Marsupialization versus Word catheter in the treatment of Bartholin cyst or abscess: retrospective cohort study

Bartholin cysts or abscesses are observed in approximately 2% of women, usually in their reproductive years. Although none of the treatments appear to be superior, there are several options including drainage with basic incision, Word catheter application, marsupialization, silver nitrate application, and excision. The primary outcome in this study was to evaluate the recurrence rates in patients who underwent marsupialization or Word catheter for the treatment of Bartholin cyst or abscesses, and the secondary outcome was to evaluate the rates of patient satisfaction.

A total of 196 patients who underwent either Word catheterization or marsupialization for the treatment of Bartholin cyst or abscesses between 2014 and 2017 were included in this retrospective cohort study. The size and location of the cyst/abscess, the operation duration, and the recurrence was recorded. A 5-point visual analog scale (VAS) was used to assess patient satisfaction and whether patients would recommend thier treatment to others.

Recurrence was observed in 11 (8.3%) patients in the marsupialization group, and 12 (18.8%) patients in the Word catheter group (p=0.034). Median (range) VAS scores in the marsupialization group were better than the Word catheter group [4 (1-5) vs 3 (1-5); p<0.001].

Higher recurrence rate and dissatisfaction level were found in the Word catheter group. The only advantage of using Word catheter was its short operation time. These results appear to show that marsupialization should be the first-line treatment for Bartholin cysts and abscesses. However, the small number of cases and the retrospective nature of this study mean that larger, prospective studies are required to support this hypothesis.