Experience of surgical treatment of Bartholin duct cysts in outpatient department

Abstract

Background. The optimal surgical technique for the treatment of Bartholin duct cysts is still not finally chosen. Currently, the following methods are used: needle aspiration, with or without alcohol sclerotherapy; silver nitrate cyst ablation; use of lasers technique; fistulization using a Word catheter, Foley catheter, or a Jacobi ring; incision and drainage followed by primary suture closure; marsupialization of the cyst; gland excision. However, the frequency of recurrence of the disease is high and averages about 20%. This article presents an original technique of suturing when performing marsupialization of Bartholin duct cysts and an analysis of the results of treatment of patients using this technique. Aims: to evaluate the results of surgical treatment of Bartholin duct cysts using an original technique for creating a new ostium of the duct during marsupialization. Materials and methods. 14 patients aged 23 to 39 years with diagnosis of Bartholin duct cysts were operated on during the period from 2018 to 2023. Operations were performed in the outpatient department. Marsupialization was chosen as the method of surgical treatment. The operation was performed 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 tissues of the vagina vestibule according to the original method. Results. The maximum size of Bartholin duct cysts in the patients treated by us was up to 5.0 cm and averaged 4.4±0.2 cm. The patients complained on the presence of a unilateral tumor in the entrance to the vagina and moderate intensity pain in its projection. The duration of the operation was from 10 to 15 minutes, the volume of blood loss was from 3.0 to 5.0 ml. There were no complications in the postoperative period. Complete fusion of the tissues of the vestibule of the vagina and the Bartholin duct occurred within a week. The duration of observation of patients after surgical treatment ranged from 5 years to 6 months. There were no relapses of the disease during the observation period. Conclusions: the results of the study show that the proposed original method of performing marsupialization of the Bartholin duct cysts is an effective and promising technique aimed at preventing recurrence of the disease.