapausal patients are more tend to underwent surgeries, however individualized treatment strategies may required in clinical practice.

Keywords

• Tubo-ovarian abscess
• pelvic inflammatory disease
• menopause.

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