Aim: To develop a treatment and management algorithm for vulvar abscess.
Methods: We evaluated the clinical findings and treatment modalities of patients hospitalized with vulvar abscess via a comprehensive literature review and a clinical study. Patients with a diagnosis of vulvar abscess (n = 28) between 2015 and 2019 in the gynecology clinic of our hospital were included in the clinical study. Each patient's age, obstetric history, body mass index, presence of concomitant diseases, abscess culture and size, mean length of hospital stay, treatment modalities, and recurrence rate were recorded.
Results: The mean age and body mass index of the patients were 47.7 ± 11.5 years and 30.3 ± 2.7 kg/m2 , respectively. Diabetes mellitus was the most common concomitant disease (60.7%, n = 17). The abscesses of 22 (78.5%) patients drained spontaneously. The abscess cavities of the remaining six (21.4%) patients were treated via incisional drainage. Gentamicin + clindamycin or levofloxacin + metronidazole were used as the primary antibiotic treatment. Hemovac drains were placed in four (14.2%) patients with abscess sites greater than 5 cm. By applying our treatment methods, 26 (92.8%) of our patients were discharged with full recovery, and two patients (7.2%) were referred due to uncontrolled diabetes mellitus. The recurrence rate of vulvar abscess was 0%.
Conclusions: This is the first study in the literature to present a successful algorithm for the treatment and management of vulvar abscess. Our treatment methods shed light on the treatment and management of vulvar abscess.
Keywords: algorithm; incision and drainage; treatment; vulvar abscess; vulvar disease.
© 2022 Japan Society of Obstetrics and Gynecology.