Outpatient treatment of recurrent Bartholin’s duct cysts using a Word catheter: a case study

Treatment of Bartholin’s duct cysts and gland abscesses, with the exception of small asymptomatic cysts, is always surgical. The question of the preferred surgical technique remains relevant and has not been fully resolved. Literature data demonstrate the advantage of marsupialization and fistulization using the Word catheter or the Jacobi ring over other techniques. In this article, we report a clinical case of treating a recurrent Bartholin’s duct cyst in a patient who had undergone three Bartholin’s gland abscess incisions and drainages and one Bartholin’s duct cysts excision (enucleation). Given the multiple recurrences, a decision was made to perform fistulization using a Word catheter, which is a silicone tube with a balloon at one end and a single channel for inflation. The diameter of the catheter with an emptied balloon is 15 Fr (Ch) or 5 mm; the balloon volume is 3 ml; and the catheter length is 55 mm. The catheter is supplied in a sterile package with a disposable #11 scalpel blade, 7.5 cm long, and a disposable 3.0 ml syringe with a 22G (0.7 × 25.4 mm) needle. The catheter’s balloon should be inflated with liquid. When air is used, the balloon deflates and falls out prematurely. The catheter’s in-wound retention time is typically 6–8 weeks. The surgery was performed on an outpatient basis under local infiltration anesthesia with 2.0 ml of 2% lidocaine solution. After the surgery, the patient was prescribed antibacterial therapy with amoxicillin (875 mg) and clavulanic acid (125 mg) orally twice daily. The therapy was discontinued 3 days after the surgery due to the results of bacteriological examination of the discharge from the cyst cavity, which showed no growth of microflora. The pain was relieved within 24 hours after the surgery. The Word catheter drained the cyst cavity perfectly, causing no discomfort, with the patient’s activity not limited. 6 weeks after the surgery, the Word catheter was removed. During that time, a fistula draining the gland had formed. The patient had no relapse of the disease within 6 months after the treatment. This clinical case demonstrates that the Word catheter is effective in the treatment of recurrent Bartholin’s duct cysts. The advantages of this technique include the following: the procedure can be performed on an outpatient basis, it is easy to perform, and it allows for rapid symptom relief and reliable and long-lasting drainage of the cyst cavity.