From the Research
Marsupialization is the recommended treatment for Bartholin's cysts or abscesses due to its lower recurrence rate and higher patient satisfaction compared to Word catheter placement, as shown in the most recent and highest quality study 1.
Diagnosis and Treatment
Bartholin's cysts are fluid-filled swellings that develop in one or both Bartholin's glands, which are located on either side of the vaginal opening. Most small, asymptomatic Bartholin's cysts don't require treatment and may resolve on their own. For symptomatic cysts, warm sitz baths for 10-15 minutes several times daily can provide relief and may help small cysts drain naturally. If the cyst becomes infected (forming an abscess) or is large and painful, medical intervention is necessary.
Treatment Options
Treatment options include:
- Marsupialization (creating a permanent opening to allow drainage)
- Word catheter placement (a small balloon catheter inserted for 4-6 weeks to create a new duct)
- Incision and drainage for abscesses, typically combined with antibiotics like amoxicillin-clavulanate 875/125 mg twice daily for 7 days Recurrent cysts may require gland excision. Bartholin's cysts occur when the ducts of these glands become obstructed, causing secretions to accumulate. While most are benign, women over 40 should have the cyst tissue examined to rule out rare cases of cancer. Sexual partners don't need treatment as these cysts aren't sexually transmitted, though infections of the cysts can sometimes involve bacteria associated with sexual activity.
Key Findings
A retrospective cohort study 1 found that marsupialization had a lower recurrence rate (8.3%) compared to Word catheter placement (18.8%), and higher patient satisfaction. Another study 2 found comparable recurrence rates for treatment of Bartholinic abscess/cyst with Word catheter and marsupialisation, but marsupialization is still preferred due to its higher patient satisfaction and lower recurrence rate in the most recent study 1.