Pelvic abscesses in postmenopausal women.

Seventeen postmenopausal women with pelvic abscesses were cared for at the Los Angeles County-University of Southern California Women's Hospital during the past eight years. Nine had experienced either postmenopausal bleeding or uterine instrumentation, or both, within the prior six months. Findings from physical examination and various laboratory and roentgenologic studies did not significantly help in improving the accuracy of preoperative diagnosis. In four, the abscess was associated with intra-abdominal pathologic conditions, and six had poorly controlled adult onset diabetes mellitus. Transfusion was required in eight patients. Two patients had a prolonged hospital stay because of pulmonary and septic complications. One patient had carcinoma of the ovary while another had carcinoma of the cervix uteri that was undiagnosed preoperatively. Our conclusion is that about one-half of postmenopausal patients with pelvic and tubo-ovarian abscesses have postmenopausal bleeding. The remainder may have associated intra-abdominal infective pathologic findings or a malignant condition of the genital tract. Expeditious surgical treatment should be undertaken.