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Large and reoperated cysts have a dense capsule fused with the surrounding tissues and vessels of the vestibular bulb; enucleation requires intravenous anesthesia, careful hemostasis and often drainage; festering cysts require antibiotics and control. Observation in a hospital makes it possible to exclude bleeding and hematoma in the first hours, to provide anesthesia and dressing. The next morning the patient is discharged with recommendations; sutures dissolve on their own; There are practically no relapses after complete excision.
Indications
- Bartholin gland cyst more than 2–3 cm, causing discomfort when walking, sitting, and sexual activity;
- recurrent bartholinitis and abscesses after opening;
- suppuration of the cyst (abscess) - opening and drainage followed by excision;
- cyst in women over 40 years old - excision with histology.
Excision or marsupialization
The cyst is formed when the duct of the Bartholin gland is blocked and does not resolve on its own; a simple autopsy results in a relapse rate of 30–50%. The radical method is excision (husking) of the cyst with capsule and gland: there are practically no relapses, the tissue is examined histologically. Marsupialization preserves the gland and its moisturizing function by creating a new duct - preferable in young women with a primary cyst. In case of an abscess, an opening with drainage is first performed, and excision is performed after the inflammation subsides after 1–2 months.
