Positioning
Contraindications
Anesthesia
Indications
Technique
There are no absolute contraindications for Bartholin cyst or abscess incision and drainage. Relative contraindications include a complex or recurrent abscess that requires drainage under general anesthesia in the operating room.
Explain the procedure, risks, benefits, possible complications, alternative options, and postprocedure care to the patient or her legal representative and obtain a written informed consent. A female chaperone should be present in the procedure room throughout the procedure.
Incision and drainage is indicated for selected Bartholin cysts that have a diameter of 1 cm or larger or are symptomatic (painful, tender, interferes with physical or sexual activity) and/or any Bartholin abscess.
Place the patient in the lithotomy position.
Incision and drainage of a Bartholin cyst or abscess requires anesthesia of the labial mucosa. Because infiltration of the labial mucosa with a local anesthetic may be painful, discuss options such as intravenous narcotics and procedural sedation and analgesia with each patient.
