Window operation: an alternative treatment method for Bartholin gland cysts and abscesses

Approach to Bartholin's abscesses and recurrences under office conditions

OBJECTIVE

The aim of this study is to investigate the various treatment methods and recurrence rates regarding Bartholin's gland abscesses under office conditions in our clinic.

METHODS

In our study, the data of 155 patients who applied to the gynaecology and obstetrics clinic of our hospital between January 2017 and November 2020 and had Bartholin's abscess that was treated with surgical methods under office conditions were analyzed retrospectively.

RESULTS

Of the 155 patients included in the study, 111 underwent incision drainage, 22 underwent marsupialization, and 22 underwent incision drainage+ silver nitrate. Bartholin's abscess was localized on the right side in 48.4% of the patients and on the left side in 51.6% of the patients. Recurrence was detected in 53 of 155 patients included. Recurrence was detected in 39.6% of the patients who underwent incision drainage in the first treatment, 31.8% of those who underwent marsupialization, and 9.1% of those who underwent incision+silver nitrate. The difference in success, based on recurrence rates, was found to be statistically significantly in favour of silver nitrate (p<0.05). In secondary treatments for recurrent cases, marsupialization or incision+silver nitrate treatment was effective in over 90% of cases, while incision drainage was effective in 30% of patients.

CONCLUSION

The findings of our study show that silver nitrate application led to a lower recurrence rate than the other two methods. In view of this, we recommend that marsupialization or silver nitrate be preferred, especially in the treatment of recurrent cases.

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.

CO2 laser treatment for Bartholin gland abscess: ultrasound evaluation of risk recurrence

STUDY OBJECTIVE

To evaluate the efficacy of CO2 laser treatment and parameters correlated with recurrence in patients with Bartholin gland abscesses treated using this approach.

DESIGN

Prospective study (Canadian Task Force classification II-2).

SETTING

University hospital.

PATIENTS

One hundred forty-seven patients who met eligibility criteria.

INTERVENTION

Preoperative ultrasound evaluation of Bartholin gland lesions and CO2 laser treatment.

MEASUREMENTS AND MAIN RESULTS

All patients received CO2 laser therapy, with median operative time 15 minutes (range, 12-35 minutes). Median postoperative stay was 1 hours (range, 1-4 hours). Estimated 3-year relapse-free rate was 88.56%. Lesion wall thickness 0.5-1.5 mm, multilocular lesion, and hyperechogenic lesion were correlated with recurrence.

CONCLUSION

CO2 laser of Bartholin gland abscesses could be a valid option. Ultrasound characteristics of Bartholin gland lesions could predict lesion recurrence rate.

Novel technique for management of Bartholin gland cysts and abscesses

BACKGROUND

Definitive methods for treatment of a Bartholin cyst and abscess include placement of a Word catheter, marsupialization, application of silver nitrate, and surgical excision. Placement of a Word catheter is the most frequently employed technique for office and emergency department (ED) management. However, many institutions do not have the Word catheter available; in addition, the catheter has a tendency to dislodge before epithelialization, leading to recurrence of the cyst.

OBJECTIVE

We have developed a simple technique for management of Bartholin gland abscess or cyst using readily available materials. This technique involves using a small loop of plastic tubing, which is secured to prevent expulsion before epithelialization of a drainage tract.

CASE REPORT

A 25-year-old woman presented to the ED with a Bartholin gland abscess. After administration of local anesthetic, a loop of tubing was placed, allowing for drainage of the abscess. The patient was discharged home with a course of oral antibiotics. At 3-week follow-up, the Bartholin gland abscess was found to be healed; the device was removed without difficulty, leaving two drainage tracts.

CONCLUSION

This technique may be used as an alternative to placement of a Word catheter for management of Bartholin gland abscess or cyst.

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.

[Postoperative complications of Bartholin's duct abscess. About two cases]

Bartholinitis is the most common infectious vulvar disease and develops in approximately 2% of all women. The choice concerning treatment may be uneasy between medical or surgical modalities, and we have to be cautious because of the risk of severe complications associated with the procedure. We report two cases: one case of sepsis and the other one of bacterial cellulitis after Bartholin's duct abscess marsupialization. In the light of epidemiological and bacteriological date referring to Bartholinitis, we recommend a safe and effective management (particularly the use of broad-spectrum antibiotics) that we will describe.

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.