Tubo-Ovarian Abscess Formation in Users of Intrauterine Devices Remote From Insertion: A Report of Three Cases

Marc R. Toglia, Joseph I. Schaffer

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background: The association between tubo-ovarian abscess formation and the presence of an intrauterine device (IUD) is well recognized. It has been suggested that the risk of upper-genital-tract infection is highest during the immediate period following the insertion of an IUD, returning to baseline by 5 months postinsertion. We present 3 cases of women who, 10-21 years after insertion of their IUDs, developed tubo-ovarian abscesses that were not causally related to sexually transmitted diseases (STDs) or actinomycetes. Cases: Three women, ages 39-47 years, presented to our gynecology service for evaluation of abdominal pain. One woman had bilateral tubo-ovarian abscesses and the other 2 had unilateral tubo-ovarian abscesses. All 3 were IUD users, with an interval from IUD insertion to presentation of 10-21 years. In each case, the cervical cultures for gonorrhea and chlamydia were negative at presentation and the sexual history was not consistent with an STD mode of spread. All 3 women initially received broad-spectrum antibiotics, but 2 eventually required definitive surgical therapy. Conclusion: Long-term users of IUDs remain at risk for serious, indolent pelvic infections. These women should be counseled by their gynecologists on an ongoing basis as to this persistent risk. Tubo-ovarian abscess should be strongly considered in the differential diagnosis of an IUD user who presents with an adnexal mass, fever, or abdominal pain.

Original languageEnglish (US)
Pages (from-to)85-88
Number of pages4
JournalInfectious Diseases in Obstetrics and Gynecology
Issue number2
StatePublished - 1996


  • Pelvic inflammatory disease
  • pelvic abscess
  • salpingitis

ASJC Scopus subject areas

  • Dermatology
  • Obstetrics and Gynecology
  • Infectious Diseases


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