Bartholin gland cyst and abscess: Word catheter placement
- Katherine T Chen, MD, MPH
Katherine T Chen, MD, MPH
- Professor of Obstetrics, Gynecology, and Reproductive Science
- Icahn School of Medicine at Mount Sinai
The Bartholin glands (also called the greater vestibular glands) are located in the vulva, and blockage of the Bartholin ducts is a common etiology of a vulvar mass. The most common Bartholin masses are cysts or abscesses. The mainstay of management of a Bartholin abscess is incision and drainage (I&D), and a Word catheter is often placed as well (picture 1). The Word catheter is a balloon that is placed in the Bartholin gland after I&D to allow continued drainage and reepithelialization of a tract for future drainage.
This topic will review the procedure for incision, drainage, and placement of a Word catheter for treatment of a Bartholin cyst or abscess. General principles of the diagnosis and management of a Bartholin cyst or abscess and the management of other types of vulvar abscess are discussed in detail separately. (See "Bartholin gland masses: Diagnosis and management" and "Vulvar abscess".)
INDICATIONS AND CONTRAINDICATIONS
The indication for incision and drainage (I&D) and Word catheter placement is the presence of an uncomplicated Bartholin abscess. Placement of a Word catheter into the abscess allows the contents to drain and, over time, to form around the catheter a fistulous tract from the dilated duct or abscess to the vestibule to allow future drainage.
The stem of the Word catheter is latex, and thus use of this device is contraindicated in patients with latex allergy. There are few other contraindications to Word catheter placement.
PREPROCEDURE EVALUATION AND PREPARATION
The patient is evaluated prior to the procedure to confirm that a vulvar mass is a Bartholin abscess, rather than another vulvar mass. (See "Bartholin gland masses: Diagnosis and management", section on 'Evaluation'.)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Hill DA, Lense JJ. Office management of Bartholin gland cysts and abscesses. Am Fam Physician 1998; 57:1611.
- Omole F, Simmons BJ, Hacker Y. Management of Bartholin's duct cyst and gland abscess. Am Fam Physician 2003; 68:135.
- Scott PM. Draining a cyst or abscess in a Bartholin's gland with a Word catheter. JAAPA 2003; 16:51.
- Word B. Office treatment of cyst and abscess of Bartholin's gland duct. South Med J 1968; 61:514.
- Haider Z, Condous G, Kirk E, et al. The simple outpatient management of Bartholin's abscess using the Word catheter: a preliminary study. Aust N Z J Obstet Gynaecol 2007; 47:137.
- Reif P, Ulrich D, Bjelic-Radisic V, et al. Management of Bartholin's cyst and abscess using the Word catheter: implementation, recurrence rates and costs. Eur J Obstet Gynecol Reprod Biol 2015; 190:81.