Bartholin cyst or abscess also called bartholinitis, result from the obstruction and

infection of the greater vestibular (Bartholin’s), which lie on both sides of the vagina at
the base of the labia minora and serve to lubricate the vagina. Most cases are sterile, but
some may result from cellulitis caused by mixed vaginal flora (abscesses). The abscess
or cyst may spontaneously rupture or enlarge and become painful. Infection is often
caused by sexually transmitted diseases (STD).

Assessment:

1. May be symptomatic.
2. Warmth, erythema, pain, swelling in labia minora
3. If abscess is present --- pain, edema, cellulitis

Diagnostic evaluation:

1. Culture of drainage or aspirated fluid identifies infectious organism.

2. Biopsy (indicated for women over 40 years of age) rules out cancer.

Collaborative management:

1. Provide warm soaks or sitz baths.

2. If cellulitis or STD is present, administer antibiotics.

Surgical intervention:

1. Abcess or cyst may require incision or drainage. Although this provides

immediate relief, problem may recur.
2. Marsupialization, for recurrent abscesses:
a. Contents are opened and drained; ward catheter is then inserted to keep
cavity open.
b. Healing occurs from within the area of abscess.

Nursing Diagnoses:

1. Acute pain
2. Impaired tissue integrity
3. Urge urinary incontinence

Nursing Interventions:

1. Administer pain medications as indicated.

2. Instruct the patient to apply warms soaks or take sitz bath three to four times a
day for 15 to 20 minutes to promote comfort and drainage.
 3. Encourage the patient to remain in bed as much as possible, because pain is
exacerbated by activity.
4. Prepare the patient for incision and drainage if indicated.
5. For marsupialization: apply ice packs intermittently for 24 hours to reduce
edema and provide comfort; thereafter, warm sitz baths or perineal heat pack
can be used.
6. If caused by STD:
a. Tell the patient to instruct her partner to be tested and treated for STD.
b. Advise patient to abstain from intercourse until cyst or abscess has
completely resolved and she has completed her antibiotic regimen.

Education and Health Maintenance:

1. Review principles of perineal hygiene with the patient.
2. Discuss STD and methods of prevention.
3. Encourage patient to follow up for recurrent abscess to rule out malignancy.
Surgical treatment is often necessary for recurrence.

Source: Lippincott Manual of Nursing Practice Handbook. 3rd edition. P. 78