BARTHOLINS GLAND ABSCESS
GENERAL INFORMATION
Bartholins gland is located immediately outside of the
entrance to the vagina. The gland produces a slippery
liquid that travels through a very small tube (called a
duct). This fluid helps keep the entrance to the vagina
lubricated. One gland empties on the right side and the
other on the left.
Sometimes this small duct gets plugged, and the fluid
cannot get out. The duct forms a sac (called a cyst)
filled with this fluid. This fluid can become infected,
producing an abscess.
Figure 1. Typical location (arrow) of a Bartholins cyst abscess.
COMMON SIGNS AND SYMPTOMS
Early on, a Bartholins gland cyst might not produce
any symptoms at all. If it is small, many women dont
even know it is there. If it gets larger, it can cause
pain with sexual intercourse or with walking and
sitting.
If the cyst becomes infected, it becomes swollen and
can be extremely painful to touch.
DIAGNOSIS
Usually, the diagnosis can be made by taking a
detailed history and doing a thorough physical
examination.
The cyst can be seen just next to the opening of the
vagina. It can be felt easily with the fingers. It is not
usually confused with anything more serious.
THERAPY
Many Bartholin cysts may be treated conservatively
with warm sitz baths. Often this helps the cyst to
open and drain on its own.
q Copyright 1999 by WB Saunders Company. All rights reserved.
Cysts or abscesses that come back usually need an
operation.
The treatment for a Bartholin cyst abscess is to drain
the pus in it, or to open it wide and purposely leave
it that way (this is called marsupialization).
If a symptomatic Bartholin cyst is not infected, then
the treatment is to remove it entirely.
Abscesses of the gland that come back even though
they were drained properly need to be removed after
the acute infection is treated.
After careful consideration of all factors, the
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 office 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 fine 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
marsupialized, the abscess edges will be sewn open
to help prevent recurrence.
You should be able to go home directly after the
operation.
Arrangements will be made for any antibiotics or
pain medicine and for a follow-up office visit.
The doctor will discuss with you the possibility of
having this cyst removed entirely after things quiet
down.
For a Noninfected Bartholin Cyst
You will be given medicine that will make you feel
drowsy before you are brought to the operating
room.
The operation will be done under general anesthesia
or a spinal-epidural block.
You will be positioned on the table the same as for a
regular pelvic examination.
The area around the cyst will be painted with an
antiseptic solution and draped.
The entire cyst will be removed and the skin closed
with absorbable suture.
BARTHOLINS GLAND ABSCESS 65
 You will wake up in a recovery room. When your
blood pressure, pulse, and breathing are stable, you
will be taken to a regular hospital room.
You should be able to go home the next day.
Arrangements will be made for any antibiotics or
pain medicine and for the follow-up office visit.
As with any operation, complications are always
possible. With your type of operation they can
include bleeding and infection and possibly others.
HOME CARE
Resume your usual activities.
You may eat as you did before the operation.
You may shower as you wish.
You may wish to take sitz baths to relieve discomfort
in the area.
66 BARTHOLINS GLAND ABSCESS
Be careful that you do not become constipated.
Include enough roughage and liquid in your
diet.
You may need a mild laxative (example: milk of
magnesia), a stool softener (Colace, Surfak), or a
glycerine suppository.
You may return to work when you feel up to it.
Driving your car is all right, but do not do so if you
are taking pain medicine that reduces your alertness.
During your follow-up visit, lets discuss when you
may resume sexual activity.
CALL OUR OFFICE IF
The area becomes red or swollen, and there is
drainage from it.
You develop a temperature higher than 1007F.
You have any questions.
q Copyright 1999 by WB Saunders Company. All rights reserved.