Conservative surgery for adnexal abscess.

Twenty-eight women were treated with conservative surgery for adnexal abscesses over a six-year period (1968-74). The mean age was 29.9 +/- 8.9 years (SD) and mean parity 1.2 +/- 1.1. Indications for surgery included failure to respond to medical therapy (16 cases) and exploration of a pelvic mass of uncertain etiology (12). The mean admission-operation interval was 8.7 +/- 9.9 days. The mean total hospital stay was 23.1 +/- 14.7 days. The most common procedures were unilateral adnexectomy (13 cases), simple drainage (6) and bilateral medial ligation (4). The intraoperative complications (one fatal cardiac arrest, two bladder lacerations and one bowel laceration) did not appear to be related to the conservative nature of the surgery. The postoperative complications, wound sepsis (six cases) and fecal fistula (one case), might have occurred equally with more radical operations. Menstrual function was retained in all the surviving patients and the potential for pregnancy in 18 (62%). Extrapolating these data from unselected cases in a developing nation, it seems likely that conservative procedures would afford an acceptable option in well-selected, fully informed women undergoing surgery for adnexal abscess in developed countries.