What is marsupialization of a Bartholin abscess?

Updated: Nov 17, 2017
  • Author: Gil Z Shlamovitz, MD, FACEP; Chief Editor: Christine Isaacs, MD  more...
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Answer

Answer

Marsupialization involves opening the Bartholin cyst or abscess and then suturing the edges, thereby forming a permananent open pocket or pouch and allowing continued drainage. [13]  This procedure may be performed under general or local anesthesia, is more complicated than Word catheterization, and is typically reserved for recurrent cysts or abscesses. [14]

In general, the effectiveness,  complication rates, and recurrence rates  are similar between marsupialization and Word catheterization.

In a study of 30 Austrian women with Bartholin cyst or abscess that evaluated office implementation, recurrence rates, and costs between Word catheterization and marsupialization, investigators noted an 87% success rate and 3.8% recurrence rate in women treated using the Word cathether. [5]  Word catherization was simpler to use and cost seven-fold less than marsupialization.

In a different analysis, the investigators also evaluated quality of life and sexual activity during and following treatment of Bartholin cyst or abscess with Word catherization and reported improved pain levels as well as significantly improved pain/discomfort dring sexual activity. [15] The mental component summary score of the quality of life evaluation showed a significant improvement after treatment compared with the pretreatment period, although the physical component summary score did not show a significant change. [15]

A randomized, controlled trial by Kroese et al found that 1-year recurrence rates were similar following treatment with a Word catheter or marsupialization for a Bartholin gland abscess or cyst. The study included 82 women who were treated with a Word catheter and 79 who underwent marsupialization. [16]


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