Excision of Bartholin duct cysts using the CO2 laser

Bartholin Duct Cyst and Nodular Hyperplasia: A Clinicopathological Study of 32 Patients

Background: Inflammatory lesions and cysts are the most common Bartholin glands pathologic diagnoses. There have been very few reports of benign solid lesions of Bartholin glands such as nodular hyperplasia. Materials and methods: Thirty-two lesions diagnosed as Bartholin duct cyst in the gynecologic specialized institute were reviewed by two expert gynecological pathologists. Results: Using specific criteria, 7 qualified as nodular hyperplasia, 25 as Bartholin duct cyst. The average age of the patients with nodular hyperplasia was 31 years (range, 24 to 43). These lesions were solid, solid and cystic or purely cystic, had a mean maximal dimension of 3.3 cm, and were frequently thought to be Bartholin cysts on clinical examination. Four lesions were diagnosed as Bartholin duct cysts, while in the review they were considered as nodular hyperplasia. Conclusion: Nodular hyperplasia of Bartholin gland may be more common than is reported in the literature. This study showed that the diagnosis of nodular hyperplasia has been overlooked due to limited literature sources.

The impact of CO2 laser for treatment of Bartholin's gland cyst or abscess on female sexual function: a pilot study

The aim of this study is to evaluate the sexual functionality before and after treatment of Bartholin's gland diseases (BGD) with CO₂ laser and to compare our results to patients who underwent surgical cold knife and to a healthy control group (HCG). Consecutive patients (n = 15) affected by BG cyst or abscess who underwent CO₂ laser treatment were evaluated. Patients were asked to complete the Italian translation of the Female Sexual Functioning Index (FSFI) before and 4 weeks after treatment. Results after CO₂ laser were compared with two control groups: patients affected by BG cyst (n = 15) or abscess treated with surgical cold knife treatment and a HCG (n = 18). A statistically significant advantage of CO₂ laser versus cold knife treatment in terms of lubrication, pain and global score were recorded. Both the single scores of five domains and total score of FSFI were globally higher after any treatment compared to before (CO₂ and cold knife) of BGD. According to our data, CO₂ laser therapy is often well tolerated by patients and correlated with a favorable sexual health recovery.

Complication and recurrence rate in laser CO2 versus traditional surgery in the treatment of Bartholin's gland cyst

PURPOSE

The treatment of Bartholin's gland cysts by traditional surgery is characterized by some disadvantages and complications such as hemorrhage, postoperative dyspareunia, infections, necessity for a general anesthesia. Contrarily, CO2 laser surgery might be less invasive and more effective as it solves many problems of traditional surgery. The aim of our study is to describe CO2 laser technique evaluating its feasibility, complication rate and results vs traditional surgery.

METHODS

Among patients treated for Bartholin's gland cyst, we enrolled 62 patients comparing traditional surgical excision vs CO2 laser surgery of whom 27 patients underwent traditional surgery, whereas 35 patients underwent CO2 laser surgery. Mean operative time, complication rate, recurrence rate and short- and long-term outcomes were assessed.

RESULTS

The procedures required a mean operative time of 9 ± 5.3 min for CO2 laser surgery and 42.2 ± 13.8 for traditional surgery. Two patients (5.7 %) needed an hemostatic suture for intraoperative bleeding in the laser CO2 laser technique against 14.8 % for traditional surgery. Carbon dioxide allows a complete healing in a mean time of 22 days without scarring, hematomas or wound infections and a return to daily living in a mean time of 2 days. Instead, patients undergone traditional surgery required a mean time of 14 days to return to daily life with a healing mean time completed in 28 days.

CONCLUSIONS

The minimum rate of intra- and post-operative complications, the ability to perform it under local anesthesia in an outpatient setting make CO2 laser surgery more cost-effective than traditional surgery.

Clinical Pathology of Bartholin's Glands: A Review of the Literature

The Bartholin's glands are located symmetrically at the posterior region of the vaginal opening and play an important role in the female reproductive system. These two pea-sized glands are involved in mucus secretion and vaginal lubrication. Cyst formation in the glands is common and results from mucus build-up in gland ducts. It is important to monitor such cysts because they may occur in the form of carcinomas. Larger cysts and abscesses are found in the lower vestibular region and typically present with erythema and edema. Biopsy is an effective method for distinguishing between Bartholin's gland cysts and differential diagnosis. While smaller cysts may be asymptomatic and may be left untreated, larger cysts require medical attention. Several treatment options are available, including marsupialization and CO2 laser. Healing and recovery depend on the severity of infection and course of treatment.

A review of the management of diseases of the Bartholin's gland

Bartholin's abscess and cyst account for 2% of all gynaecological visits per annum. This article reviews the anatomy, epidemiology and pathophysiology of the Bartholin's gland. The management of Bartholin's abscess including antibiotic use in the early stage of the condition together with options for surgical intervention are discussed and in so doing the variation of clinical practice in other countries is considered. The use of the word catheter, carbon dioxide laser are compared with traditional surgical techniques of incision and drainage and marsupialisation. The outcomes of treatment particularly the high recurrence rate (2-25%) and the associated morbidity are reviewed. Finally the issue of cancerous pathology as an aetiology is highlighted in the postmenopausal age group.

CO2 laser therapy of the Bartholin’s gland cyst: Surgical data and functional short- and long-term results

The Bartholin's gland cyst is a condition that occurs in approximately 2% of women, most of whom are of reproductive age. Although benign, it is associated with significant patient discomfort. Definitive treatment involves the surgical removal of the entire cyst. The objective of this study was to describe an alternative conservative surgical technique with CO(2) laser adopted in our institution and to evaluate the feasibility, complication rate, and results obtained with this technique in an office setting. Our study showed that CO(2) laser treatment of the Bartholin's gland cyst can be carried out safely in an outpatient setting, with minimum patient discomfort and high long-term cure rates.

Multiple pigmented follicular cysts of the vulva successfully treated with CO2 laser: case report and literature review

BACKGROUND

A pigmented follicular cyst is an uncommon epithelial cyst, typically occurring as a single asymptomatic pigmented papule or nodule on the head and neck of adult men. To the authors' knowledge, no previous cases of vulvar pigmented follicular cyst have been reported. Although benign, pigmented follicular cyst can affect quality of life when multiple and symptomatic.

OBJECTIVE

The objective was to describe the clinicopathologic features of vulvar pigmented follicular cyst and to evaluate the efficacy of CO(2) laser therapy in this region.

METHODS

A 62-year-old woman with multiple pigmented follicular cysts affecting the labia majora bilaterally is described. Owing to frequent inflammation and tenderness, continuous-wave CO(2) laser was used to treat the skin lesions under local anesthesia.

RESULTS

All cystic nodules were successfully ablated with CO(2) laser. The patient tolerated the procedure well and had a satisfactory cosmetic outcome.

CONCLUSION

CO(2) laser is a tolerable and effective therapeutic modality for multiple and symptomatic pigmented follicular cysts of the vulva.

The Bartholin Gland Cyst: Past, Present, and Future

Bartholin gland cysts account for 2% of all gynecologic visits per year. The treatment of Bartholin gland cysts has evolved from a complicated, bloody procedure requiring general anesthesia to, most recently, a simple puncture of the cyst and placement of a drain performed in the office. Although treatments for Bartholin gland cysts seem simple on the surface, recurrent cysts as well as diagnosing simple cysts versus abscesses versus malignant tumors can complicate treatment for this common problem. This article exams a history of the treatment of Bartholin gland cysts, including the use of the traditional treatments of excision, fistulization, marsupialization, as well as cauterization with carbon dioxide laser and silver nitrate. Modern variations are discussed, including the use of hydrodissection for excision, as well as the application of magnetic resonance imaging use in devising treatment for recurrent cysts.

Outpatient management of Bartholin gland abscesses and cysts with silver nitrate

This study reports results of 52 patients with Bartholin abscesses or cysts who were managed by silver nitrate stick insertion into the cyst or abscess cavity for 48 hours. All patients showed complete healing within 15 days. However, 2 (3.8%) had recurrences within the first 2 months; 1 of these patients was treated with excision and the other by repetition of the same method with no further complaints. Silver nitrate application for Bartholin cysts or abscesses was found to be an effective, simple, inexpensive and the least anaesthetic requiring procedure, which can easily be carried out in the outpatient setting.