Bartholin gland cysts are not uncommon, especially in women over 40. There are several types of treatment. Their choice and purpose depend on the nature and characteristics of the pathological cavity. Marsupialization of a Bartholin gland cyst is a quick and effective method for removing tumors. Unlike extirpation, this procedure is painless and a gentle treatment.
Bartholin's cyst
Large paired secretory organs of the vestibule of the vagina in medicine are called bartholin glands. Their size is about 2 cm, the excretory duct is 2.5 cm long. When the gland is pressed, a fluid (secret) is secreted, which maintains the normal moisture of the mucosa and moisturizes it during coitus (sexual intercourse). The secretion is removed from the glands along the excretory ducts, which open from the vestibule.
With partial or absolute obstruction of the duct, the outflow of secretion ceases. The fluid accumulates in the clogged channel, creating a Bartholin gland cyst (photo for ethical reasons is presented in the form of a picture). In appearance, it is similar to a tumor formation. Under the influence of adverse factors, its suppuration may occur, followed by an abscess of the glands.
What affects the formation of cysts
In most cases, a pathological cavity is formed against a background of chronic bartholinitis. This disease is a consequence of an infectious and inflammatory process that occurs in the large gland of the vestibule. Basically, bartholinitis develops against a background of sexually transmitted infections:
- Mycoplasmosis
- Trichomoniasis
- Gonorrhea.
- Chlamydia
- Candidiasis.
- Ureaplasmosis.
Other factors may contribute to infection:
- Inappropriate genital hygiene.
- Injury to the skin of the vulva.
- Genital irritation from synthetic or tight underwear.
- Surgical abortion.
- Labia piercing.
Inflammation of the glands can occur against the background of chronic inflammatory processes: pyelonephritis, tonsillitis, sinusitis.
Diagnosis of the tumor is carried out by a gynecologist. After a physical examination and laboratory tests, an operation of a Bartholin gland cyst or conservative therapy is prescribed. More often than not, due to late treatment, surgical tactics have to be used.
Conservative therapy
Treatment of a Bartholin gland cyst without surgery is carried out if the tumor is small and asymptomatic. The use of various medicines can reduce the pathological cavity, but will not completely get rid of it. Medicines can be divided into three groups:
- Antibacterial drugs ("Ceftazidime", "Cefotaxime", "Cefuroxime") are prescribed depending on the causative agent of the infection, which is determined by the results of the analyzes.
- Anti-inflammatory ointments (Levomekol, Vishnevsky ointment) are prescribed locally. They, in addition to direct function, contribute to the removal of edema, pain.
- Medicinal herbs. Douching with a decoction of chamomile, calendula helps restore the natural microflora of the vagina.
Some women use folk remedies. Sometimes they are very effective, but it is better to use them after consulting a gynecologist.
Indications for surgery
Neoplasms in the glands occur against the background of infection with sexually transmitted infections, for example, pappilovirus. Poor hygiene of external reproductive organs, damage to their mucosa contribute to the appearance of cysts. A secret accumulates inside the pathological cavity, which quickly transforms into serous fluid or purulent exudate. Indications for surgery:
- Acute or regularly occurring purulent inflammation of tissues with the formation of a turbid fluid in the cavity.
- Rapid increase in neoplasm.
- Purulent processes: boils, phlegmon, endometrium.
- Discomfort, the feeling that something is interfering.
- Pain of various kinds.
- Inefficiency of conservative treatment.
Drainage and husking is done with cyst sizes starting from 5 cm. Marsupialization of the Bartholin gland cyst is a procedure for “cleaning” a pathological cavity of small dimensions. The main task is to remove the secret and prevent the inflammatory process. This operation is especially indicated during pregnancy.
Gentle cyst treatment
There are several techniques for the surgical treatment of cystic tumors. The optimal option is selected by the doctor in agreement with the patient.
Hulling - opening a cyst with the subsequent removal of accumulated fluid. An incision is made on the pathological cavity and a catheter is inserted, the contents of the tumor are removed through it (serous exudate, pus). The drainage tube is removed after wound healing, and a new artificial duct remains at the installation site.
Laser removal is a bloodless and almost painless cyst vaporization procedure. After surgery, regeneration is faster, and the risk of relapse is minimal.
Cyst aspiration (puncture) - abduction of the contents of a cystic formation with a syringe. Manipulation is more often used as a diagnostic method: the evacuated liquid is sent for cytology. After the study, treatment tactics are determined.
But most often, doctors apply to marsupialization of a Bartholin gland cyst. The method also aims to form a new output channel.
What is cyst marsupialization?
Marsupialization is a surgical method for treating cysts, including opening it, removing the contents, and suturing its edges in a circle into the external wound. The procedure is indispensable for thin-walled pathological cavities, ingrown into vital organs, the elimination or arthrotomy of which is impossible.
Marsupialization of a Bartholin gland cyst is a quick and painless method of eliminating neoplasm on the vulvar lips and resuming patency of the secretion. The operation refers to organ-saving, since the gland and its functions are preserved. The method is used to treat already inflamed glands, or those with a tendency to relapse inflammatory processes.
Before invasive manipulation they are tested. Surgical gynecology recommends that the procedure be carried out immediately after menstruation, so that before the start of the next cycle, the wound has time to heal.
Preparation for the operation and stages
The decision on the use of marsupialization is made by the doctor together with the patient. It depends on the type of cyst, the state of the hemostatic system and the health of the patient. Preoperative diagnosis mainly consists of the following laboratory examinations:
- general blood test;
- biochemical analysis;
- determination of the rhesus factor;
- determination of glucose level;
- detection of HIV and sexually transmitted infections;
- taking a smear on the microflora;
- uterine cytograms;
- coagulograms (an indicator of blood coagulability);
- general analysis of urine;
- fluorography.
Surgical intervention is done only in a hospital setting under general or local anesthesia. Anyone who has done the marsupialization of a Bartholin gland cyst knows that the type of anesthesia can be discussed in advance with the doctor who will conduct the invasive procedure. Regional anesthesia is done at the site of the most bulging cavity.
Using a two-handed examination, the area of inflammation is determined. An oval-shaped flap about 1.5 cm in size is cut out at the site of the vaginal vestibule, and a cyst is symmetrically dissected in the same way. Its contents are removed, the cavity itself is thoroughly washed. The cyst wall is hemmed in a circle to the edge of the labia mucosa, forming an artificial duct.
After marsupialization
In the case of surgery under regional anesthesia, the patient can go home immediately after its completion.
After marsupialization of the Bartholin gland cyst, as well as after any surgical manipulation, it is necessary to follow the doctor's recommendations:
- Physical activity and sports are excluded for a period of 2 weeks.
- Abstinence from sexual activity for 30 days.
- Re-examination of the gynecologist after 6-8 weeks.
Preventive measures
Marsupialization of Bartholin's cysts reviews is mostly positive. And yet this is an invasive manipulation, involving, albeit small, but a violation of the integrity of the tissues of the organ.
The best method of combating pathology is preventive measures that prevent its appearance. Each disease has developmental causes that, if possible, should be prevented or prevented. To avoid the occurrence of a cyst, simple expert advice will help:
- Regularly conduct thorough hygiene of the vulva.
- Systematically visit a gynecologist.
- Do not have a promiscuous sex life.
- In time to treat diseases that provoke the formation of cysts.
If neoplasms occur, you should immediately visit a doctor. Timely detected cyst allows you not to resort to radical methods of treatment.