From the Research
Marsupialization is the recommended treatment for Bartholin cysts or abscesses due to its lower recurrence rate and higher patient satisfaction compared to Word catheter placement, as shown in the most recent study 1.
Treatment Options
- Conservative approaches, such as warm sitz baths and over-the-counter pain relievers, can be used initially for small, asymptomatic cysts.
- For infected cysts (Bartholin abscesses), antibiotics may be necessary, with common regimens including amoxicillin-clavulanate or doxycycline.
- Surgical drainage is typically recommended for persistent or recurrent cysts causing symptoms.
Surgical Procedures
- Marsupialization: a small incision creates a permanent opening allowing continued drainage.
- Word catheter placement: insertion of a small balloon catheter for 4-6 weeks to create a new duct.
Key Considerations
- Surgical intervention becomes necessary when cysts are large (>3cm), extremely painful, or recurrent despite conservative management.
- Procedures are typically performed as outpatient surgeries with local anesthesia.
- Bartholin cysts form when the Bartholin gland ducts become obstructed, causing fluid accumulation in these glands located at the vaginal opening, which normally provide lubrication.
Evidence Summary
- A 2022 retrospective cohort study 1 found that marsupialization had a lower recurrence rate (8.3% vs 18.8%) and higher patient satisfaction compared to Word catheter placement.
- Other studies, such as 2 and 3, have also compared the effectiveness of marsupialization and Word catheter placement, but the 2022 study 1 provides the most recent and highest quality evidence.