Name of the Procedure:

Excision of Bartholin's gland or cyst
Common name(s): Bartholin gland cyst removal, Bartholin gland excision

Summary

An excision of the Bartholin's gland or cyst is a surgical procedure to remove a Bartholin's gland cyst, which is a fluid-filled swelling that can form near the vaginal opening. This procedure provides relief from discomfort, pain, or infection caused by the cyst.

Purpose

The procedure addresses the presence of a Bartholin's gland cyst, which can cause pain, swelling, discomfort during walking or sitting, and painful intercourse. The goal is to remove the cyst or gland to relieve these symptoms and prevent recurrent infections.

Indications

• Recurrent Bartholin's gland cysts or abscesses
• Cysts that are large, painful, or have become infected
• Discomfort during daily activities or sexual intercourse
• Failed non-surgical treatments, such as drainage or antibiotics

Preparation

• Fasting may be required if general anesthesia will be used.
• Avoid certain medications as advised by the surgeon, including blood thinners.
• Pre-procedure diagnostic tests might include a pelvic exam, ultrasound, or bacterial cultures to check for infections.

Procedure Description

1. The patient is positioned comfortably and anesthesia is administered (local, regional, or general).
2. A small incision is made near the site of the Bartholin's gland or cyst.
3. The cyst or gland is carefully removed using surgical instruments.
4. The incision is closed with sutures, and a small drainage tube may be placed temporarily.
5. The area is cleaned and bandaged to aid healing.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The surgery is commonly performed in a hospital or outpatient surgical center.

Personnel

• Surgeon (gynecologist or general surgeon)
• Nursing staff
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Scarring or changes in vulvar anatomy
• Pain or discomfort during recovery
• Recurrence of the cyst or abscess

Benefits

• Relief from pain and discomfort
• Reduced risk of recurrent infections
• Improved quality of life and comfort during daily activities and intercourse

Recovery

• Post-procedure instructions: Keep the area clean, avoid strenuous activities, and follow-up as directed.
• Pain management: Over-the-counter pain relievers, prescribed medication if needed.
• Recovery time: Usually 1 to 2 weeks for initial healing, with follow-up appointments to monitor recovery.
• Restrictions: Avoid sexual intercourse and use of tampons until fully healed.

Alternatives

• Marsupialization: Creating a permanent opening for drainage.
• Word catheter insertion: Temporary drainage of the cyst.
• Antibiotics: To treat infections associated with the cyst.
• Pros and cons: Alternatives may offer less invasive options but might not prevent recurrence as effectively as excision.

Patient Experience

• During the procedure: Local anesthesia might cause slight discomfort; general anesthesia will render the patient unconscious.
• After the procedure: Mild to moderate pain which can be managed with medication; possible swelling and bruising.
• Comfort measures: Ice packs, sitz baths, and prescribed pain medication to aid in recovery.