Transvaginal Drainage of Pelvic Collections: a 5-year Retrospective Review in a Tertiary Gynaecology Centre.

Dear Editor, Imaging-guided aspiration and drainage is a feasible alternative to surgery in the treatment of pelvic collections.1-10 Traditionally, interventional radiologists access the pelvic collections via transabdominal, transgluteal and endorectal approaches. The transabdominal approach usually entails long distances to the pelvic lesions and risks transgression of intervening viscera. The transgluteal approach risks damaging the nerves and vessels, and is occasionally obstructed by the pelvic bones.11 The endorectal approach is useful for accessing collections adjacent to the rectum12 but it is non-sterile. Transvaginal approach was initially described in the early 1990s.7,11 The approach allows accurate, real time ultrasound-guided needle and drain placement, but has often been overlooked by interventional radiologists, owing to unfamiliarity and lack of data to guide case selection. The Royal College of Obstetricians and Gynaecologists (RCOG) noted that ultrasound-guided aspiration of pelvic fl uid collections may be equally effective as surgery, and this has been incorporated into the United Kingdom national guideline for the management of pelvic infl ammatory disease since June 2011.12 The aim of this study was to retrospectively review the indications, complications and success rates of transvaginal ultrasound-guided aspiration and catheter drainage of pelvic collections at our institution.