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BARTHOLINS GLAND ABSCESS

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