Outpatient removal
After infiltration with an anesthetic, the doctor makes an incision along the inner surface of the labia minora, carefully removes the entire cyst without opening it, stops the bleeding with a radio wave coagulator and sutures the bed and mucous membrane; Drainage is usually not needed. After an hour of observation, the patient goes home and can work the next day. Sitz baths with an antiseptic, abstinence from sexual activity for 3 weeks and examination after a week are recommended. Complete excision with the capsule eliminates recurrence; the moisturizing function is provided by the gland on the other side.
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.
