Tubo-ovarian abscesses are likely to occur in women suffering from deep endometriosis. The aim of surgical management of tubo-ovarian abscesses is the laparoscopic drainage, while deep endometriosis resection should be delayed. Laparoscopic procedure carried out in emergency does not attempt at the excision of deep endometriotic lesions, and must avoid the choice of the laparoconversion, in order to avoid further changes in the pelvic anatomy rendering more difficult a curative surgery. We report six cases of patients presenting tubo-ovarian abscesses arising on deep endometriosis, and we discuss the choice of the 2-step surgical management. In four cases, deep endometriosis resection has been performed by laparoscopic route few months after the drainage of abscess and provided macroscopically complete excision of the disease.
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