Word catheter and marsupialisation in women with a cyst or abscess of the Bartholin gland (WoMan-trial): a randomised clinical trial

J. A. Kroese, M. van der Velde, L. P. Morssink, M. H. Zafarmand, P. Geomini, P. J M van Kesteren, C. M. Radder, L. F. van der Voet, J. P W R Roovers, G. C M Graziosi, W. M. van Baal, J. van Bavel, R. Catshoek, E. R. Klinkert, J. A F Huirne, T. J. Clark, B. W J Mol, N. Reesink-Peters

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: To compare recurrence of a cyst or abscess of the Bartholin gland after surgical treatment using a Word catheter or marsupialisation. Design: Multicentre, open-label, randomised controlled trial. Setting: Eighteen hospitals in the Netherlands and one hospital in England. Population: Women with a symptomatic cyst or abscess of the Bartholin gland. Methods: Women were randomised to treatment with Word catheter or marsupialisation. Main outcome measures: The primary outcome was recurrence of the cyst or abscess within 1 year of treatment. The secondary outcomes included pain during and after treatment (measured on a 10-point scale), use of analgesics, and time from diagnosis to treatment. Analysis was by intention-to-treat. To assess whether marsupialisation would reduce the recurrence rate by 5% (from 20 to 15%) we needed to include 160 women (alpha error 0.05, beta error 0.2). Results: One hundred and sixty-one women were randomly allocated to treatment by Word catheter (n = 82) or marsupialisation (n = 79) between August 2010 and May 2014. Baseline characteristics were comparable. Recurrence occurred in 10 women (12%) allocated to Word catheter versus eight women (10%) allocated to marsupialisation: relative risk (RR) 1.1, 95% confidence interval (CI) 0.64–1.91; P = 0.70. Pain scores after treatment were also comparable. In the first 24 hours after treatment, 33% used analgesics in the Word catheter group versus 74% in the marsupialisation group (P < 0.001). Time from diagnosis to treatment was 1 hour for placement of Word catheter versus 4 hours for marsupialisation (P = 0.001). Conclusions: In women with an abscess or cyst of the Bartholin gland, treatment with Word catheter and marsupialisation results in comparable recurrence rates. Tweetable abstract: Comparable recurrence rates for treatment of Bartholinic abscess/cyst with Word catheter and marsupialisation.

Original languageEnglish
Pages (from-to)243-249
Number of pages7
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume124
Issue number2
DOIs
Publication statusPublished - 1 Jan 2017

Keywords

  • Bartholin gland
  • Word catheter
  • marsupialisation

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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