BARTHOLIN’S CYST


There is closure of the duct or the opening of an

acinus.The cause may be infection or trauma follo-

wed by fibrosis and occlusion of the lumen.



                         Bartholins cyst



Pathology:

It may develop in the duct (common) or in

the gland. Commonly, it involves the duct; the gland

is adherent to it posterolaterally. Cyst of the duct or

gland can be differentiated by the lining epithelium.

The content is glairy colorless fluid—secretion of the

Bartholin’s gland.


Clinical Features: 

A small size often remains

unnoticed to the patient or escapes attention to the

physician even following internal examination. If

it becomes large (size of hen’s egg), there is local

discomfort and dyspareunia. Examination reveals

an unilateral swelling on the posterior half of the

labium majus which opens up at the posterior end

of the labium minus. Its medial projection makes

the vulval cleft ‘S’-shaped. The overlying skin is

thin and shiny. The cyst is fluctuant and not tender


Treatment: 

Marsupialization is the gratifying

surgery for Bartholin’s cyst. An incision is made on

the inner aspect of the labium minus just outside the

hymenal ring. The incision includes the vaginal wall

and the cyst wall. The cut margins of the either side

are to be trimmed off to make the opening an elliptical

shape and of about 1 cm in diameter. The edges of

the vaginal and cyst wall are sutured by interrupted

catgut, thus leaving behind a clean circular opening.

The advantages of marsupialization over

the traditional excision operation are:

 (i) Simple.

(ii) Can be done even under local anesthesia.

(iii) Shorter hospital stay (24 hours). (iv) Post-

operative complication is almost nil. (v) Gland

function (moisture) remains intact.


~ Thank you for reading ........