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How is it diagnosed?
An examination by a doctor can usually diagnose the problem. A Bartholin's cyst and
abscess have a typical appearance. No test is usually needed to make the diagnosis.
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noticeable. But this new opening is, in effect, like a new duct which allows any fluid that is
made by the gland to drain.
A course of antibiotics may be prescribed if pus is drained from an abscess. However,
antibiotics are not always needed once the pus has been drained.
Marsupialisation is usually successful. In only a few cases does the problem recur if this
procedure is done. If a simple cut is made to drain the fluid or pus without then doing a
marsupialisation, there is a higher chance that the problem will recur at some point.
As with all operations there is a small chance of problems. For example, infection of the
wound occurs in a small number of cases following marsupialisation.
Other types of operation
In recent years, various other procedures have been introduced which are sometimes used
instead of marsupialisation. For example:
A variation of the traditional operation where the fluid or pus is drained, but then the
cyst or cavity wall is stitched together.
Insertion of a Word catheter. This is a small, thin rubber tube. The head of the
catheter is inserted through a small cut made into the cyst or abscess. The tip of the
catheter has a tiny balloon which is blown up to keep the catheter in place for 2-6
weeks. Whilst the catheter is in place you can go about your normal activities. The
aim is to keep the opening from closing up. As the tissues heal, it allows the cells to
form a new 'duct' over the catheter.
Insertion of a Jacobi ring. This too is a thin catheter that is passed into the cyst or
abscess through one small cut and out from a separate cut. The two ends of the
catheter are tied together with a silk thread that goes through the middle of the
catheter. As with a Word catheter, this is left in place for a few weeks to allow a new
'duct' to form.
The operation chosen depends on factors such as the size of the cyst or abscess, and the
preference and expertise of the surgeon. They all seem to work well with a low rate of
recurrence.
Other techniques
Some people recommend that sitting in a warm bath for 10-20 minutes, three or four times a
day, may encourage a Bartholin's cyst to burst naturally. It is not clear how well this may
work. However, it is always best to see a doctor if you think an abscess is developing.
Other less commonly used procedures include application of silver nitrate to an abscess
cavity, and use of a carbon dioxide laser.
Sometimes the entire gland is removed by a surgical operation. This is considered a 'last
resort' but may be advised if you have several recurrences of a Bartholin's cyst or abscess.
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References
Patil S, Sultan AH, Thakar R; Bartholin's cysts and abscesses. J Obstet Gynaecol.
2007 Apr;27(3):241-5.
Schecter JC, Hipp A; Bartholin Gland Diseases. eMedicine, December 2009.
Omole F, et al, Management of Bartholin's Duct Cyst and Gland Abscess. American
Family Physician July 1, 2003
DA Hil and JJ Lense, Office Management of Bartholin Gland Cysts and Abscesses,
American Family Physician, April 1998
Shlamovitz GZ; Bartholin Abscess, Drainage. eMedicine, May 2009.; Excellent
explanation - with illustration/media - of procedures
Gennis P, Li SF, Provataris J, et al; Jacobi ring catheter treatment of Bartholin's
abscesses. Am J Emerg Med. 2005 May;23(3):414-5.
Haider Z, Condous G, Kirk E, et al; The simple outpatient management of Bartholin's
abscess using the Word catheter: a preliminary study. Aust N Z J Obstet Gynaecol.
2007 Apr;47(2):137-40. [abstract]
Balloon catheter insertion for Bartholin's cyst or abscess, NICE Interventional
Procedure Guideline (December 2009)