What it is
The Bartholin glands sit on either side of the vaginal opening. Each one drains through a duct narrow enough to block.
When the duct blocks, fluid backs up and forms a cyst. If it gets infected it becomes an abscess, and that is painful enough that sitting hurts.
Draining it takes the pain off quickly. The harder part is keeping the duct open so it does not fill back up.
Why it is done
- A painful lump on one side of the vaginal opening
- Swelling that makes sitting, walking or sex hurt
- A cyst that keeps coming back after draining on its own
- An abscess that antibiotics alone will not clear
- A lump large enough to be uncomfortable even without infection
- A new Bartholin lump after 40, where the tissue should be sampled
What happens, step by step
- 1
Numbing the skin
Local anesthetic is injected around the lump.
- 2
A small opening
A short cut is made on the inside surface, not the outer skin.
- 3
Draining it
The fluid or pus is let out and the cavity is rinsed.
- 4
Culture if infected
Pus is sent for culture when infection is likely.
- 5
Word catheter
A small balloon-tipped catheter is left in to hold the duct open.
- 6
Taking it out
The catheter stays four to six weeks, then comes out in the office.
Questions people ask
- Does it hurt?
- The numbing injection stings. The pressure comes off as soon as it drains.
- Can I drive home?
- Yes. Only local anesthetic is used.
- Will it come back?
- It can. A Word catheter left in long enough lowers the chance. Marsupialization is the next step if it keeps recurring.
- Is this a sexually transmitted infection?
- No. A Bartholin cyst is a blocked duct, not an infection you catch. Abscess fluid is cultured to see what grew.
- Can I have sex with the catheter in?
- Better not to. It can pull the catheter out early.
- Do I need antibiotics?
- Not for a simple cyst. Dr. Mueller adds them when there is infection in the surrounding tissue or fever.