Kelechi woke up three days before her job presentation with a lump that made sitting impossible. She had no idea what it was. Mascot Healthcare drained it the same day — she sat through her presentation two days later.
HR professional. Presented with a rapidly enlarging, extremely painful swelling at the 4 o'clock position of the vulva for 3 days. Unable to sit, walk normally, or pass urine comfortably. Examination confirmed a Bartholin gland abscess.
Bartholin Gland AbscessKelechi noticed a small, tender area on a Monday evening. By Tuesday morning it was the size of a grape and walking was uncomfortable. By Wednesday — the day she came in — it was the size of a golf ball and she had not slept from the pain. She was due to present a major departmental review on Friday.
She searched her symptoms online: vulval lump, painful, rapidly growing. "Bartholin cyst or abscess" was the most consistent result. She called Mascot Healthcare at 8 am and was seen by 9:30 am.
The doctor confirmed a Bartholin gland abscess at first glance — the position (4–8 o'clock on the posterior introitus), the degree of fluctuance, the heat and erythema. She was told the treatment was incision and drainage under local anaesthesia, to be performed that morning.
A Bartholin gland abscess develops rapidly when the Bartholin gland duct becomes blocked and infected. It is one of the most acutely painful vulval conditions.
A golf ball-sized, tender swelling at the left posterior vaginal opening — appeared over 72 hours.
Pain so severe that sitting, walking, and crossing legs were impossible.
The overlying skin was red, shiny, and hot — classic abscess signs.
The swelling displaced the urethra slightly, causing discomfort during urination.
Low-grade fever indicating systemic response to the localised infection.
Warm sitz baths × 3 per day — appropriate initial management for a Bartholin cyst before abscess formation; had not prevented progression to abscess.
Ibuprofen TDS — partial pain relief; did not halt abscess development.
Topical antiseptic cream — no penetrating effect on an abscess.
The area was cleaned and draped. Local anaesthetic was infiltrated carefully. A 1 cm incision was made over the point of maximum fluctuance and approximately 15 mL of purulent material was drained. A Word catheter was inserted and inflated — this keeps the tract open, allowing complete drainage and reducing the risk of recurrence.
Kelechi reported almost immediate pain relief as the abscess was decompressed. She was prescribed a course of medication to cover the mix of bacteria typical of Bartholin abscesses. She was advised to continue warm sitz baths, keep the area clean, and return in 4 weeks for Word catheter removal.
A swab of the drained pus was sent for culture — results showed mixed anaerobic flora, no gonococcus.
Bartholin Gland Abscess (left, 4 o'clock position) — clinical diagnosis; pus culture: mixed anaerobic flora
Incision and drainage under LA; Word catheter insertion; a course of medication; warm sitz baths; Word catheter removed at 4 weeks
Complete pain resolution within 24 hours of drainage. No recurrence at 3-month review.
Kelechi sat through her departmental presentation on Friday — two days after drainage — with minor residual discomfort. The Word catheter was removed at 4 weeks. No recurrence has occurred.
A Bartholin abscess is intensely painful but very treatable. Same-day drainage under local anaesthesia relieves pain almost immediately.
Word catheter insertion after drainage significantly reduces recurrence compared to simple incision alone — a detail that matters for long-term outcome.
A Bartholin abscess needs drainage — not more warm baths. Same-day treatment means same-week relief.
Book an appointment at Mascot Healthcare, Akoka — same-day slots often available, 4.9★ rated.