The tools you need 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
- 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.
How to drain a Bartholin gland abscess
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!
- To get a good view of the abscess, place your patient in stirrups in the lithotomy position.
- 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.
- Anesthetize the most fluctuant part of the abscess on the mucosal side. The numbed area will blanch in a few minutes.
- 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.
- Depending on the size of the abscess, you can use a hemostat to gently probe and break up any possible loculations.
- Once all the pus has drained, insert the catheter into the incision and inflate with 3–5 cc of water.
Post-procedure care for a Bartholin gland abscess
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.