GENERAL INFORMATION Cysts or abscesses that come back usually need an
operation. Bartholins gland is located immediately outside of the The treatment for a Bartholin cyst abscess is to drain entrance to the vagina. The gland produces a slippery the pus in it, or to open it wide and purposely leave liquid that travels through a very small tube (called a it that way (this is called marsupialization). duct). This uid helps keep the entrance to the vagina If a symptomatic Bartholin cyst is not infected, then lubricated. One gland empties on the right side and the the treatment is to remove it entirely. other on the left. Abscesses of the gland that come back even though Sometimes this small duct gets plugged, and the uid they were drained properly need to be removed after cannot get out. The duct forms a sac (called a cyst) the acute infection is treated. lled with this uid. This uid can become infected, After careful consideration of all factors, the producing an abscess. recommendation is that you have an operation to correct your problem. PREOPERATIVE PREPARATION An examination of your blood, urine, heart (EKG), and lungs (chest x-ray) may be done. Do not eat or drink anything for 8 hours before the operation. You may be asked to douche on the morning of the operation. OPERATION For an Abscess of Bartholins Cyst This may be performed in the doctors ofce or as an outpatient procedure. You will be positioned on the table, the same as for a pelvic examination. The area around the abscess will be painted with an antiseptic solution and draped with sterile towels. A very ne short needle will be used to inject an anesthetic in the skin over the abscess. This will make the area numb. The abscess will be opened and drained. You should get pain relief very soon. If the abscess is Figure 1. Typicallocation (arrow )ofa B artholins cystabscess. marsupialized, the abscess edges will be sewn open to help prevent recurrence. COMMON SIGNS AND SYMPTOMS You should be able to go home directly after the Early on, a Bartholins gland cyst might not produce operation. any symptoms at all. If it is small, many women dont Arrangements will be made for any antibiotics or even know it is there. If it gets larger, it can cause pain medicine and for a follow-up ofce visit. pain with sexual intercourse or with walking and The doctor will discuss with you the possibility of sitting. having this cyst removed entirely after things quiet If the cyst becomes infected, it becomes swollen and down. can be extremely painful to touch. For a Noninfected Bartholin Cyst DIAGNOSIS You will be given medicine that will make you feel Usually, the diagnosis can be made by taking a drowsy before you are brought to the operating detailed history and doing a thorough physical room. examination. The operation will be done under general anesthesia The cyst can be seen just next to the opening of the or a spinal-epidural block. vagina. It can be felt easily with the ngers. It is not You will be positioned on the table the same as for a usually confused with anything more serious. regular pelvic examination. THERAPY The area around the cyst will be painted with an antiseptic solution and draped. Many Bartholin cysts may be treated conservatively The entire cyst will be removed and the skin closed with warm sitz baths. Often this helps the cyst to open and drain on its own. with absorbable suture. Copyright 1999 by WB Saunders Company. All rights reserved. BARTHOLINS GLAND ABSCESS 65 You will wake up in a recovery room. When your Be careful that you do not become constipated. Include enough roughage and liquid in your blood pressure, pulse, and breathing are stable, you will be taken to a regular hospital room. diet. You may need a mild laxative (example: milk of You should be able to go home the next day. Arrangements will be made for any antibiotics or magnesia), a stool softener (Colace, Surfak), or a glycerine suppository. pain medicine and for the follow-up ofce visit. You may return to work when you feel up to it. As with any operation, complications are always Driving your car is all right, but do not do so if you possible. With your type of operation they can are taking pain medicine that reduces your alertness. include bleeding and infection and possibly others. During your follow-up visit, lets discuss when you may resume sexual activity. HOME CARE CALL OUR OFFICE IF Resume your usual activities. You may eat as you did before the operation. The area becomes red or swollen, and there is You may shower as you wish. drainage from it. You may wish to take sitz baths to relieve discomfort You develop a temperature higher than 100F. You have any questions. in the area. Copyright 1999 by WB Saunders Company. All rights reserved. 66 BARTHOLINS GLAND ABSCESS