Bartholin cyst surgery

Bartholin cysts are fluid-filled sacs in your Bartholin gland. These glands are located on each side of the vaginal opening. They can become infected and form an abscess, or sac of pus. If a cyst is infected, large, or painful, your doctor may need to cut a small hole in the cyst to let fluid drain.

You may also have other procedures to treat the cyst:

Word catheter.

The doctor makes a small cut in the cyst. This cut is called an incision. Then the doctor puts a small rubber tube, called a catheter, in the incision. The catheter keeps the area open so fluid can drain out of it. This treatment can be done in the doctor's office. The doctor will numb your vulva so you feel less pain. Your doctor will take out the catheter after several weeks.

Marsupialization.

The doctor makes a small incision in the cyst. Then the doctor puts a few stitches on either side of the incision. Fluid from your cyst drains out of this small, permanent opening. This treatment is often done in an operating room of a hospital or surgery center. The doctor will numb your vulva so you feel less pain. And you may have general anesthesia.

Excision.

The doctor cuts out the entire cyst and sometimes the gland and duct. This is not done often. This is a more complex surgery. It is done in an operating room of a hospital or surgery center. The doctor will numb your vulva so you feel less pain. And you may have general anesthesia.

Most people go home the same day of surgery. You can expect to feel better each day. But you will probably need 2 to 4 weeks to recover. You may want to avoid sex until your vulva is healed.

Unless you had an excision surgery, it is possible for your cyst to come back. Some people need more than one surgery to permanently get rid of a cyst.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Ask your doctor if you will need someone to take you home. Anesthesia and pain medicine can make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start out by walking a little more than you did the day before. Bit by bit, increase the amount you walk.
• You can resume your regular activities when you are feeling better.
• Ask your doctor when you can drive again. Anesthesia and pain medicine can make it unsafe for you to drive.
• You may need to take a few days off work. It depends on the type of work you do and how you feel.
• Ask your doctor when it is okay for you to have sex. Do not douche.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowels are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. Take a fiber supplement such as Citrucel or Metamucil every day. If you have not had a bowel movement after a couple of days, take a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also be given instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor tells you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• Follow your doctor's instructions about removing any gauze from your wound.
• Wash the area daily with warm, soapy water, and pat it dry.
• Keep the area clean and dry. You may cover it with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• You may have some blood or fluid draining from the wound. Wear sanitary pads if needed.
• Sit in a few inches of warm water (sitz bath) for 15 to 20 minutes 3 times a day. Then pat the area dry. The warm water helps the area heal and eases discomfort.
• If you cannot take a bath, put a warm, clean washcloth on your vulva to help with healing and pain.
• If you have had a catheter placed in the cyst to help it drain, follow your doctor's instructions for activities until the tube comes out.

Other instructions

• Wear cotton underwear. Avoid underwear made from nylon, polyester, or silk.
• Do not wear tight clothing until your wound has healed.
• If sitting is painful, you may want to try sitting on a doughnut-shaped pillow.