Marsupialisation of Bartholin's cyst or abscess

Summary

Marsupialisation is a short operation to treat a Bartholin's cyst or abscess — a blocked lubricating gland at the entrance of the vagina that has swollen with fluid or become infected. Rather than just draining it (after which it often comes back), marsupialisation stitches the cyst open so it drains permanently and the gland can work again.

• A day procedure of about 15–20 minutes, usually under general anaesthetic.
• Relief from an abscess is immediate once the pressure is released.
• Dissolvable stitches; healing in about 2 weeks.
• Recurrence is much lower than with simple drainage — around 5–15%.

This information supports discussion with your healthcare team. Reading, saving or printing it does not constitute consent to surgery.

About the operation

The Bartholin's glands sit either side of the vaginal entrance and produce lubricating fluid. If a gland's duct blocks, fluid builds into a painless cyst; if infection sets in, it becomes an abscess — exquisitely tender, swollen and sometimes fever-making, often over just a day or two.

Marsupialisation ("making a pouch") opens the cyst, drains it, and stitches its lining to the skin edge so a small permanent opening remains. The gland keeps draining the way it should, which is why this operation prevents recurrence far better than needle drainage or a simple incision. The stitched opening shrinks to an invisible channel as it heals.

Why it is performed

• A Bartholin's abscess — painful, swollen and needing urgent drainage
• A recurrent or large cyst that is uncomfortable, interferes with sex or walking, or keeps re-filling after simple drainage
• In women over 40, removal or biopsy of the gland may be advised instead, to examine the tissue — your consultant will discuss this.

Benefits

• Immediate relief of an abscess.
• Low recurrence compared with simple drainage.
• The gland is preserved and keeps doing its job.

Alternatives

• Warm baths and painkillers — small cysts and early infections sometimes drain by themselves.
• Antibiotics — an adjunct when infection is spreading, not a substitute for drainage of an abscess.
• Gland excision — removal of the whole gland, for repeated recurrences or where tissue diagnosis is needed; a bigger operation with more bleeding risk.

Preparing for surgery

An abscess is often treated urgently — preparation is then simply fasting from arrival and the routine safety checks. For a planned cyst procedure: fasting from 6 hours before (water up to 2 hours), a medicines review, and someone to take you home.

The day of surgery

The team confirms your identity and the plan, you meet the anaesthetist and surgeon, and you sign the consent form — which covers what will be done if the findings differ (for example, a solid area needing biopsy). You can still change your mind at this point.

During the operation

Under a short general anaesthetic, a small cut is made over the cyst just inside the vaginal entrance, the fluid or pus is drained (and sent for testing), and the cyst lining is stitched open to the skin edge with fine dissolvable stitches, leaving a small draining pouch. The procedure takes about 15–20 minutes.

After the operation

• Relief from abscess pain is usually immediate; soreness at the site lasts a few days.
• Discharge — the pouch drains for days to a couple of weeks as it heals; a small pad is enough.
• Going home the same day.

Recovery at home

• Warm salt-water baths or showers once or twice daily keep the area clean and comfortable.
• Wear loose cotton underwear; avoid tight clothing.
• Back to work within a few days; avoid cycling and swimming for about 2 weeks.
• Sex: wait until the area is comfortable and no longer draining — usually about 2 weeks.

Risks and complications

Expected, temporary effects

• Soreness, swelling and discharge from the pouch for up to two weeks

Complications

• Recurrence — about 5–15%; a repeat procedure or gland excision is then discussed.
• Infection of the wound — treated with antibiotics (uncommon).
• Bleeding or haematoma (uncommon).
• Scarring or tenderness at the site (uncommon).
• Anaesthetic risks — serious complications of a short anaesthetic are rare.

When to seek help

After you go home, seek medical advice the same day if you notice:

• Heavy bleeding from the operation site or vagina
• Fever (38 °C or higher) or feeling increasingly unwell
• Worsening pain not controlled by your painkillers
• An offensive-smelling discharge
• The swelling and pain returning quickly

Preparing for your consent discussion

Consent is a conversation, not a signature. Before agreeing you should feel you understand why this procedure is recommended for you, what the realistic alternatives are, and which risks matter most in your case. Print this checklist and bring it to your consultation.

Sources and review

This page was drafted against the published guidance below. Each reference was live when checked; dates will be confirmed at clinical review.

1. National Health Service (UK). Bartholin's cyst. Available from: https://www.nhs.uk/conditions/bartholins-cyst/ [last checked 12 August 2026].
2. Royal College of Obstetricians and Gynaecologists. Patient information — browse all. Available from: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/ [last checked 12 August 2026].