58820 Drainage of ovarian abscess; vaginal approach, open

Name of the Procedure:

Drainage of ovarian abscess; vaginal approach, open.

• Common names: Ovarian abscess drainage, Vaginal abscess drainage
• Medical terms: Oophoritis drainage, Vaginal incision and drainage (I&D)

Summary

In this procedure, a surgical incision is made through the vaginal wall to drain an abscess located in or around the ovary. It's performed to remove pus and infected material to relieve symptoms and prevent the spread of infection.

Purpose

• Medical Condition: This procedure addresses ovarian abscesses, which are collections of pus caused by bacterial infections.
• Goals/Outcomes: The goal is to drain the abscess, alleviate pain, reduce infection, and prevent complications such as sepsis or infertility.

Indications

• Severe pelvic pain and tenderness
• Fever and chills
• Elevated white blood cell count indicating infection
• Abscess confirmed through pelvic ultrasound or CT scan
• Failure of abscess to respond to antibiotic therapy alone

Preparation

• Fasting several hours before the procedure
• Stopping certain medications as advised by your healthcare provider
• Pre-procedure blood tests and imaging studies (ultrasound, CT scan)
• Discussion of medical history, including allergies and current medications

Procedure Description

1. The patient is given appropriate anesthesia, typically general anesthesia.
2. The surgeon makes an incision in the vaginal wall to access the abscess.
3. Pus and infected material are carefully drained from the abscess.
4. The area is cleansed and, if necessary, a drain is placed to ensure continued drainage.
5. The incision is either left open to heal naturally or closed with sutures.
   • Tools/Equipment: Surgical scalpel, suction device, drainage tubes, sterile dressing
   • Anesthesia: General anesthesia to ensure the patient is asleep and pain-free.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity of the abscess and other factors.

Setting

Performed in a hospital operating room or a surgical center equipped to handle such procedures.

Personnel

• Surgeon (usually a gynecologist or a general surgeon)
• Anesthesiologist
• Surgical nurses
• Assisting healthcare staff

Risks and Complications

• Infection and bleeding
• Pain and discomfort at the incision site
• Recurrence of the abscess
• Damage to surrounding organs or structures
• Anesthesia-related risks
• Scar tissue formation
• Possible infertility in severe cases

Benefits

• Immediate relief from pain and discomfort
• Resolution of infection
• Prevention of further complications, including potential infertility
• Improved quality of life relatively soon after the procedure

Recovery

• Initial recovery in a post-anesthesia care unit (PACU) for monitoring
• Hospital stay typically ranging from a few hours to a couple of days, depending on recovery and complications
• Post-procedure pain management with prescribed analgesics
• Avoiding heavy lifting and strenuous activity for a few weeks
• Follow-up appointments to monitor healing and manage any complications

Alternatives

• Antibiotic therapy alone (may be insufficient for large or persistent abscesses)
• Laparoscopic drainage (a minimally invasive surgical option)
• Image-guided drainage (using ultrasound or CT guidance)
• Each alternative has its own risk, benefit profile, and suitability depending on the patient's condition.

Patient Experience

• Expect initial pain and discomfort managed with medication.
• Some vaginal bleeding or discharge is common post-procedure.
• Most patients experience significant relief from symptoms within days.
• Advised to rest and gradually return to normal activities based on the surgeon's recommendations.