Laparoscopic treatment of tuboovarian and pelvic abscess.

Twenty-five women with pelvic abscess were treated laparoscopically. Following intravenous antibiotic coverage, laparoscopic surgical techniques were utilized to lyse bowel adhesions, drain purulent fluid, and excise acute and necrotic inflammatory adhesions, including tuboovarian adhesions. Treatment during the acute phase and results per second-look laparoscopy were documented in five cases, with photomicrographs revealing relatively normal pelvic anatomy. One postappendectomy abscess with a peritoneovaginal fistula in a 10-year-old girl was also managed laparoscopically. Four of seven women desiring pregnancy conceived, and two women had unplanned pregnancies. The treatment of choice for acute pelvic abscess may be a combination of intravenous antibiotics and an early laparoscopic surgical procedure.