Trial finds transvaginal drainage not proven noninferior to laparoscopy for abscess

The PACTOL randomized trial compared ultrasound-guided transvaginal drainage with laparoscopy for evacuation of tubo-ovarian abscess in 208 patients across 19 French hospitals. The trial reported that noninferiority of transvaginal drainage was not established, with reintervention needed more often in the transvaginal drainage group (13.0% vs 3.3%), though hospitalization was shorter and pain scores decreased more quickly with transvaginal drainage. The trial reported no differences between groups in persistence of the collection, reintroduction of antibiotic therapy, or rates of grade II or higher surgical complications.

Most relevant for: Women undergoing evacuation procedures for tubo-ovarian abscess.

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