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Image-guided transvaginal drainage of pelvic abscesses and fluid collection using a modified seldinger technique

Background: Transvaginal drainage using the trocar method is advantageous as a single-step procedure; however, the procedure may occasionally be difficult to perform, due to buckling of the catheter in the elastic vaginal tissues, despite the presence of a stiff stylet. Purpose: To evaluate the efficacy and the safety of image-guided transvaginal drainage of pelvic abscesses and fluid collection using a modified Seldinger technique. Material and Methods: Fifteen patients (mean age 43 years, range 24–82 years) who underwent transvaginal aspiration (n=1) or catheter drainage (n=14) guided by ultrasound and fluoroscopy were enrolled in this retrospective study. A small coronal incision was performed to facilitate puncture using an 18G needle, tract dilatation, and the insertion of a drainage catheter by the Seldinger technique. Outcome was analyzed with respect to clinical success, technical success, and procedure-related complications. Results: The overall clinical success rate was 87% (13/15 cases). The success rate of catheter drainage was 86% (12/14 cases), and the use of aspiration alone was successful in one patient. Technical success was achieved in all patients, without procedure-related complications. Conclusion: Image-guided transvaginal drainage with a modified Seldinger technique can be a safe and effective alternative treatment for pelvic abscesses and fluid collection.