Pelvic Abscess Drainage

A pelvic abscess is a collection of pus in the pelvis or lower abdomen caused by infection, appendicitis, a burst ulcer, or complications after surgery. An abscess usually appears 2-3 weeks after the initial infection or complication and can become multiple abscesses if left untreated. Sometimes healthcare providers do not recommend treatment until it has ‘ripened’ enough to be easily opened and drained.

Symptoms of pelvic abscess are:

  • Abdominal pain
  • Vaginal spotting
  • Joint swelling
  • Rash
  • Vomiting
  • Nausea
  • Joint pains
  • Fatigue
  • Malaise
  • Heavy menstrual bleeding

Laparoscopy involves the insertion of a fiberoptic scope (laparoscope) into a small incision made in the abdomen. A fiberoptic scope is a long, thin flexible surgical instrument. Through the scope, a doctor can inspect the internal organs. Laparoscopy can be used to identify inflammation, abnormal organ shapes, and the presence of certain tumors. Surgical treatments can also be performed during laparoscopy.

The advantages of laparoscopy include direct visualization of the pelvis and more accurate bacteriologic diagnosis if cultures are obtained. However, laparoscopy is not always available in acute PID. In addition, this procedure is costly and requires general anesthesia. It should be used if the diagnosis is in doubt. However, if operative laparoscopy is used early in the course of the disease, copious irrigation and separation of thin adhesions by blunt dissection may prevent later sequelae.

Most patients are able to walk within 24 hours after pelvic abscess surgery, however, they often experience some discomfort for several days. Sometimes the drainage tube needs to stay in place for 2 weeks. Patients can usually bathe normally, so long as the tube and incision area are kept dry. Driving is often possible within 3-4 weeks, assuming no discomfort or pain occurs. Sexual activities can usually be resumed after 3 weeks.

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