Haider Zara, Condous George, Kirk Emma, Mukri Faizah, Bourne Tom
Early Pregnancy, Acute Gynaecology and Minimal Access Surgery Unit, St. George's Hospital, London, UK.
Aust N Z J Obstet Gynaecol. 2007 Apr;47(2):137-40. doi: 10.1111/j.1479-828X.2007.00700.x.
Bartholin's cysts/abscess affects 2% of women. Conventional treatment is marsupialisation under general anaesthetic. We evaluated a conservative approach in a non-randomised prospective interventional study over 12 months.
Women with a Bartholin's abscess were counselled and those who opted for the Word catheter (WC) had it inserted under local anaesthetic (follow up at one week and four weeks, when catheter was removed). Women recorded pain scores and completed a qualitative questionnaire and had telephone follow up at six months. Outcome measures were abscess resolution and acceptability of treatment.
Fifty-eight women attended with a Bartholin's abscess requiring drainage. Twenty-three of 58 (40%) elected for marsupialisation. Thirty-five of 58 (60%) women had a WC inserted. Twenty-seven of 35 (77%) women retained their catheter for four weeks (three catheters fell out within 24 h of insertion, three catheters fell out within one week, one fell out after 11 days and there was one failed insertion). One woman had a recurrence six months after treatment. Abscess resolution occurred in 34 of 35 (97%). No woman reported significant discomfort at one week. Twenty-four of 27 women (89%) said that if they suffered a recurrence, they would have another WC inserted. Three of 27 (11%) women had intercourse within the second week of catheter insertion and reported that it was not uncomfortable. Fourteen women who had marsupialisation were traced and none had suffered a recurrence six months after treatment.
The WC is a safe and effective treatment for a Bartholin's abscess. It may be considered as an alternative to marsupialisation.
巴氏腺囊肿/脓肿影响2%的女性。传统治疗方法是在全身麻醉下进行袋形缝合术。我们在一项为期12个月的非随机前瞻性干预研究中评估了一种保守治疗方法。
对患有巴氏腺脓肿的女性进行咨询，选择使用沃氏导管（WC）的女性在局部麻醉下插入导管（在插入导管一周和四周后进行随访，此时取出导管）。女性记录疼痛评分并完成一份定性问卷，并在六个月时进行电话随访。观察指标为脓肿消退情况和治疗的可接受性。
58名患有巴氏腺脓肿需要引流的女性前来就诊。58名中的23名（40%）选择了袋形缝合术。58名中的35名（60%）女性插入了WC。35名中的27名（77%）女性保留导管四周（3根导管在插入后24小时内脱落，3根导管在一周内脱落，1根在11天后脱落，还有1次插入失败）。一名女性在治疗六个月后复发。35名中的34名（97%）脓肿消退。没有女性在一周时报告有明显不适。27名女性中的24名（89%）表示，如果她们复发，会再次插入WC。27名中的3名（11%）女性在导管插入的第二周内进行了性交，并报告没有不适感。对14名接受袋形缝合术的女性进行了追踪，治疗六个月后均未复发。
WC是治疗巴氏腺脓肿的一种安全有效的方法。它可被视为袋形缝合术的替代方法。
