what to expect with a bartholin cyst and marsupialisation

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I had a marsupialisation yesterday and would like to explain it for those who may be facing one.

My family physicians first attempt to drain a very large bartholin abcess was unsuccesful. I was immediately prescribed an antibiotoc which did indeed reduce some of the symptoms of infection (fever, pain and swelling.) Apparently the attempt to drain it in a Doctor's office fails about 13% of the time. Warm sitz baths and warm compresses helped with pain but also did not precipitate drainage so off I went to the gynecologist for an exam. He recommended marsupialisation right away which caught me off guard somewhat because it required a hospital visit. The abcess was very large and had more of a banana shape than a round shape. It became bumpy as well.

Friends, do not delay. Go to the gyno as soon as you can. A drained cyst will return almost certainly. The marsupialisation will spare you that and the risk of a bursting gland.

I had to fast for 8 hours and then the operation was done right away.

The procedure was done in an operating room with a staff of three assisting the surgeon. I am 44 and in good health (other than the cyst) and was permitted to choose either full or partial sedation. I chose not to 'go under.' The anaaesthetist put in an intravenous drip into which went some sedative including morphine. The surgeon gave me a local anaesthetic by needle. I did not feel it going in. A sheet was draped across my tummy so that I would not watch. Rod Stewart's \"hot legs\" in muzak style was playing over a loud speaker. I thought that was hilarious given that my legs were being strapped into stirrups in the air and I felt anything but hot and sexy smile

I could net feel any pain whatsoever but was aware enough to know that the procedure was going well. It was over quickly (about half an hour all in.) Time was irrelevant with the morphine. I was treated very nicely in the recovery area - warm sheets, soft pillow. I drifted in and out of sleep for about an hour. I still had an IV and was hooked up to a monitor. After that I was given a cookie and some juice and some warm wet towels to wipe off the iodine which to my surprise covered my entire abdomen, genitals and part of my legs! I had not felt that being applied. I was not shaved. There was some blood on my bed but not a lot. A sanitary pad was enough to control it by the time I was wiping away the iodine. I still felt no pain.

Within another half hour the staff contacted my family to pick me up. I was given the wrong after care leaflet but since the doctor had promised to phone me in the morning I just left.

About an hour later the local started to wear off and it became painful. I had been given Tylenol 3 which i gladly used. I could walk but was most definately impaired. When I got home I ate heartilly and went to sleep. When I woke I had a look and found swelling, a few blood drops and a small packing of gauze in the \"pouch.\" Not knowing what to do with it I left it in place. ThIs was the right thing to do. Mine was supposed to stay in place for 24 hours.

Today, on the Doctor's instruction, I removed it. It hurt a lot but was over quickly and the subsequent lack of pressure in the wound is making me more comfortable.

For me going back to work right away is out of the question. I called in sick. Unless your employer allows you to take frequent warm bath breaks (3 a day at least) and sit with your hoo hoo in the air and an ice pack on it, don't plan to work right away.

Ice controls the swelling nicely, warm soaks are soothing and I still take the occasional pain reliever. I can look after myself but I won't leave the house for another day or so.

All in all, I feel relieved and on the mend.

Hope this helps any woman who might have trepidation about the surgery.

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7 Replies

  • Posted

    Hi there, thanks for sharing your experience and am glad that you felt better. I had a marsupialisation on my bartholin's abscess last Wednesday evening (the build up to it was excruciating)..stayed overnight in hospital and went home the next morning. I felt slightly sore and was bleeding but the nurses said that it wasn't heavy bleeding so was ok. Don't think I had a \"packing\" in there as no one had taken it out. Am still bleeding 5 days later (although it is not excessive) and still feel a little sore. Had walked a bit (slowly) on the day I was discharged, but after that stayed home for 3 days..other than today when i had to get some groceries (and the sore seemed worse again)..have been off work but am slightly concerned if the walk I had on the day I went home could have affected it.. other than that, am not sure how the wound can be kept dry when I go to the toilet, so have tried to dab it dry gently after the toilet and have at least 2 showers for that part..

    just wondered if I should be overly concerned that I'm still bleeding..? thanks.

    Hope all sufferers out there will get relief soon. For me, it took quite a while and hot water bottles didn't seem to work for me much. Ibuprofen is effective though..and no squeezing..I did it and think it gave me a secondary infection which fingers crossed seems to have gone after it burst.. Good luck to all..

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  • Posted

    I wanted to echo Wanda's comments -- after all the SCARY things I had read about the procedure I thought it would be good to write something to eleviate some of the fears that you all may be having.

    I had the marsup (can't spell the whole thing - far too long!) a few weeks ago and i have to say it went very well. I had had 4 previous golf-ball sized batholin cysts (3 of which we're drained in the ER/doctors office and one that burst on its own - sooooo gross!)

    I had had one cyst drained and a catheter put in (let me just say to anyone going that route - don't do it - it was SOOO painful -- worst than the cyst -- you can't sit down and they don't tell you til afterwards that it has to stay in for a month!!! It was done at the ER and when my doctor found out she was appauled - she doesn't even do them anymore because they're impossible to deal with. I ended up having to have mine taken out in a week because I couldn't deal with it).

    Finally we decided that the draining/baths weren't working so I had the marsup done. Very similar experience to Wanda - except I was put completely under. The drugs helped alot for the first day. Day 2-3 I was a bit sore and really tired. But by day 4 I was up and around. I did have bleeding which scared me at first, but it stopped by about day 4 (never more than a pad or so a day - much less than a typical period). I took it easy (no running or sex or anything) for about a month, and every now and then I'd feel a \"pinch\" down there (from the stitches I think?), but now it seems to be completely healed. I have had some 'discharge' issues (not sure if this is common?? Anyone?) but compared to what the cyst felt like its nothing.

    I know people say they come back sometimes and the marsup isn't 100% - but I'm hopeful that this will be the last of it -- if nothing else its been nice to not live in fear all the time (don't know about the rest of you, but I spent so much time worrying about when the cyst was gonna come back - its nice to not worry - if only for a bit!)

    Just thought I'd share a success story for those of you who might be going thru the same thing!

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  • Posted

    Thanks for sharing your experience.  I had the marsupialisation done 6 days ago and was told I would be able to return to work the next day, but I am still having a lot of pain, some bleeding, and I can't sit down normally in a chair or walk very far at all!  So I definitely can't work (which is a problem because I'm a freelancer, so if I don't work, I don't get paid).  I'm just curious how long it took you before you felt back to "normal"?

    The doctor had said no exercise or sex for a week, but I have a feeling it's going to be a lot longer than that!

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  • Posted

    Hi ladies, I had a bartholins cyst about a week ago and it got extremely painful and grew to the size of what I can only describe as a testicle shape !! So painful I went to the gyno who had a look and she popped it with a cotton bud swab which was a second of tiny pain and the cyst was popped! So relieving! The nurse gave me cotton elasticated knickers and pads and I was on my way. I already have anti biotics and strong painkillers I've been taken since the beginning of the week. The nurse said to carry on taking them, I'm just wondering what sort of after care there is? Nurse said salt baths but I've read that you shouldn't do that until it's fully healed and mine is still kind of sticky almost and still slightly painful.

    Thanks ladies x

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  • Posted

    Thanx a lot for the info, I am going for the procedure tomorrow I didn't know what to expect

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  • Posted

    Hi ladies.

    Thanks for your stories. I had a marsupulisation yesterday, arrived at the hospital at 7am actually looking forward to it! The reason is that I've had 3 bartolins previously, one burst as I was waiting in A&E, another I had the incision and drainage on and another (by the time I had my marsuplulisation appointment) has decreased so much in size that the surgeon couldn't operate!! So this time around as soon as the cyst was big enough I made a GPs appointment and was referred to emergency gynae on the day, was booked in for my surgery 2 and had it yesterday. Arrived at 7am and after so many questions, verifying I'D etc and waiting a couple of hours (had to fast for 8 hours) I was seen, put under General anasthetic and a drip to keep me hydrated I woke in the recovery ward and given morphine. I've never been on morphine before and was as high as a kite! In and our of sleep then finally had some water, juice and a sandwich l. The nurse removed the catheter (instructions were on a band on my arm). Feel very woozy yesterday, ate and conked out. Woke up this morning feeling sore, have been taking the prescribed 1G of paracetamol as well as antibiotics as directed. This evening it feels like I have cystitis- burns especially when I go for a pee. Did a bit of walking and had a nap earlier. I'm hoping the bleeding and pain will subside soonest. I have a follow up appointment next week. I'm really hoping I can stop living in fear the dreaded cyst will come back. Does nothing for ones self confidence or when being intimate!

    Good luck ladies x

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