How to drain a Bartholin gland abscess

The first step when draining a Bartholin abscess is to collect the necessary medication and tools:

• Sterilizing solution (e.g., betadine)
• 1% lidocaine with epinephrine
• 3 cc syringe with 27 gauge (G) needle
• #11 scalpel
• Hemostat
• Word catheter (e.g., balloon catheter)
• 5 cc syringe with 20 gauge (G) needle, filled with sterile water

If you don’t have a Word catheter, and the abscess is very large, you can use the loop drainage technique.

Before the procedure, put on a face mask and personal protective equipment. Often, the pus in a Bartholin abscess is under a lot of pressure and can spray out!

1. To get a good view of the abscess, place your patient in stirrups in the lithotomy position.
2. Gently pull the labia laterally to expose the mucosal membrane of the abscess, so that the incision can be made on the mucosal inner surface.
3. Anesthetize the most fluctuant part of the abscess on the mucosal side. The numbed area will blanch in a few minutes.
4. Once the patient is numb, use the #11 scalpel to make a small incision (no bigger than 0.5 cm) into the numbed blanched mucosal surface.
5. Depending on the size of the abscess, you can use a hemostat to gently probe and break up any possible loculations.
6. Once all the pus has drained, insert the catheter into the incision and inflate with 3–5 cc of water.

Antibiotics are not needed unless the patient has a fever or is immunocompromised. The only thing left to do now is to arrange for follow up in two days.