Bartholins llt - James Paget University Hospitals

James Paget University Hospitals
NHS Foundation Trust
Women & Child Health Division
Drainage or Marsupialisation
of a Bartholins Cyst or Abscess
Gynaecology Department
Patient Information
Please bring this information when attending your hospital appointments.

Some Information about your
Operation
This booklet has been written to give you information
about the operation which your doctor has discussed with
you. These notes do not cover everything - if you want to
know more please ask your surgeon or any member of
your healthcare team.
Please bring this booklet with you to future hospital
appointments and when you come in for your operation.
We have provided contact numbers on the last page of
this booklet – please use them if you want to discuss
anything with us.
Medical, nursing and physiotherapy students all work in
this hospital. You may be asked if they can observe or
take part in some aspects of your care. Your consent must
be obtained before they do so and you are able to say no.
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What is a Bartholin’s cyst or abscess?
The Bartholin’s glands lie at each side of the vulva. Their job is to
produce lubrication. It is possible for the neck of the gland to become
blocked. This is often due to an infection and leads to the formation
of a painful abscess at one side of the vulva. It may settle by itself, but
it can result in the formation of a painless cyst.
What does the operation consist of?
The problem can be treated by incision. This is an opening of the
abscess or cyst. A better result can often be obtained by a
marsupialisation. This involves opening the cyst and stitching the lining
of the cyst to the skin, leaving a small pouch. This allows the gland to
drain freely in future.
Which is best for me?
Marsupialisation is usually the operation of choice. Occasionally
incision is better, particularly if there is active infection. Removal of
the gland may be an option where there have been recurrent
problems.
Why do I need treatment of the Bartholin’s
abscess or cyst?
If there is an abscess there will be acute pain, which is best relieved by
draining the pus. If there is a cyst then this can cause discomfort with
intercourse and the possibility of recurrent infections.
Are there alternatives?
Small abscesses may settle with antibiotics. If there is a large collection
of pus or fluid then it is usually best to drain it by one of the
operations already mentioned.
What are the complications?
It is possible that there will be some scarring or a painful scar.
3

What are the risks?
All care is taken to ensure that you have a safe and uneventful
recovery following your operation. However, there is always an
element of risk associated with surgery and a general anaesthetic.
What happens before the operation?
Your operation may be arranged as an emergency. If your operation is
planned you will usually have an appointment to attend the preassessment
clinic several days before your scheduled admission. You
will be interviewed and examined by the nurse.
Welcome to the Ward
You will be welcomed to the ward by the nurses or the receptionist.
Your details will be checked and you will be shown to your bed. You
will be asked to change into your nightwear. You will have some basic
tests done such as pulse, temperature, blood pressure and urine
examination.
Please bring your current medication when you come into hospital
and hand it in to the nurse. If you need a special diet, please tell the
nursing staff, so that it can be ordered for you.
Please inform us if you have allergies to any drugs, dressings or latex
rubber.
If you are a smoker, try not to smoke for several days before and after
your operation. This will help to keep your lungs clear after the
operation and reduce the amount of coughing.
Visits by the surgical team
You will be seen by the doctor, who will interview and examine you.
The operation will be explained to you and you will be asked to sign
for consent for the operation. If you are not clear about any part of
the operation, ask for more details. The surgeon who is performing
the operation, will see you to check all necessary preparations have
been made.
4

Visits by the anaesthetic team
The anaesthetist who will be giving your anaesthetic will interview
and examine you. They will be especially interested in breathing or
heart problems, dental treatment and any previous anaesthetics you
have had. Tell them about any anaesthetic problems in your
immediate family as well.
Food and drink
You will have your usual diet until six hours before the operation.
Then you will be asked to have nothing to eat or drink. This will let
your stomach empty to prevent vomiting during your operation.
Timing of the operation
This will depend upon the urgency of your operation. The nurses will
tell you when to expect to go to the operating theatre. Do not be
surprised, however, if there are changes to the exact timing.
Pre-medication
You may be given sedative tablet about an hour before the operation.
You will then be expected to stay in bed, and a call bell will be close at
hand if you need any help.
Going to theatre
When you are due to go to theatre, you will be taken by your nurse
and a theatre support worker. You will be wearing a cotton gown.
Wedding rings will be fastened with tape. If you wear dentures, a
hearing aid or glasses you may continue to wear these to theatres.
The theatre reception nurse who is responsible for your care will greet
you and take you into the anaesthetic room. Here you will meet the
anaesthetist and your anaesthetic will begin. A small tube will be
placed into the back of your hand (this feels like a scratch). Through
this you will be given anaesthetic drugs to help you drift off to sleep.
The operation is then performed.
5

Coming round from the anaesthetic
Although you will be conscious a minute or two after the operations
ends, you are unlikely to remember anything until you are back on the
ward. Some patients feel a bit sick, but this passes. You may be given
some treatment for sickness if necessary.
You may be given oxygen from a face mask for a few hours to help
you recover from the anaesthetic.
Will it hurt for long?
You will have been given some pain relief in theatre. You will also
have some to take home. It is usual to feel sore for two to three days.
When can I eat and drink?
You should be able to eat and drink fairly quickly after the operation.
What about going to the toilet?
Unless you have had an unusually large abscess or cyst you will be able
to pass urine normally.
There should be no change to your bowel function.
Will I have any stitches?
This will depend on the type of surgery performed and preference of
your surgeon. It is common to have dissolvable stitches. In rare
situations the sutures may not dissolve easily. If you experience any
discomfort from the sutures please contact Ward 12 for advice.
What about washing?
You will be given a wash by the ward staff to freshen you up after the
operation. Following this you will be advised to take regular baths.
How long will I be in hospital?
This will depend on how well you recover from your surgery. Most
women go home the same day.
6

After you leave hospital
You are likely to feel tired and will need to rest in the day for a couple
of days. You need to take things gradually, and not rush your recovery.
When can I drive?
You cannot drive for 24 hours after your operation.
What about sex?
You may resume sexual intercourse when you are comfortable. This is
usually at least a week.
What about work?
You will have some degree of discomfort for a few days but you will
not do yourself any harm returning to work when you feel able to do
so. This would normally be two or three days. If you need a sick
certificate please ask the nurse.
General advice
The operation should be straightforward. Patents are often surprised
how quickly they return to normal health. If you have any problems or
queries, please ask the nurses or doctors.
Any complaints
If you have any complaints or concerns, please tell a member of staff
as soon as possible so this can be discussed with you.
Visiting Times
Visiting times on Ward 12 are 2.30-4.30pm and 7-8pm. It is important
for your recovery that you receive rest and also to see your family and
friends for short periods. Please could you ensure that your family are
aware of the visiting times. Two visitors are allowed at any one time.
Please speak to the nursing staff before arranging for children to visit
the ward.
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Useful contact numbers
Ward 12: 01493 452628/9
Daycare Unit: 01493 452022
Hospital: 01493 452452
Patient Advisory and Liaison Services (PALS) 01493 453240
Liz Barber is more than willing to discuss more general information
about your stay in the James Paget University Hospital.
The hospital is able to arrange for an
interpreter to assist you in
communicating effectively with staff
during your stay through INTRAN.
If you need an interpreter or a person to sign, please let
us know.
If you require a large print version of this
booklet, please contact PALS on
01493 453240
References:
www.doctoronline
Patient satisfax information
© November 2004
Revised June 2008
James Paget University Hospitals NHS
Foundation Trust
Review Date: June 2011
GY 19