Bartholin's Abscess Research Articles

Feasibility and Satisfaction With the Word Catheter in Treatment of Bartholin's Cyst and Abscess.

The Word catheter is a silicone device with a balloon system that may be inserted into a Bartholin's cyst or abscess in order to provide drainage and epithelization. The aim of this study was to evaluate the Word catheter as a therapy for Bartholin's cyst and abscess. Both patient and physician satisfaction, as well as the feasibility in an outpatient setting, were examined. A total of 51 women with a Bartholin's cyst or abscess were given the option of Word catheter insertion in an outpatient setting between August 2013 and March 2018. Both the patients and the consulting physicians were asked to complete two questionnaires, before, during and after treatment, with a view to evaluating the overall pain level, any discomfort symptoms and sexual activity, as well as satisfaction levels. The insertion procedure seemed to constitute a short yet quite painful procedure. In most cases, the consulting physicians and the patients were content with the results. Nevertheless, dislodgement of the catheter or abscess recurrence were common. The removal of the Word catheter seemed to be short, painless, and uncomplicated. Most patients experienced pain and discomfort after catheter placement over the first days, with the symptoms fading over time. Sexual intercourse appeared to be negatively influenced. The Word catheter was frequently well tolerated for the treatment of Bartholin's cysts and abscesses, with few non-serious side-effects, however, it did interfere with sexual health. Nonetheless, it may not be possible to make general recommendations based on this exploratory study.

Our treatment outcomes in bartholin cysts or abscesses

The purpose of this study was to examine the outcomes of Bartholin abscess or cyst surgery, silver nitrate therapy, and cyst or abscess excision in terms of recurrence, duration of the procedure, and healing times. The files of 100 patients treated in our hospital for Bartholin cysts or abscesses between March 2022 and December 2022 were reviewed retrospectively. The patients’ demographic characteristics were recorded. Demographic data, the location and size of Bartholin abscesses, complaints at presentation, and cases with recurrence were noted. The patients were divided into three groups according to the treatment applied and were compared with one another, especially in terms of recurrence, operative time, and recovery time. Group 1 consisted of those who underwent drainage due to Bartholin cyst or abscess, Group 2 of those treated with silver nitrate, and Group 3 of those who underwent cyst excision. Recurrence was detected in 12 (40%) of the cases in Group 1. Relapsed cases were treated with silver nitrate. Recurrence was observed in only one patient in the group treated with silver nitrate (Group 2). Bartholin cyst excision was performed on that patient. Mean operation times were 2.80 min in Group 1, 4.40 min in Group 2, and 23 min in Group 3 (p=0.0001). Mean recovery times were 3.37±0.49 days in Group 1, 6.13±0.73 days in Group 2, and 13.70±2.09 days in Group 3 (p=0.0001). A comparison of the patients in all three groups revealed that the recurrence rate was higher in the group receiving abscess drainage. While recurrence was observed in only one patient in the silver nitrate group, no recurrence occurred in the cyst excision group (p<0.001). This study emphasizes that silver nitrate application is a simple practical method that can be performed using local anesthesia, and involving minimal scar tissue, a faster procedure time, and faster recovery.

Management of Bartholin's cyst and abscess

Management of Bartholin's cyst and abscess

Female sexual function after surgical treatment of Bartholin's Gland Abscess: Marsupialization versus Gland excision

Objective: In this research, we compared the pre-operative and post-operative sexual function scores in patients who underwent marsupialization and gland excision procedures for Bartholin's gland abscesses using the validated Female Sexual Function Index (FSFI). Material and Methods: A total of 106 patients were enrolled in the study. Patients undergoing surgery due to a Bartholin's abscess were divided into two groups: 54 (51%) were treated by marsupialization and 52 (49%) by gland excision. The FSFI was used to evaluate sexual function status. The patients were asked to complete the FSFI questionnaire preoperatively and at 3 months after the post-operatively, and the pre-operative and post-operative total and subscale FSFI scores were compared between the treatment groups. Results: Both treatment groups had significantly improved sexual quality of life at the 3-month follow-up. The mean total FSFI score in the marsupialization group increased from 19.5 ± 7.2 to 24.9 ± 7.5 (p = 0.001). The mean total FSFI score in the gland excision group increased from 18.3 ± 6.8 to 25.3 ± 3.2 (p = 0.001). When the two groups were compared preoperatively and post-operatively, there was no statistically significant difference. The gland excision group was characterized by higher mean post-operative lubrication, satisfaction, and pain FSFI subscale scores compared to the marsupialization group. Conclusion: Gland excision and marsupialization methods applied to Bartholin's gland abscesses significantly improved the quality of sexual life. Although not statistically significant, greater FSFI scores were observed for patients who underwent gland excision. The physiological aspects of sexual life improved more in the women in the cyst excision group. Total removal of the gland did not seem to affect sexual function adversely.

Vaginal leiomyoma misdiagnosed as a Bartholin abscess: A case report from Damascus, Syria

Fibroids are benign neoplasms that are primarily found in the uterus. Fibroids can rarely be found in the vagina—most commonly arising from the anterior wall. Generally, the vagina is an unusual location for tumors. In this article, we present the case of a 30-year-old multigravid Syrian woman presenting to the emergency department with painful swelling of the left labia, mistakenly diagnosed as a Bartholin abscess. A surgical excision was recommended for the solid mass and the mass was sent for histopathological examination which confirmed the diagnosis of a vaginal leiomyoma.

Approach to Bartholin's abscesses and recurrences under office conditions

ObjectiveThe aim of this study is to investigate the various treatment methods and recurrence rates regarding Bartholin's gland abscesses under office conditions in our clinic. MethodsIn our study, the data of 155 patients who applied to the gynaecology and obstetrics clinic of our hospital between January 2017 and November 2020 and had Bartholin's abscess that was treated with surgical methods under office conditions were analyzed retrospectively. ResultsOf the 155 patients included in the study, 111 underwent incision drainage, 22 underwent marsupialization, and 22 underwent incision drainage+ silver nitrate. Bartholin's abscess was localized on the right side in 48.4% of the patients and on the left side in 51.6% of the patients. Recurrence was detected in 53 of 155 patients included. Recurrence was detected in 39.6% of the patients who underwent incision drainage in the first treatment, 31.8% of those who underwent marsupialization, and 9.1% of those who underwent incision+silver nitrate. The difference in success, based on recurrence rates, was found to be statistically significantly in favour of silver nitrate (p<0.05). In secondary treatments for recurrent cases, marsupialization or incision+silver nitrate treatment was effective in over 90% of cases, while incision drainage was effective in 30% of patients. ConclusionThe findings of our study show that silver nitrate application led to a lower recurrence rate than the other two methods. In view of this, we recommend that marsupialization or silver nitrate be preferred, especially in the treatment of recurrent cases.

English

Bartholin gland cyst is the most common vulval cyst that arises from the dilated duct resulting from the obstruction of its opening. Most cysts are asymptomatic, but if not treated adequately and remain obstructed, they get infected and can result in Bartholin gland abscess. Abscess is usually present in the women of reproductive age. Patients commonly present with fever and painful progressive swelling of labia. Imaging modalities are used to diagnose the disease and it also aids to understand its extension in the complex pelvic floor region. The vulvar region is a host of various benign and malignant lesions. Vulva is a collective term for several anatomical structures: Mons pubis, labia majora and minora, vestibule, Bartholin gland and clitoris. Most common vulva cysts are the Bartholin gland cysts. In majority of the cases, these cysts are asymptomatic or are incidentally found on imaging studies. If these cysts are not properly treated, they can get infected and cause complication such as Bartholin gland abscess. 2 % of women during their lifetime develop Bartholin gland abscess or cysts.1 Pain is one of the most common indicators of infection in Bartholin cyst. Bartholin abscess starts with progressive swelling of labia majora later accompanied by fever and painful swelling of affected vulva side.2 Imaging modalities such an ultrasonography and magnetic resonance imaging aid in the diagnosis and extension of the lesion. We present a case of 55-year perimenopausal female of Bartholin gland abscesses diagnosed using imaging modalities such as ultrasound sonography (USG) and magnetic resonance imaging (MRI).

Solitary Vulvar Involvement of Ovarian Non-Hodgkin Lymphoma Mimicking Bartholin's Abscess on 18F-FDG PET/CT.

A 49-year-old woman was diagnosed with diffuse large B-cell lymphoma of the left ovary. Two months after the hysterectomy and bilateral salpingo-oophorectomy operation, the patient was referred to 18F-FDG PET/CT for staging. A mass lesion measuring 2.8 × 3 cm with intense 18F-FDG uptake was observed at right labium majus, which could be considered as a Bartholin's cyst or abscess. The lesion was excised, and non-Hodgkin lymphoma involvement of vulva was revealed by histopathology.

Abscess Management: An Evidence-Based Review for Emergency Medicine Clinicians.

Abscesses are commonly evaluated and managed in the emergency department. Recent research has evaluated the use of ultrasonography, packing, incision and drainage (I&D), and antibiotics. There are evidence-based nuances to the management of specific types of abscesses, such as Bartholin, breast, dental, hidradenitis suppurativa, peritonsillar, and pilonidal abscesses. This review provides emergency medicine clinicians with a summary of the current literature regarding abscess management in the emergency department. Ultrasound is valuable in diagnosing abscesses that are not clinically evident and in guiding I&D procedures. Although I&D is traditionally followed by packing, this practice may be unnecessary for small abscesses. Antibiotics, needle aspiration, and loop drainage are suitable alternatives to I&D of abscesses with certain characteristics. Oral antibiotics can improve outcomes after I&D, although this improvement must be weighed against potential risks. Many strategies are useful in managing Bartholin abscesses, with the Word catheter proving consistently effective. Needle aspiration is the recommended first-line therapy for small breast abscesses. Dental abscesses are often diagnosed with clinical examination alone, but ultrasound may be a useful adjunct. Acute abscess formation caused by hidradenitis suppurativa should be managed surgically by excision when possible, because I&D has a high rate of abscess recurrence. Peritonsillar abscesses can be diagnosed with either intraoral or transcervical ultrasound if clinical examination is inconclusive. Needle aspiration and I&D are both suitable for the management of peritonsillar abscesses. Pilonidal abscesses have traditionally been managed with I&D, but needle aspiration with antibiotics may be a suitable alternative. This review evaluates the recent literature surrounding abscess management for emergency medicine clinicians.

Upgrading Bartholin's abscess management using novel technologies? A challenge for generating knowledge through research that translates well.

Upgrading Bartholin's abscess management using novel technologies? A challenge for generating knowledge through research that translates well.

Evaluation of treatments for Bartholin's cyst or abscess: a systematic review.

No consensus on the management of symptomatic cysts or abscesses of the Bartholin's gland exists. To assess the effectiveness and safety of surgical interventions for a symptomatic Bartholin's cyst or abscess. We searched bibliographical databases from inception to April 2019. Randomised trials evaluating a surgical intervention for the treatment of a symptomatic Bartholin's cyst or abscess. Eight trials, reporting data from 699 women, were included. Study characteristics and methodological quality were recorded for each trial. Summary estimates were calculated using random-effects methods. When considering the recurrence of a symptomatic Bartholin's cyst or abscess, the evidence was consistent with notable effects in either direction (risk ratio [RR] 0.76; 95% confidence interval [CI] 0.41-1.40) when comparing marsupialisation with incision, drainage and insertion of a Word catheter. Limited inference could be made when comparing marsupialisation with incision, drainage and silver nitrate insertion (RR 1.00; 95% CI 0.57-1.75), and incision, drainage and cavity closure (RR 0.25; 95% CI 0.01-4.89). There was limited reporting of secondary outcomes, including haematoma, infectious morbidity and persistent dyspareunia. Current randomised trial evidence does not support the use of any single surgical intervention for the treatment of a symptomatic cyst or abscess of the Bartholin's gland. PROSPERO: International Prospective Register of Systematic Reviews; CRD42018088553. Further research is needed to identify an effective treatment for #Bartholin's cyst or abscess. @jamesmnduffy.

Cost-utility Analysis Treatment of Bartholin's Abscess : Word Catheter Versus Incision-drainage.

Cost-utility Analysis Treatment of Bartholin's Abscess : Word Catheter Versus Incision-drainage.

Word Catheter Placement for Bartholin's Gland Abscess: Applications for Clinical Practice and Simulation.

For women who present with Bartholin's abscesses, placement of a Word catheter offers a minimally invasive approach for effective management in urgent care and emergency department settings. Although the procedure is relatively simple, the frequency of placement in the ED setting varies. Provider familiarity with both the device and the procedure can be enhanced using simulation techniques. This article presents the diagnostic and treatment approaches to Bartholin's abscesses and describes in detail both low- and high-fidelity simulations for Word catheter placements.

Sexual function after Bartholin gland abscess treatment: A randomized trial of the marsupialization and excision methods

ObjectiveTo compare sexual function scores in patients who had marsupialization and gland excision procedures for the treatment of Bartholin gland abscesses. Study designPatients who had bartholin abscess for the first time were randomized into marsupialization or gland excision methods. The primary outcome was to compare post surgical Female Sexual Function Index (FSFI) scores between the marsupialization group and the excision group. Secondary outcomes were to calculate the recurrence rates and other postoperative complications after the surgery. Results195 women were evaluated for the treatment of Bartholin abscess and 154 of them were included in our study. The final analysis was carried out on 134 participants. There was no statistically significant difference among the study groups in terms of age, BMI, gravidity, parity, site of the abscess, and diameter of the abscess. The mean diameter of the abscess was not significantly different among patients who had dyspareunia (4 ± 1.34 cm) and did not have dyspareunia (3.39 ± 0.99 cm). No recurrence was observed in the gland excision group while 5 patients had a recurrence of the abscess in the marsupialization group. Dyspareunia after the procedure was more common in patients who underwent marsupialization (2.9% vs 15.1%, p = 0.01). The FSFI scores were <26.5 in both treatment groups. The total score was 24.76 ± 4.32 in the excision group and was 22.33 ± 5.15 in the marsupialization group. ConclusionThe excision of the gland for treating the Bartholin abscess resulted in less dyspareunia and recurrence when compared to the marsupialization procedure. Lower FSFI scores were reported in both groups, however, FSFI scores in the excision group were higher than in the marsupialization group. The excision of the Bartholin gland did not hamper sexual function.

“Management of Bartholin Cysts and Abscess” in a Tertiary Care Centre, Jeddah, Saudi Arabia

Objective: To analyse all cases of Bartholin glands pathology (cysts and abscess), and identify the different variable affecting the method of management with Marsupialization or excision. Methods: This study is a cross-sectional retrospective analysis of all cases of Bartholin cysts and abscess admitted and managed at KAUH, from January 2017 to December 2017. Results: 48 patients were analysed: age (32.60 ± 9.9), parity, BMI (26.9 ± 4.98). Out of 48 patients, 25 (52.1%) were diagnosed as Bartholin cysts and 23 (47.9%) as Bartholin abscess. 72.9% (35) patients were managed with Marsupialization, and only 27.1% ended with excision. Comparing age in years, parity and BMI in the cases managed by Marsupialization with those with excision, the only statically significant difference was found in the parity. When comparing the important factors collected, younger subjects less than 35 years old, never being pregnant and BMI less than 30 had more Marsupialization than excision. But age < 35 was statistically significant (Table 1). Abscess and non-recurrent had more Marsupialization but were statistically not significant. Other factors, past medical and surgical history and type of anaesthesia were the same in both groups. Logistic regression performed using the dependent variable for Marsupialization rather than excision with different covariant categorised variable, age less than 35, single, abscess, non-recurrent, and BMI less than 30 (Table 2). Age less than 35 and BMI less than 30 were

Gebelikte, Rekürren Bartolin Apsesine Bağlı Gelişen Vulva Ödemi

Vulvar edema appears as a manifestation in many diseases rather than (being) a disease. It does not have a specific etiology; it can appear as a result of allergic, inflammatory and neurological diseases affecting vascular and/or lymphatic system, or trauma. In its etiology there are herpes infections, Bartholin abscess, lymphogranuloma venereum, Crohn's disease, Behcet's disease, which are of infection origin. Vulvar edema in pregnancy is a rare clinical condition that often appears at the third trimester, is due to lymphatic obstruction and toxemia of pregnancy. In this paper we present a 25-year-old female patient who was primipara, developing edema of the vulva arising from recurrent Bartholin abscess at the second trimester of pregnancy. After the examinations, vulvar edema was attributed to Bartholin abscess caused by bacterial colonization due to traumatic coitus.

Acute Bartholin's abscess: microbial spectrum, patient characteristics, clinical manifestation, and surgical outcomes.

The purpose of this investigation was to evaluate the patient characteristics, clinical manifestations, microbiology, and modes of treatment of a large cohort of women with acute Bartholin's abscess, from a single medical center. A retrospective study was undertaken of all women diagnosed with acute Bartholin's gland abscess who were admitted to the gynecology department in a university-affiliated tertiary hospital in central Israel from January 2004 to December 2013. A total of 267 women were included in the study. The mean age at diagnosis was 33.5 ± 12.1 years and the mean hospitalization period was 1.4 ± 0.9days. Pain presented in 152 (56.9%), swelling in 81 (30.3%), and fever in 34 (12.7%). Leukocytosis was detected in 149 (55.8%). The three main treatment modalities were: antibiotics (75.7%), abscess drainage (19.1%), and marsupialization (80.9%). Bacterial infections were detected in 154 (57.7%) cultures, Escherichia coli presented in 59 (22.1%), and Streptococcus species in 27 (10.1%). The clinical and patient characteristics were similar between women with bacterial and sterile Bartholin's abscesses, though leukocytosis was more prevalent among women with bacterial infections. E. coli was the single most frequent pathogen in cultures of acute Bartholin's abscess. Respiratory tract-associated organisms were also common. This study indicates the polymicrobial spectrum of acute Bartholin's abscess.

Word balloon catheter for Bartholin's cyst and abscess as an office procedure: clinical time gained.

BackgroundAround 2 % of women develop a Bartholin’s cyst or abscess at least once in their life time. The use of Word balloon catheter as an office procedure for the management of Bartholin’s cyst and abscess has been well described and indicates high patient acceptance, low short-term recurrence rates and reduced cost. In most of the reported studies, the reduced costs are attributed to savings from equipment cost, operating theatre costs and health personnel costs. An evaluation of the actual clinical time gained with this office procedure has not been reported and hence the rationale for this study. This study was conducted from December 2011 to January 2014 on 35 patients. An initial retrospective clinical audit of 14 cases of marsupialization under general anesthetic between December 2011 and December 2012 was performed. The findings were compared with a subsequent prospective observational service evaluation of 21 consecutive patients between December 2012 and January 2014.ResultsCompared to marsupialization under general anesthetic, the mean clinical time gained from admission to insertion of Word balloon catheter as an office procedure is 15 h and 40 min and the mean clinical time gained from admission to discharge is at least 24 h. There were very few minor complications and no major complications in the Word catheter group compared to the marsupialization group.ConclusionsThere is a clinically significant time gained with the use of Word balloon catheter as an office procedure compared to marsupialization under general anesthetic for Bartholin’s cyst and abscess. The findings from our study could assist other units that want to adopt this procedure justify the efficiency savings in terms of clinical time gained when a business case is submitted. Further studies are needed to investigate and address the underlying causes for the delays encountered when marsupialization under general anesthetic is chosen by patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1795-3) contains supplementary material, which is available to authorized users.

Recurrent Bartholin′s gland abscess in pregnancy: An uncommon presentation

Bartholin's gland cysts and abscesses are the most common cystic swelling of the vulva in women of reproductive age and are usually small in size, as the discomfort associated with it necessitates early consultations. Huge Bartholin's abscesses are uncommon and even fewer cases have been reported were among non-pregnant women. This case involved a 25-year old grandmultipara, who presented at a gestational age of 24 weeks with a huge vulval swelling measuring 14cm x 10cm, following failure of its resolution from self-medicated antibiotics. She had experienced similar but smaller vulvar enlargements in her two preceeding pregnancies that had resolved following similar medical treatment. She was treated successfully with marsupialization, without any adverse effect on the pregnancy. This case illustrates the likelihood of huge Bartholin's abscess complicating pregnancy and that there should be no hesitation to apply marsupialization in its treatment. The recurrence of the abscess in three successive pregnancies in this woman, who kept using self-prescribed antibiotics is a worrying trend that will require the education of women at various reproductive health care clinics about vulvar swellings and warn against antibiotics abuse.

English

INTRODUCTION: The Laryngeal Mask Airway (LMA) has been used extensively to provide a safe airway in spontaneously breathing patients who are not at risk from aspiration of gastric contents. The increased risk of aspiration in Obstetric population was initially considered as a relative contra indication for LMA usage. But LMA proved to be safe in this subgroup and in fact significantly decreased tidal volume was noted during IPPV with a decreased the risk of aspiration. METHOD: This is a prospective study, performed in Niloufer Hospital for Children & Women from June 2011 - January 2014 over a period of 30months. We studied the ease of insertion of single use ILMA and associated complications in 35 ASA 1 obstetric patients. RESULTS: The mean age of the patients was 27.4 years. The mean BMI was 28.4 kg /m 2 . 21 patients were admitted for cerclage (60.0%), 5 Bartholin's abscess (14.28%), 6 cases of manual removal of placenta (17.14%), 3 cases of vescicular mole for evacuation (8.57%). The duration of anesthesia ranged from 20-40 min with a mean duration of 19 minutes. The first time insertion rate was 88.57%, 31 out of 35 patients had the LMA inserted in first attempt. 4 patients needed reinsertion. None of the patients had aspiration or other complications associated with LMA. There were no failed insertions. CONCLUSION: We conclude that the LMA is effective and safe for in carefully selected ASA 1 pregnant patients in the hands of experienced Anesthesiologist.