Office-based management of Bartholin cysts and abscesses: a comparison of three surgical methods

Yıl 2022, , 363 - 367, 15.03.2022

Gökçen Erdoğan , Coşkun Şimşir

https://doi.org/10.32322/jhsm.1006426

Öz

Aim: In the present study, we aimed to compare the effectiveness of incision + drainage alone, marsupialization, and incision + drainage followed by silver nitrate application for the office management of Bartholin cysts/abscesses.
Material and Method: A total of 128 women who presented to our clinic, diagnosed with Bartholin cysts/abscesses and underwent Bartholin gland sparing office-based surgery were included in this retrospective study. Patients’ demographic data, laterality and size of the cyst, surgical method performed, operational time, presence of recurrence, and treatment method of recurrent cysts/abscesses were recorded. Patients were divided into three group according to the operation they have undergone as incision + drainage alone, incision + drainage followed by silver nitrate, marsupialization.
Results: The mean cyst diameter was found as 3.00±1.05 cm. Eighteen (14.1%) patients developed recurrence. Of all patients, 37.5% underwent incision + drainage alone, 8.6% incision + drainage followed by silver nitrate application and 62.5% marsupialization. The mean operational time was significantly longer in the marsupialization group compared to incision + drainage alone and incision + drainage followed by silver nitrate groups (both, p<0.001). None of the patients in the marsupialization group developed recurrence, while recurrence was observed in 35.1% of the patients in the incision + drainage and 45.5% of the patients in the incision drainage + silver nitrate group.
Conclusion: Marsupialization technique was superior over the other techniques in terms of recurrence. However, operational time was longer with this technique and no definitive conclusion could be drawn.

Anahtar Kelimeler

Bartholin cyst, abscess, infusion, drainage, marsupialization

Kaynakça

• Haider Z, Condous G, Kirk E, Mukri F, Bourne T. The simple outpatient management of Bartholin’s abscess using the word catheter: a preliminary study. Aust N Z J Obstet Gynaecol 2007; 47: 137–40.
• Lee WA, Wittler M. Bartholin Gland Cyst 2020 Nov 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020.
• Marzano DA, Haefner HK. The bartholin gland cyst: past, present, and future. J Low Genit Tract Dis 2004; 8: 195-204.
• Yuk JS, Kim YJ, Hur JY, Shin JH. Incidence of Bartholin duct cysts and abscesses in the Republic of Korea. Int J Gynaecol Obstet 2013; 122: 62-4.
• Tavares KADS, Moscovitz T, Tcherniakovsky M, Pompei LM, Fernandes CE. Differential Diagnosis between Bartholin Cyst and Vulvar Leiomyoma: Case Report. Rev Bras Ginecol Obstet 2017; 39: 433-5. English.
• Lee MY, Dalpiaz A, Schwamb R, et al. Clinical pathology of Bartholin’s glands: a review of the literature. Curr Urol 2015; 8: 22-5.
• Omole F, Kelsey RC, Phillips K, Cunningham K. Bartholin duct cyst and gland abscess: office management. Am Fam Physician 2019; 99: 760-6.
• Mayeaux EJ Jr, Cooper D. Vulvar procedures: biopsy, Bartholin abscess treatment, and condyloma treatment. Obstet Gynecol Clin North Am 2013; 40: 759-772.
• Wechter ME, Wu JM, Marzano D, et al. Management of Bartholin duct cysts and abscesses: a systematic review. Obstet Gynecol Surv 2009; 64: 395-404.
• Speck NM, Boechat KP, Santos GM, et al. Treatment of Bartholin gland cyst with CO2 laser. Einstein (Sao Paulo) 2016; 14: 25-9.
• Kroese JA, van der Velde M, Morssink LP, et al. Word catheter and marsupialisation in women with a cyst or abscess of the Bartholin gland (WoMan-trial): a randomised clinical trial. BJOG 2017; 124: 243-49.
• Kafali H, Yurtseven S, Ozardali I. Aspiration and alcohol sclerotherapy: a novel method for management of Bartholin’s cyst or abscess. Eur J Obstet Gynecol Reprod Biol 2004; 112: 98-101
• Illingworth B, Stocking K, Showell M, Kirk E, Duffy J. Evaluation of treatments for Bartholin's cyst or abscess: a systematic review. BJOG 2020; 127: 671-8.
• Krissi H, Shmuely A, Aviram A, From A, Edward R, Peled Y. Acute Bartholin's abscess: microbial spectrum, patient characteristics, clinical manifestation, and surgical outcomes. Eur J Clin Microbiol Infect Dis 2016; 35: 443-6.
• Riche VP, Schirr-Bonnans S, Cardaillac C, et al. Hospital care pathway of women treated for Bartholin's gland abscess and budget impact analysis of outpatient management: A national hospital database analysis. J Gynecol Obstet Hum Reprod 2020; 49: 101689.
• Cardaillac C, Dochez V, Gueudry P, et al. Surgical management of Bartholin cysts and abscesses in French university hospitals. J Gynecol Obstet Hum Reprod 2019; 48: 631-5.
• Ozdegirmenci O, Kayikcioglu F, Haberal A. Prospective randomized study of marsupialization versus silver nitrate application in the management of bartholin gland cysts and abscesses. J Minim Invasive Gynecol 2009; 16: 149-52.
• Mungan T, Uğur M, Yalçin H, Alan S, Sayilgan A. Treatment of Bartholin's cyst and abscess: excision versus silver nitrate insertion. Eur J Obstet Gynecol Reprod Biol 1995; 63: 61-3.
• Cho JY, Ahn MO, Cha KS. Window operation: an alternative treatment method for Bartholin gland cysts and abscesses. Obstet Gynecol 1990; 76: 886-8.
• Rotem R, Yahoy D, Diamant C, et al. Risk factors associated with recurrent referral to the emergency room following surgical treatment of Bartholin's gland abscess. J Obstet Gynaecol 2020; 40: 111-5.