Bartholin's cysts and abscesses

Who to refer:

• Symptomatic abscesses that have not responded to medical treatment or patients that are systemically unwell, refer to the on-call Gynae registrar at BGH via switchboard.
• Recurrence of Bartholin’s cyst/abscess before full resolution following prior spontaneous discharge/medical/surgical management, refer to the on-call Gynae registrar at BGH via switchboard.
• Post menopausal women with Bartholin’s abscess, refer to the on-call Gynae registrar at BGH via switchboard.
• Patients with inactive, bothersome cysts which haven’t resolved with conservative management can be referred for a routine Gynaecology outpatient clinic via SCI gateway.

Who not to refer:

• Spontaneously discharging abscess with treated, or absent cellulitis.
• Asymptomatic Bartholin cysts.

How to refer:

Via SCI gateway

Asymptomatic:

A small, asymptomatic cyst can be managed conservatively with a bath or warm compress to encourage drainage.

Spontaneous Drainage:

If the cyst or abscess has ruptured and pus is draining, take a swab for culture to guide or indicate antibiotics if this fails to resolve spontaneously. Patient with surrounding cellulitis around the gland usually benefit from antibiotics (see recommendations below). No further treatment or follow-up is usually required.

Medical treatment:

Antibiotics may be used if there is evidence of cellulitis around the Bartholin gland.

Antibiotic Recommendation – 5 days total recommended duration

Surgical Treatment:

Surgical intervention or Insertion of a Word Catheter remain the mainstay of treatment for symptomatic cysts and abscesses.

Balloon catheter insertion for Bartholin's cyst or abscess (nice.org.uk)

Patient information leaflet: Information for the public | Balloon catheter insertion for Bartholin's cyst or abscess | Guidance | NICE

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