Experience in surgical treatment of Bartholin duct cysts in outpatient department

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BACKGROUND: The optimal surgical technique for the treatment of Bartholin duct cysts has not been finally chosen. Currently, the following methods are used: needle aspiration, with or without alcohol sclerotherapy; silver nitrate cyst ablation; use of laser techniques; cyst fistulization using a Word catheter, a Foley catheter, or a Jacobi ring; cyst incision and drainage followed by primary suture closure; cyst marsupialization; and cyst excision. However, the relapse rate of the disease is high and averages about 20%. This article presents an original technique for suturing when performing marsupialization of Bartholin duct cysts and an analysis of the results of treating patients using this technique.

AIM: The aim of this study was to evaluate the results of surgical treatment of Bartholin duct cysts using an original technique to create a new ostium of the duct during marsupialization.

MATERIALS AND METHODS: From 2018 to 2023, 14 patients aged 23 to 39 years were operated on for Bartholin duct cysts. Marsupialization was chosen as a method of surgical treatment. Operations were performed in the outpatient department using local anesthesia by lidocaine. After emptying, the cyst cavity was washed with an antiseptic. The external ostium of the Bartholin duct was formed by circular suturing of the cyst into the mucous membrane tissues of the vaginal vestibule according to the original method.

RESULTS: The maximum size of Bartholin duct cysts in the patients we treated was up to 5.0 cm and averaged 4.4 ± 0.2 cm. The patients complained mainly of the presence of a unilateral tumor-like lesion at the entrance to the vagina and moderate-intensity pain in its projection. The duration of the operation was from 10 to 15 min, the blood loss volume being from 3.0 to 5.0 ml. There were no complications during the operation or in the postoperative period. Complete fusion of the mucous membrane tissues of the vaginal vestibule and the Bartholin duct occurred within a week. The duration of observation of patients after surgical treatment ranged from five years to six months. There were no relapses of the disease during the observation period.

CONCLUSIONS: The proposed original method for performing marsupialization of Bartholin duct cysts is an effective and promising technique aimed at preventing recurrence of the disease.

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作者简介

Dmitriy Sudakov

North-Western State Medical University named after I.I. Mechnikov; The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; Medica Family Medicine Center Ltd

Email: suddakovv@yandex.ru
ORCID iD: 0000-0002-5270-0397
SPIN 代码: 6189-8705

MD, Cand. Sci. (Med.)

俄罗斯联邦, Saint-Petersburg; Saint Petersburg; Saint Petersburg

Yulia Dymarskaya

North-Western State Medical University named after I.I. Mechnikov; Medica Family Medicine Center Ltd

编辑信件的主要联系方式.
Email: julia_dym@mail.ru
ORCID iD: 0000-0001-6027-6875
SPIN 代码: 4195-3410

MD, Cand. Sci. (Med.)

俄罗斯联邦, Saint-Petersburg; Saint Petersburg

参考

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2. Fig. 1. Bartholin duct cysts (see text for explanations)

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3. Fig. 2. The original suturing technique to create a new ostium of the Bartholin gland duct (schematic representation). 1 — gland tissue; 2 — mucous membrane of the excretory duct; 3 — cavity of the excretory duct cyst; 4 — mucous membrane of the vaginal vestibule; 5 — surgical thread on the atraumatic needle

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4. Fig. 3. View of the newly formed ostium of the Bartholin gland duct using the original suture method immediately after marsupialization

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5. Fig. 4. View of the newly formed ostium of the Bartholin gland duct using the original suture method 3 months after marsupialization

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