Bartholin's Gland Cyst – Word Catheter

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  • Treatment of symptomatic Bartholin's gland duct cyst (painful, growing)
  • Treatment of Bartholin's gland abscess
  • Any condition that would preclude incision and drainage of a vulvar cyst or abscess
  • Small asymptomatic glands do not have to be drained.
  • Word catheter (Rusch Inc., Duluth, GA; Milex Inc., Chicago, IL)
  • 3-mL syringe (for catheter inflation)
  • 22-gauge, 1-inch needle (for catheter inflation)
  • 1% to 2% lidocaine for anesthesia
  • 30-gauge, 1½-inch needle (for anesthesia)
  • 3-mL syringe (for anesthesia)
  • No. 11 blade
  • Pickups with teeth
  • Small hemostats (2)
  • 4 × 4-inch gauze pads
  • Normal saline for irrigation
  • Antiseptic solution (povidone-iodine if not allergic)
  • Dressing supplies
  • The Bartholin glands are located between the hymen and the labia minora, and the ducts open in a groove formed at about 5 o'clock and 7 o'clock.
  • Neurovascular supply is provided primarily by the perineal artery and its branches and by the pudendal and perineal nerves.

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The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

  • Tell the patient to expect a discharge.
  • Leave the Word catheter in place for 4 to 6 weeks.
  • Advise the patient that sexual activity may be resumed after 2 weeks, but it is best to defer sexual activity until the catheter is removed.
  • Encourage daily showers or tub baths.
  • Schedule a return visit in 4 to 6 weeks. To remove the catheter, evacuate the balloon, and withdraw the catheter from the incision.
  • Creation of a false tract and insertion of the balloon outside the cyst/abscess
  • Partial deflation of the balloon due to inadvertent return of saline to the syringe after inflation of the balloon
  • Continuous pain may occur after insertion of the Word catheter because the bulb is filled too much or is placed improperly.
  • With an abscessed Bartholin's gland, cellulitis may occur around the vulvar opening of the duct; this requires additional antibiotic treatment.
  • If the needle used to introduce the saline into the catheter punctures the stem, the catheter will deflate gradually and will fall out before epithelialization is complete.
  • If the stab wound is too large, the catheter will fall out.
  • Excessive bleeding is rare.
  • Recurrence is always a possibility.
  • Scarring is usually minimal.
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