Gynaecology - Outpatient Management of balloon catheter insertion for Bartholins abscess/cyst

What is a Bartholin’s Cyst or Abscess?

There is a Bartholin’s gland at each side of the entrance to the vagina.

They make a mucus type fluid which lubricates the vagina. The tiny ducts (tubes) that carry fluid from the gland can become blocked and cause a swelling (cyst). An abscess can occur if the cyst becomes infected.

What is a balloon catheter?

A balloon catheter (also referred to as Word catheter) is a thin tube which allows fluid within a Bartholin’s abscess or cyst to drain continuously.

The aim is to create a new duct over the catheter which will remain open and reduce the chance of the abscess or cyst coming back again.

What’s the advantage of this form of treatment?

●    Planned appointment
●    Performed in outpatient department
●    No need to starve
●    Avoids General Anaesthetic
●    Shorter hospital stay

What are the complications?

Possible complications include:
●    Bleeding
●    Infection
●    Pain
●    Recurrence
●    Scarring
●    Pain or discomfort during sex

How is balloon catheter inserted?

Following insertion of a local anaesthetic, a small incision (3-4mm) is made into the cyst or abscess which is then drained.

A thin tube (catheter) is inserted and a balloon at the end of the tube is inflated with approximately 2 - 3mls of water to stop the catheter falling out.

The local anaesthetic will numb the area; however, you will be aware of a sensation and may experience some discomfort. If uncomfortable we can give you more local anaesthetic.

The catheter is left in place for 3 - 4 weeks to allowing tissue to heal over the catheter forming a new tube.

How long does the procedure take?

The procedure takes approximately 15 minutes, after this you will be observed for a further 30 minutes before you leave the department.

What can I expect after the procedure?

You will feel a little sore once the local anaesthetic has worn off, but it should be much less painful than before the abscess or cyst was drained.

You are recommended to rest for 1 – 2 days. Most women will be able to resume normal day to day activities after this period of time.

You may have a small amount of discharge or bleeding from the site of the balloon catheter until the wound has healed and are advised to wear a sanitary pad and avoid tight fitting clothes.

Do I need to take any medication?

You will be given a prescription to take to the hospital pharmacy for pain relief such as Paracetamol and may be given a course of antibiotics to reduce risk of infection. If antibiotics are prescribed please make sure that you complete the entire course.

Let us know if you have any allergies to any medicines.

Can I bath and shower as normal?

Yes, you are advised to take warm baths (shower if unable to have a bath). Avoid bubble bath, oils or talcum powder while the wound is healing.

Can I use tampons?

To reduce risk of infection we advise you not to use tampons while the catheter is in place.

Can I have sex with the catheter in?

To reduce risk of infection or catheter falling out we advise avoiding intercourse until wound has healed.

What happens if I experience worsening pain after I go home?

To keep the catheter in place the balloon is filled with up to 3mls of water.

Most women are comfortable with this. If the catheter is painful please contact Gynaecology Assessment Unit (GAU) telephone number - 0161 627 8855 as we may need to remove a small amount of the fluid.

Do I need to attend for follow up?

You will be given a follow up appointment to attend GAU in 3 - 4 weeks’ time. The catheter will usually fall out once the wound has healed within. If the catheter has not fallen out, it will be removed in GAU.

Can Bartholin’s Cyst/Abscess recur?

There may be a recurrence in which further treatment may be needed.

In what circumstances should I seek medical advice?

You must contact GAU on 0161 627 8855 if you have any of the following:
●    Increased bleeding
●    Increased pain
●    Increased redness or swelling
●    High temperature
●    Offensive smelling discharge

If you experience severe bleeding, severe pain or feeling generally unwell go to your nearest Accident and Emergency department or in an emergency call 999.