|
If pain continues after catheter placement, the bulb may be too large for the cyst/abscess cavity. This can be corrected by withdrawing some of the fluid and therefore reducing the size of the bulb. 7,17
Bleeding is a rare complication. Minimal bleeding may be controlled with silver nitrate or rarely sutures. Pregnant patients are at increased risk for bleeding when Bartholin cysts or abscesses are treated due to the increase in pelvic blood flow. For this reason, surgical treatment for asymptomatic cysts is generally postponed until after delivery. 7
Secondary cellulitis may occur and the patient should be monitored for this complication. Rare septic shock has been reported after drainage of a Bartholin gland abscess. 11 Diabetic patients may be at increased risk for infectious complications (necrotizing infections) and need careful observation, consider inpatient management for high risk patients. 7
An inappropriately placed catheter, in labia, leads to fistulous tract chronically draining in labia.
Premature expulsion of catheter (<4weeks) which can result in cyst/abscess recurrence. If the initial incision was too large, the catheter will fall out. This can be avoided by recognizing the size discrepancy at the time of insertion and by placing a suture to maintain the catheter. If the needle used to introduce the saline into the catheter punctures the stem, the catheter will gradually deflate and fall out prematurely. If the catheter falls out prematurely, before epithelialization occurs, the Word catheter can be replaced. This can be difficult due to constriction of the original incision. A new incision typically is required.
Recurrence of Bartholin’s duct cyst/abscess, despite catheter remaining in place for 4-6 weeks, overall rate 2-15% 17 |
