Assessing the safety and effectiveness of trans-abdominal ultrasound-guided tube drainage for pelvic collections post-obstetrics and gynecological surgery

Abstract

Background: There are some difficulties with trans-abdominal (TA) ultrasound (US)-guided drainage with the development of different methods of drainage (transvaginal). We aimed to evaluate the feasibility and effectiveness of TA US-guided drainage of pelvic fluid collection after gynecologic and obstetric surgeries.Methods: We conducted this study on patients with postoperative pelvic fluid collections following gynecologic or obstetric surgery. We examined the cases at our Obstetrics and Gynecology Department in collaboration with the Radiology Department at Fathima Institute of medical science over 12 months. We used imaging for the diagnosis of clinically symptomatic postoperative pelvic collection. All women underwent TA US-guided drainage by a standardized protocol. We monitored patients for at least 4 to 6 weeks and judged their outcomes according to the definitions of success and failure. We analyzed patient demographics, US, and clinical characteristics of the collection for their effects on clinical success.Results: We had included 52 patients in the study. The number of resolved cases after US-guided intervention was 88%, while the number of failed cases was 12%. We observed no statistically significant association between outcome and onset after operation, duration before admission after onset, time of hospital admission after operation, and time of intervention after diagnosis. There was no statistically significant association between the outcome and US findings and the nature and culture of aspirated fluid. The presence of associated comorbidities significantly affects the success of the procedure.Conclusions: TA US-guided drainage of pelvic fluid collections is effective and safe in women’s management with infected pelvic fluid collections. The presence of comorbidities in the cases may interfere with the resolution of the abscess and failure of the procedure.