What is a Bartholin’s abscess?
The Bartholin’s glands are two small glands located on each side of the labia minora, just outside of the opening to the vagina. They secrete mucus to lubricate the vagina. If the gland becomes blocked the gland can fill with mucus and a fluid filled lump, a cyst, can occur. An abscess can occur if the gland or cyst becomes infected. You may feel the swelling but not necessarily any pain.
Symptoms include:
- tenderness
- pain
- fever
- discomfort during sex
We can treat very small abscesses with antibiotics.
We have recommended a balloon or ‘word catheter’ as the best option for you.
What is a word catheter insertion?
It involves draining the abscess using a small rubber tube called the ‘word catheter’. We do this as an outpatient procedure. It normally takes 20 to 30 minutes and you will be able to go home immediately after it has been carried out.
What happens during the catheter insertion?
We inject local anaesthetic to numb the area to relieve some of the pain.
We then make a small cut into the swelling to drain the fluid/pus.
A swab test taken from the abscess will check for any infection. We’ll then insert the catheter into the gland where it stays in place by a water filled balloon. We may need to put a stitch in to hold the balloon in place.
How long will the catheter stay in place?
4 weeks to allow complete drainage and healing of the cyst. After 4 weeks, we’ll remove the balloon painlessly by deflating it.
What are the advantages of a word catheter insertion?
It’s a quick procedure. You don’t need to stay in hospital, have a general anaesthetic or have an adult with you afterwards.
People who’ve had the catheter have a lower chance of needing pain relief after the procedure (33%) than those who have the surgical alternative under general anaesthetic (74%).
What are the disadvantages of a word catheter insertion?
These include:
- pain if the balloon is too full but we can let out some of the liquid
- an unusual or complex abscess which needs surgery under general anaesthetic
- the abscess happening again.
The rate of recurrence after one is year is the same (10 to12%) whether you have the procedure under local or general anaesthetic.
What happens when I get home?
You’ll feel some discomfort from your wound. You can take simple painkillers such as paracetamol and ibuprofen – please follow the manufacturer’s instructions and don’t have more than the recommended dose.
If we prescribe antibiotics, follow the instructions and complete the course.
When can I go back to work and do my normal activities?
As soon as you want and feel able. You can re-start exercise and have sex when you feel comfortable.
Can I have a shower?
Yes. You must keep the area clean by washing it at least twice a day in the shower. If you don’t have a shower, rinse the area with clean water after washing.
Don’t use scented soap, shower gel, bubble bath, bath oils or talcum powder as these will irritate the wound.
Use sanitary towels to protect your underwear for the next 4 weeks while the catheter drains the abscess. If you have a period in this time and usually wear tampons, you can continue to do so if you feel comfortable inserting and removing them.
When will I have a follow up appointment to remove the catheter?
We’ll make an appointment to see you after 4 weeks to remove the catheter. If it feels painful in the meantime, you should see us earlier so that we can examine you and possibly remove a small amount of the fluid in the balloon.
Occasionally the catheter falls out before 4 weeks. If this happens in the first 5 days, the doctor will try and reinsert it. If it happens more than 5 days later, then the doctor will probably suggest seeing what happens. We’ll only put another catheter in if the abscess builds up again.
Do I need a check for sexually transmitted infections?
Yes. Usually, the organisms (‘bugs’) that cause an infection in a Bartholin’s abscess are an overgrowth of the natural vaginal organisms. But occasionally we find an infection with gonorrhoea which is transmitted through sexual intercourse.
We advise anyone who’s had a Bartholin’s abscess to check for sexually transmitted infections at a sexual health (genitourinary medicine) clinic once the abscess heals.
Are there any alternative treatment options?
Yes. An operation called ‘marsupialisation’. This involves a hospital stay and a general anaesthetic.
The procedure involves making a larger cut in the cyst/abscess to drain it, with dissolvable stitches used to hold the abscess/cyst cavity open after the fluid/pus has drained out. The stitches dissolve over 4 weeks. The aim is to help the abscess/cyst heal in such a way that reduces the chance of it forming again.
Are there any disadvantages to this alternative treatment?
Yes, this includes the risk of having a general anaesthetic. You’ll need a space on the emergency operating list, so the day and time of surgery isn’t predictable. More urgent cases take priority and you may have to wait some time.
We may need to insert a small ribbon into the abscess/cyst after surgery if you have bleeding. Some people may experience pain after the procedure.
Contact us
If you need more information or have concerns after the treatment, contact the nursing staff in the emergency gynaecology clinic on 01296 316469.
About this information
It explains some of the most common side-effects that some people may experience. But it isn’t comprehensive. If you have other side-effects and want to ask anything else related to your treatment, call the gynaecology clinic on number above.
