Word catheter or marsupialization for a Bartholin gland cyst or abscess?
In a well-designed randomized control trial (RCT), investigators sought to determine as a primary outcome whether a Word catheter or marsupialization worked better at preventing a recurrence of a Bartholin gland cyst or abscess, sufficiently symptomatic to require treatment, within 1 year of treatment. Upon comparing women randomized to Word catheter (n = 82) or to marsupialization (n = 79), the researchers found:
There were no differences in
Recurrence of cyst or abscess requiring treatment within a year (Word 12.2% vs. marsupialization 10.3%)
Pain scores 24 hours and beyond after treatment
There were significant differences in
Maximal and average pain experienced during treatment were higher in the Word catheter group compared to the marsupialization group
Analgesic use, where 34% of women required analgesics in the Word group compared to 74% in the marsupialization group (P < 0.001) in the first 24 hours after treatment
Time from diagnosis to treatment was 1 hour for the Word group compared to 4 hours for the marsupialization group (P < 0.001)
Women have a lifetime risk of 2% for Bartholin cysts and abscesses. Surgical excision of the gland has been replaced by marsupialization where the abscess is drained and the edges of the incision are sutured such that skin to interior is a continuous surface and an outflow tract can be maintained. In 1963, Dr.Buford Word developed a catheter that could be placed in the abscess cavity and left in situ to serve as a drain. The authors sought to compare Word catheter placement and marsupialization directly. The multi-centered study, called the WoMan trial (Word versus marsupialisation) involved 18 hospitals in the Netherlands and one hospital in England.
Word catheter placement was performed without anesthesia or using local anesthesia, while marsupialization was performed primarily under spinal or general anesthesia
Strengths of this study include close to 100% follow up at 1 year
Multiple providers were involved and pain questionnaire responses were limited to 66%
Data from this study favors the use of outpatient Word catheter placement which was well tolerated by patients, required less analgesia following the procedure and would result in cost savings
Please log in to access ObGFirst and the 2T US Atlas
Media - Internet
Computer System Requirements
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan