RESUMEN
STUDY OBJECTIVE: Bartholin's gland abscess may occur in up to 2% of the women. Surgical drainage using the Word catheter application or marsupialization is the treatment of choice in the management of Bartholin's gland abscess. We aimed to compare the abscess recurrence rates between these 2 surgical methods. DESIGN: A retrospective cohort database study. SETTING: A university-affiliated, high-volume teaching hospital in southern Israel. PATIENTS: All women who were surgically treated for Bartholin's gland abscess. INTERVENTIONS: Different clinical and postoperative characteristics were retrieved from the patients' records. A univariate analysis was conducted, and p <.05 was considered significant. MEASUREMENTS AND MAIN RESULTS: During the study period, 321 women were admitted to our center with Bartholin's gland abscess and were managed surgically. Of these, 215 (67%) were treated using the Word catheter and 106 (33%) by drainage and marsupialization. No differences were found in clinical and microbiologic features between the study groups. In addition, recurrence rates as well as recurrent admissions did not differ significantly. Postoperative complications were similar between the groups. CONCLUSION: Our study reassures that both the Word catheter application and marsupialization are appropriate and safe when treating Bartholin's gland abscess.
Asunto(s)
Glándulas Vestibulares Mayores , Absceso/cirugía , Glándulas Vestibulares Mayores/cirugía , Catéteres , Drenaje , Femenino , Humanos , Estudios RetrospectivosRESUMEN
There is no consensus regarding the best surgical modality for the treatment of Bartholin's gland abscess. The aim of the study was to evaluate the risk factors associated with the recurrent referral of the emergency room (ER) following surgical treatment for a Bartholin's gland abscess. A retrospective cohort study was done. Clinical and microbiological characteristics were retrieved from the patients' hospital records. A univariate analysis was followed using multiple logistic regression model. During the study period, 320 women were managed surgically, of those 54 (37.0%) had had a recurrent referral to the ER. The rate of positive previous cultured abscesses was significantly higher among patients with a recurrent referral to the ER (66.7% vs. 51.3%, p value < .05). The mode of a previous abscess drainage (Word catheterisation or marsupialisation) was not associated with recurrent referral to the ER or with recurrent hospitalisation. The possible association between positive cultures and recurrence warrants re-consideration of routine antimicrobial administration for Bartholin's gland abscess.IMPACT STATEMENTWhat is already known on this subject? A recurrence of a Bartholin's gland abscess following surgical treatment varies greatly and there is no consensus regarding the best surgical modality for treatment. None of the studies have examined a recurrent referral to the emergency room (ER) as a primary outcome.What do the results of this study add? Our study strengthens previous studies and reassures that recurrence is not associated with surgical modality. Specifically, a recurrent referral to the ER and hospitalisation were not found to be associated with surgical modality, both which may be attributed to various reasons other than the recurrence of the abscess. An association was found between positive culture results and a recurrent referral to the ER.What are the implications of these findings for clinical practice and/or further research? The association found that positive results warrant further larger studies in order to determine which of the patients may benefit from antibiotic treatment in addition to the surgical treatment.