What is a Bartholin’s abscess?
There is a Bartholin’s gland at each side of the entrance to the vagina. Each gland produces lubrication that enters 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. Symptoms may include tenderness and pain, fever, and pain or discomfort during sex.
What is a Word catheter insertion?
Your doctor has recommended the insertion of a Word catheter as being the best option. Occasionally antibiotics are used to treat a very small abscess.
This procedure involves drainage of the abscess using a small rubber tube called a Word catheter. First, local anaesthetic is injected to numb the area and to relieve some of the pain you have. A small cut is made in the swelling to drain the fluid/pus and the catheter is then inserted into the gland and held in place by a tiny water-filled balloon. Rarely a stitch may be used to help hold the balloon in place. The catheter is left in place for four weeks to allow complete drainage and healing of the cyst through the newly formed passage.
What are the benefits of having this procedure?
The benefits of this procedure are that you avoid being admitted to hospital and a general anaesthetic. You do not require an adult to be with you after the procedure as you do not need a general anaesthetic. You can take up normal activities again when you are comfortable (see discharge information and at home advice). There is a good success rate and in many cases, the abscess/cyst does not return. You can also carry on with your normal life while the catheter is in place.
Are there any risks involved?
As with any surgical procedure, there is a small chance of complications such as:
- Pain: sometimes this can be relieved by letting out some of the water in the balloon. We will keep you comfortable during the procedure with pain relief.
- Occasionally the doctor will find that the abscess appears unusual or complex and therefore, surgery is needed under general anaesthetic to treat it properly.
- Bartholin’s abscesses can occur again, whatever treatment is used (the long-term recurrence rate is about 1 in 5). If you are concerned about any of these risks, or have any further queries, please speak to your nurse or doctor.
Are there any alternative treatment options?
Your consultant has recommended the insertion of a Word catheter as being the best option. Occasionally antibiotics are used to treat a very small abscess.
An alternative would be surgical treatment under a general anaesthetic, which would drain the abscess or make an opening that allows the gland to drain freely. If you would like more information, please speak to your consultant or one of the nurses caring for you.
Discharge Information and at Home Advice
You will experience some discomfort from your wound. This should be relieved by painkillers such as paracetamol – follow the manufacturer’s instructions and do not exceed the stated dose. Antibiotics may have been started during your hospital appointment and will be provided for you to take home. Please ensure you follow the instructions given.
Returning to work and normal activities
You may return to work and your normal activities as soon as you wish and feel able. You can self-certificate for the first seven days off work. Should it be required, the hospital will issue you with a Fit Note to cover your stay in hospital and the recognised recovery period. Any further certification (if necessary) should be obtained from your GP.
You may resume exercise and intercourse when the area has completely healed. It is important that you keep the area clean by washing it at least twice a day in the shower. If you do not have a shower, then make sure that you rinse the area with clean water after washing and do not use scented soap, shower gel, bubble bath, bath oils or talcum powder, as these will irritate the wound. We suggest that you use sanitary towels to protect your underwear for the next four weeks while the catheter is draining the abscess. If you have a period during this time and usually wear tampons you can continue to do so if you feel comfortable inserting and removing it.
The catheter may fall out. If this happens, contact the Ward 26 0191 445 3004 for further advice. If this occurs in the first five days, sometimes the doctor will try and reinsert it. If it is more than five days, the doctor would be likely to suggest doing nothing further unless the abscess builds up again.
If the catheter is painful in the meantime, then you should make an appointment with ward 21 to return so that you can be examined and perhaps have a small amount of the water in the balloon removed.
Follow-up
After inserting a Word catheter, the doctor or nurse will make a further appointment to see you again after four weeks, to remove it.
Usually the bacteria (‘bugs’) that cause an infection in a Bartholin’s abscess are simply an overgrowth of the bacteria that are normally present in the vagina. However, very occasionally a sexually transmitted infection is found. Therefore we suggest that all women who have had a Bartholin’s abscess think about having a check for sexually transmitted infections once the abscess has healed, at a Genito-Urinary Medicine Clinic or at your GP’s surgery.