Pyometra - What is its clinical significance?

Objective: To evaluate the clinical outcomes of pyometra. Study design: Retrospective study conducted between 1993 and 1999 in two re gional hospitals. Results: Pyometra represented 0.038% of gynecologic admissions. Of the 27 w omen with pyometra, 6 (22.2%) cases were associated with malignancy, 1 (3.7 %) was associated with genital tract abnormality, and 20 (74.1%) were idiop athic. Patients with idiopathic pyometra tended to be older and had a highe r incidence of concurrent medical conditions, Five (18.5%) women experience d spontaneous perforation of pyometra. A preoperative diagnosis was correct ly made in 17 of 22 (77.3%) patients without spontaneous perforation. Most women were treated with dilatation of the cervix and drainage. Nine women ( 33.3%) had persistent or recurrent pyometra; three of them were asymptomati c. Conclusion: Pyometra is an uncommon condition, but the incidence of associa ted malignancy is considerable, and the risk of spontaneous perforation is higher than previously thought. Dilatation and drainage is the treatment of choice, and regular monitoring after initial treatment is warranted to det ect persistent and recurrent disease.