title: Management of Bartholin's cyst and abscess using the Word catheter: implementation, recurrence rates and costs.
abstract: OBJECTIVE
  Bartholin's cysts and abscesses occur in about 2% of women. None of the surgical or conservative treatment approaches have been proven to be superior. The Word catheter is an outpatient treatment option, but little is known about aspects of implementing this therapy in an office setting. The present study's focus is on recurrence rates and organizational requirements of implementing outpatient treatment of Bartholin's cyst and abscess and compares costs of Word catheter treatment and marsupialization.
  
  
  METHODS
  Between March 2013 and May 2014 30 women were included in the study. We measured time consumed for treatment and follow-up and analyzed costs using the Word catheter and marsupialization under general anesthesia. We also assessed the ease of use of the Word catheter for application and removal using a standardized visual analog scale (VAS 1-10).
  
  
  RESULTS
  Word catheter treatment was successful in 26/30 cases (87%). Balloon loss before the end of the 4-week treatment period occurred in 11/26 cases with a mean residence time of 19.1 (±10.0) days. None of the patients with early catheter loss developed recurrent cyst or abscess. Recurrence occurred in 1/26 cases (3.8%). Difficulty-score of application was 2 [1-10] and of removal 1 [1], respectively. Costs were € 216 for the treatment in the clinic as compared with € 1584/€ 1282 for surgical marsupialization with a one-night stay or daycare clinic, respectively.
  
  
  CONCLUSIONS
  The present study indicates that the Word catheter is an easy to handle, low cost outpatient procedure with acceptable short-term recurrence rates. Treatment costs are seven times lower than for marsupialization.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Graz, Austria. Electronic address: philipp.reif@medunigraz.at.
authors.forename: Philipp
authors.initials: P
authors.lastname: Reif
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Graz, Austria.
authors.forename: Daniela
authors.initials: D
authors.lastname: Ulrich
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Graz, Austria.
authors.forename: Vesna
authors.initials: V
authors.lastname: Bjelic-Radisic
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Graz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Häusler
authors.affiliation: Department of Financial and Patient Management, Steiermärkische Krankenanstaltengesellschaft (KAGES), Graz, Austria.
authors.forename: Elke
authors.initials: E
authors.lastname: Schnedl-Lamprecht
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Graz, Austria.
authors.forename: Karl
authors.initials: K
authors.lastname: Tamussino
mesh_terms: D000038:Abscess / Q000191:economics / Q000601:surgery*; D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D001472:Bartholin's Glands / Q000601:surgery; D002404:Catheterization / Q000191:economics*; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000191:economics*; D003365:Costs and Cost Analysis; D003560:Cysts / Q000191:economics / Q000601:surgery*; D020878:Device Removal / Q000191:economics; D004322:Drainage / Q000191:economics / Q000295:instrumentation; D005260:Female; D006176:Gynecology / Q000191:economics* / Q000458:organization & administration; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D013996:Time and Motion Studies; D014845:Vulvar Diseases / Q000191:economics / Q000601:surgery*; D055815:Young Adult
keywords: Abscess; Application; Bartholin; Costs; Cyst; Time