Treatment of Skene's Gland Infections and Abscesses

Diagnosis and Presentation

Skene's glands are located on each side of the urethra, and infection can present as erythematous areas lateral to the urethra 1
Insertion of a finger into the vagina and anterior pressure may produce discharge from the ducts when infected 1

Incision and drainage is the cornerstone of treatment for Skene's gland abscesses, while antibiotics should be added only in specific clinical scenarios such as systemic signs of infection, significant surrounding cellulitis, immunocompromised status, or incomplete drainage 1, 2, 3
The procedure involves opening the abscess, evacuating the infected material, and continuing dressing changes until the wound heals by secondary intention 2
Cultures of the abscess material should be obtained during drainage to guide therapy if antibiotics become necessary 3

Antibiotics should be added to incision and drainage only if systemic signs of infection are present, such as temperature >38.5°C or heart rate >110 beats/minute 2, 3
Antibiotics should also be added if erythema extends >5 cm beyond the abscess margins, the patient is immunocompromised, source control is incomplete after drainage, or significant surrounding cellulitis is present 2, 3

If antibiotics are indicated, empiric therapy should target Staphylococcus aureus, including MRSA consideration, and streptococcal species 3
Adjust antibiotic therapy based on culture results 3

Clinical improvement, including decreased pain and swelling, should be evaluated within 48-72 hours after treatment 3
If no improvement is seen, reassess for inadequate drainage, resistant organisms, or deeper infection 3