Modified Word Catheter and Marsupialization in Women with a Cyst or Abscess of the Bartholin Gland: A randomized clinical trial

Objectives: To compare outcomes of a cyst or abscess of the Bartholin gland after surgical treatment using a modified Word catheter or marsupialization.Materials and Methods: We conducted a single-center, open-label, randomized controlled trial at Vachira Phuket Hospital, in Thailand. Women presenting with a symptomatic Bartholin gland cyst or abscess were randomly assigned to undergo either modified Word catheter placement, using a Foley catheter, or marsupialization under local anesthesia. Participants were followed-up at 1 week, 4 weeks, 6 months, and 12 months post-procedure. The primary outcome was recurrence within one year. Secondary outcomes included procedural time and perioperative pain. Analyses were performed according to the intention-to-treat principle.Results: A total of 50 women were enrolled between June 2023 and March 2024. Recurrence occurred in 3 of 25 women (12%) in the modified Word catheter group and in 3 of 24 women (12.5%) in the marsupialization group (relative risk 0.96; 95% confidence interval [CI] 0.21, 4.3; p = 0.957). The median procedural time was shorter with modified Word catheter placement (10 minutes; interquartile range [IQR] 8, 12) compared to marsupialization (14.5 minutes; IQR 14, 16; p < 0.001). Pain scores during the procedure were lower in the modified Word catheter group (mean ± standard deviation [SD] 4.7 ± 1.2) than in the marsupialization group (mean ± SD 6.6 ± 1.1; p = 0.001). Conclusion: In women with a Bartholin gland cyst or abscess, treatment with a modified Word catheter provides similar recurrence rates to marsupialization, but with shorter procedural time and less perioperative pain.