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BARTHOLINS GLAND ABSCESS

GENERAL INFORMATION Cysts or abscesses that come back usually need anoperation.Bartholins gland is located immediately outside of the

The treatment for a Bartholin cyst abscess is to drainentrance to the vagina. The gland produces a slippery the pus in it, or to open it wide and purposely leaveliquid that travels through a very small tube (called ait that way (this is called marsupialization).duct). This uid helps keep the entrance to the vagina

If a symptomatic Bartholin cyst is not infected, thenlubricated. One gland empties on the right side and thethe treatment is to remove it entirely.other on the left. Abscesses of the gland that come back even thoughSometimes this small duct gets plugged, and the uidthey were drained properly need to be removed aftercannot 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, theproducing an abscess.recommendation is that you have an operation tocorrect 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 theoperation.

You may be asked to douche on the morning of theoperation.

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 willmake the area numb.

The abscess will be opened and drained. You shouldget pain relief very soon. If the abscess isFigure 1. Typ ical loca tion (arrow ) of a B artho lins c yst ab sce ss.marsupialized, the abscess edges will be sewn opento 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 produceoperation.any symptoms at all. If it is small, many women dont

Arrangements will be made for any antibiotics oreven know it is there. If it gets larger, it can causepain 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 anddown.can be extremely painful to touch.

For a Noninfected Bartholin CystDIAGNOSIS 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 operatingdetailed history and doing a thorough physicalroom.examination.

The operation will be done under general anesthesia The cyst can be seen just next to the opening of theor 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 ausually confused with anything more serious.regular pelvic examination.

THERAPY The area around the cyst will be painted with anantiseptic 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 toopen and drain on its own. with absorbable suture.

Copyright 1999 by WB Saunders Company. All rights reserved. BARTHOLINS GLAND ABSCESS 65

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You will wake up in a recovery room. When your Be careful that you do not become constipated. Include enough roughage and liquid in yourblood 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 aglycerine 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 youpossible. 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