Douglas space abscess is the most common type of abdominal abscesses. It is an abscess limited with a capsule, located between the rectum and the bladder in men or between the rectum and uterus in women. In advanced cases, the amount of pus in the abscess may reach 2 liters. Surgery is the only option for treatment of this disease.
The surgical treatment tactics and indications are based on the case history, rectal examination, as well as general clinical and pelvic examination findings. To confirm the presence of pus in the abdomen during the preoperative period, the Douglas space puncture may be required. The pus obtained during the puncture is sent for microbiological testing to determine the type of bacteria and antibiotic susceptibility. It is necessary for adequate selection of antibacterial drugs for post-operative treatment.
Surgery of opening the abscess and its subsequent drainage requires general anesthesia. Access to the abscess is implemented through the rectum or vagina. An abscess is opened, its content is removed, the cavity is rinsed with antiseptic solution and double-lumen drainage is installed for content outflow during the postoperative period.
The patient stays in the hospital with a full board for up to 10 days. After surgery, the antibiotic and symptomatic treatment is prescribed. The cost of required medicines shall be confirmed with the attending physician. The patient is discharged after a follow-up examination and receipt of further recommendations.