Why and how to proceed to an ultrasound-guided transvaginal drainage of tubo-ovarian abscesses (with demonstrative video)?

Abstract

The treatment of the acute phase of complicated tubo-ovarian abscesses relies on antibiotics associated with surgical management in caseof visible abscess, poor clinical tolerance and resistance to medical treatment. Transvaginal, ultrasound-guided, puncture drainage can beconsidered as an alternative to initial laparoscopy and has multiple advantages over the latter: same success rate, less invasive nature, simpleand fast to perform, easy to access, better tolerated by the patient, decreased hospitalization time and less cost. This video article describes andstandardizes the essential steps to perform a transvaginal adnexal abscess drainage with a step-by-step explanation of the technique in logicalsequences, making the procedure ergonomic and easy to learn. Thus, as part of minimally invasive approach, this technique is henceforthsuggested as an effective alternative and signifies a first-line procedure that can promote a therapeutic de-escalation strategy. (J Turk Ger GynecolAssoc 2020; 21: 218-20)