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Muñoz de Toro M, Masatkar V, Blankenship HT, Holt JB, Sangüeza OP. Vulvar Lesion With Incidental Histopathologic Findings: Answer. Am J Dermatopathol 2025; 47:155. [PMID: 39851909 DOI: 10.1097/dad.0000000000002893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2025]
Affiliation(s)
| | - Vaishali Masatkar
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC; and
| | | | - John B Holt
- Department of Pathology, Novant Health, Charlotte, NC
| | - Omar Pastor Sangüeza
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC; and
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2
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Clauser P, Dolciami M, Grassi F, D'Amario A, Persiani S, Celli V, Oliva E, Fragomeni SM, Garganese G, Sala E, Gui B. The role of magnetic resonance imaging in the rare pathologies of the vulva. Eur J Radiol 2025; 183:111926. [PMID: 39826155 DOI: 10.1016/j.ejrad.2025.111926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Revised: 01/08/2025] [Accepted: 01/09/2025] [Indexed: 01/22/2025]
Abstract
Pathologies of the vulva encompass a wide range of mesenchymal and epithelial benign and malignant lesions. Suspicion is raised by non-specific symptoms or clinical findings detected during routine gynecological examinations, and histopathology is essential for the diagnosis. The role of imaging has often been limited, but it can be essential in guiding treatment and, in some cases, in helping differential diagnosis. In particular, magnetic resonance imaging (MRI) can play a central role in identifying the extent of disease and planning surgical treatment. To this aim, rigorous image acquisition, correct disease evaluation in the context of vulvar anatomy and understanding of the possible differential diagnosis are essential. The aim of this article is to review the role of MRI in the evaluation of rare vulvar pathologies, focusing on different sites of origin, imaging characteristics, and local extent.
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Affiliation(s)
- P Clauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Wahringer Gurtel 18-20, 1090, Vienna, Austria
| | - M Dolciami
- Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - F Grassi
- Division of Radiology, Università degli Studi della Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - A D'Amario
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili di Brescia, 25123, Brescia, Italy
| | - S Persiani
- Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - V Celli
- Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - E Oliva
- Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - S M Fragomeni
- Division of Radiology, Università degli Studi della Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - G Garganese
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - E Sala
- Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - B Gui
- Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
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3
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Worrall AP, Alaya F, Fullston E, Geary MP, Salameh F. Impact of an Outpatient Word Catheter Program for Bartholin cysts and abscesses: A retrospective cohort study. Int J Gynaecol Obstet 2025; 168:244-252. [PMID: 39137229 DOI: 10.1002/ijgo.15850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 07/15/2024] [Accepted: 07/30/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVE To assess the impact of an Outpatient Word Catheter Program (OWCP) on outcomes in women presenting with Bartholin cysts or abscesses (BC/BAs). . METHODS This retrospective cohort study reviewed 408 women presenting with BC/BAs to our tertiary unit from 2017-2022. Analysis of medical records, with subgroup analysis of pregnant patients, and comparative analysis between pre- and post-intervention groups, was completed. Financial impact analysis using national activity-based funding pricing guidance to estimate cost was conducted. RESULTS Pre-intervention, 65% (n = 34) of procedures were completed in theater, but after the introduction of OWCP, 61% (n = 213) of cases were treated in the day ward (χ2 = 67.43, P <0.001). Similarly, inpatient admissions reduced; 94.2% (n = 49) pre-intervention versus 26% (n = 92) post-intervention (χ2 = 92.25, P <0.001). The mean all patient admission duration decreased from 1.52 ± 0.89 days to 0.69 ± 0.59 days (P <0.001). The mean cost for those women attending in the pre-OWCP period was €4798, versus €2704 in the women who attended post-OWCP introduction (P < 0.001). CONCLUSION After OWCP introduction, there were significant decreases in inpatient admissions, surgical procedures in theater, general anesthetic exposure, and duration of admission. Financial impact analysis revealed a significant cost reduction of ~€2100 per patient. Outpatient or day-care Word catheter programs are feasible, affordable and acceptable services to provide to women presenting with BC/BAs.
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Affiliation(s)
- Amy P Worrall
- Rotunda Hospital, Dublin, Ireland
- Royal College of Surgeons Ireland, Dublin, Ireland
| | - Fátimah Alaya
- Rotunda Hospital, Dublin, Ireland
- Royal College of Surgeons Ireland, Dublin, Ireland
| | | | - Michael P Geary
- Rotunda Hospital, Dublin, Ireland
- Royal College of Surgeons Ireland, Dublin, Ireland
| | - Fadi Salameh
- Rotunda Hospital, Dublin, Ireland
- Royal College of Surgeons Ireland, Dublin, Ireland
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Akbarzadeh-Jahromi M, Taheri N, Mohajerani S, Taheri N, Abiri F. Bartholin Duct Cyst and Nodular Hyperplasia: A Clinicopathological Study of 32 Patients. Int J Surg Pathol 2024; 32:908-912. [PMID: 37853702 DOI: 10.1177/10668969231204944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Background: Inflammatory lesions and cysts are the most common Bartholin glands pathologic diagnoses. There have been very few reports of benign solid lesions of Bartholin glands such as nodular hyperplasia. Materials and methods: Thirty-two lesions diagnosed as Bartholin duct cyst in the gynecologic specialized institute were reviewed by two expert gynecological pathologists. Results: Using specific criteria, 7 qualified as nodular hyperplasia, 25 as Bartholin duct cyst. The average age of the patients with nodular hyperplasia was 31 years (range, 24 to 43). These lesions were solid, solid and cystic or purely cystic, had a mean maximal dimension of 3.3 cm, and were frequently thought to be Bartholin cysts on clinical examination. Four lesions were diagnosed as Bartholin duct cysts, while in the review they were considered as nodular hyperplasia. Conclusion: Nodular hyperplasia of Bartholin gland may be more common than is reported in the literature. This study showed that the diagnosis of nodular hyperplasia has been overlooked due to limited literature sources.
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Affiliation(s)
- Mojgan Akbarzadeh-Jahromi
- Department of Pathology, Maternal-fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | - Negar Taheri
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | - Sadaf Mohajerani
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | - Nasim Taheri
- Azad University, Shiraz, Islamic Republic of Iran
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5
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Psilopatis I, Emons J, Levidou G, Hildebrandt T, Pretscher J, Kehl S. Feasibility and Satisfaction With the Word Catheter in Treatment of Bartholin's Cyst and Abscess. In Vivo 2024; 38:1292-1299. [PMID: 38688643 PMCID: PMC11059863 DOI: 10.21873/invivo.13568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/03/2024] [Accepted: 02/08/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND/AIM The Word catheter is a silicone device with a balloon system that may be inserted into a Bartholin's cyst or abscess in order to provide drainage and epithelization. The aim of this study was to evaluate the Word catheter as a therapy for Bartholin's cyst and abscess. Both patient and physician satisfaction, as well as the feasibility in an outpatient setting, were examined. PATIENTS AND METHODS A total of 51 women with a Bartholin's cyst or abscess were given the option of Word catheter insertion in an outpatient setting between August 2013 and March 2018. Both the patients and the consulting physicians were asked to complete two questionnaires, before, during and after treatment, with a view to evaluating the overall pain level, any discomfort symptoms and sexual activity, as well as satisfaction levels. RESULTS The insertion procedure seemed to constitute a short yet quite painful procedure. In most cases, the consulting physicians and the patients were content with the results. Nevertheless, dislodgement of the catheter or abscess recurrence were common. The removal of the Word catheter seemed to be short, painless, and uncomplicated. Most patients experienced pain and discomfort after catheter placement over the first days, with the symptoms fading over time. Sexual intercourse appeared to be negatively influenced. CONCLUSION The Word catheter was frequently well tolerated for the treatment of Bartholin's cysts and abscesses, with few non-serious side-effects, however, it did interfere with sexual health. Nonetheless, it may not be possible to make general recommendations based on this exploratory study.
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Affiliation(s)
- Iason Psilopatis
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Julius Emons
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Georgia Levidou
- Department of Pathology, Medical School, Klinikum Nuremberg, Paracelsus University, Nuremberg, Germany
| | - Thomas Hildebrandt
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Jutta Pretscher
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Sven Kehl
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany;
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6
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Alsayed AS, Elkadi TTH, Alshamari MS, Attallah AT. Prepubertal Female Bartholin's Gland Abscess: A Comprehensive Case Report Study. Case Rep Pediatr 2024; 2024:8812350. [PMID: 38601474 PMCID: PMC11006452 DOI: 10.1155/2024/8812350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/05/2024] [Accepted: 03/09/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Bartholin's gland abscesses are rare in pediatric patients, with limited documented cases. This case report aims to contribute valuable insights into managing this uncommon condition in children. Methods A thorough examination and diagnostic workup were conducted on a 4-month-old female infant presenting with labial swelling. Clinical assessment strongly suggested the presence of a Bartholin's gland abscess. A culture of purulent discharge revealed the presence of Escherichia coli and Gram-negative Klebsiella pneumoniae. Antibiotic susceptibility testing guided the choice of treatment. Case Presentation. Despite initial treatment with oral antibiotics and sitz baths, there was limited therapeutic response. Close surveillance under the guidance of a pediatric surgeon continued for two months. Subsequently, surgical excision of the Bartholin gland was performed, and the specimen was sent for pathological examination. Results Pathological analysis revealed signs of ulceration and granulation tissue, indicative of a mixed inflammatory response. An eight-month follow-up demonstrated marked improvement and overall well-being in the patient. Conclusion This case report underscores the importance of considering Bartholin's gland abscess in diagnosing labial swelling in pediatric patients. The successful outcome achieved through surgical excision and appropriate antibiotic therapy provides valuable insights for potential treatment approaches in similar cases. Continued research and comprehensive studies are essential for establishing optimal treatment protocols for this patient demographic.
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Affiliation(s)
- Ahmed Salh Alsayed
- Riyadh Armed Forces Hospital, Riyadh Regional Lab, Ulaishah, Riyadh 12746, Saudi Arabia
| | | | | | - Azza Tawfik Attallah
- Riyadh Armed Forces Hospital, Riyadh Regional Lab, Ulaishah, Riyadh 12746, Saudi Arabia
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Fernández Figueras MT, Alzoghby-Abi Chaker J, Fernandez-Parrado M, García Herrera A, Garrido M, Idoate Gastearena MÁ, Llamas-Velasco M, Monteagudo C, Onrubia J, Pérez Muñoz N, Ríos-Martín JJ, Rodríguez Peralto JL, Rozas Muñoz E, Sanmartín O, Santos-Briz Á, Saus C, Suárez Peñaranda JM, Velasco Benito V, Beato Merino MJ, Fernandez-Flores Á. [Main Types of Cysts in Dermatopathology: Part 2]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2024; 57:97-110. [PMID: 38599743 DOI: 10.1016/j.patol.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/23/2023] [Indexed: 04/12/2024]
Abstract
This is the second article in a two-part series published in this journal, in which we examine the histopathological characteristics, as well as the differential diagnosis, of the main entities that present as cystic and pseudocystic structures in cutaneous biopsy. In this second article, we address ciliated cutaneous cysts, branchial cysts, Bartholin's cysts, omphalomesenteric cysts, thymic cysts, thyroglossal duct cysts, synovial cysts, and median raphe cysts, as well as mucocele, ganglion, and auricular and digital myxoid pseudocysts.
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Affiliation(s)
- María Teresa Fernández Figueras
- Servicio de Anatomía Patológica, Hospital Universitari General de Catalunya, Grupo QuironSant Cugat del Vallès, Barcelona, España
| | | | | | | | - María Garrido
- Servicio de Anatomía Patológica, Hospital Universitario 12 de Octubre, Madrid, España
| | | | - Mar Llamas-Velasco
- Servicio de Dermatología, Hospital Universitario de la Princesa, Madrid, España
| | - Carlos Monteagudo
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia, Valencia, España
| | - José Onrubia
- Servicio de Anatomía Patológica, Hospital Universitario San Juan de Alicante, Alicante, España
| | - Noelia Pérez Muñoz
- Servicio de Anatomía Patológica, Hospital Universitari General de Catalunya, Grupo QuironSant Cugat del Vallès, Barcelona, España
| | - Juan José Ríos-Martín
- Servicio de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, España
| | | | | | - Onofre Sanmartín
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - Ángel Santos-Briz
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Salamanca, Salamanca, España
| | - Carles Saus
- Servicio de Anatomía Patológica, Hospital Universitario Son Espases, Palma de Mallorca, España
| | | | - Verónica Velasco Benito
- Servicio de Anatomía Patológica, Hospital Universitario de Cruces, Barakaldo, Vizcaya, España
| | | | - Ángel Fernandez-Flores
- Servicio de Anatomía Patológica, Hospital Universitario El Bierzo, Ponferrada, León, España.
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8
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Bakouei F, Zolfaghari F, Mirabi P, Farhadi Z, Delavar MA. Comparison of Word Catheter and Marsupialization in the Management of Bartholin's Glands: A Systematic Review and Meta-Analysis. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102357. [PMID: 38215822 DOI: 10.1016/j.jogc.2024.102357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE There is no consensus on the best option for the management of Bartholin's gland abscesses. This systematic review and meta-analysis aimed to compare the Word catheter placement and marsupialization methods in the management of women with a cyst or abscess of the Bartholin's glands. DATA SOURCES The PubMed, Scopus, Embase, Web of Science, and Cochrane Library databases, as well as Google Scholar, were searched to retrieve articles published between January 1990 and July 2023, comparing the Word catheter treatment with marsupialization for women with a cyst or abscess of the Bartholin's glands. STUDY SELECTION Both observational studies and randomized controlled trials (RCTs) were included in this meta-analysis. DATA EXTRACTION AND SYNTHESIS After the review, out of 9 relevant articles, only 4 (2 observational studies and 2 RCTs) were included in this meta-analysis, providing the data of 735 patients (396 in the Word catheter group vs. 339 in the marsupialization group). The data was extracted from the selected articles, using a data extraction form. Comparison of the Word catheter and marsupialization methods suggested that the risk of recurrence was approximately 7.6% in the Word catheter group and 9.4% in the marsupialization group. The findings indicated no significant difference in the recurrence of cysts or abscesses when comparing the Word catheter treatment with marsupialization (odds ratio = 0.99, 95% confidence interval: 0.29-3.43, P = 0.990, I2 = 77%). CONCLUSION This meta-analysis found no significant difference in the rate of recurrence between the Word catheter and marsupialization methods. In general, marsupialization and Word catheter placement in the treatment of Bartholinitis seem to be equally effective.
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Affiliation(s)
- Fatemeh Bakouei
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Zolfaghari
- Committee of Research, Babol University of Medical Sciences, Babol, Iran
| | - Parvaneh Mirabi
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zeynab Farhadi
- Department of Public Health, School of Public Health, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mouloud Agajani Delavar
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Turetta C, Mazzeo R, Capalbo G, Miano S, Fruscio R, Di Donato V, Falcone F, Mangili G, Pignata S, Palaia I. Management of primary and recurrent Bartholin's gland carcinoma: A systematic review on behalf of MITO Rare Cancer Group. TUMORI JOURNAL 2024; 110:96-108. [PMID: 37953636 DOI: 10.1177/03008916231208308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Bartholin gland carcinoma is an extremely rare disease. Information regarding treatment is scarce and there is no strict consensus on best practice. All studies reporting cases of Bartholin's gland cancer were screened and evaluated for inclusion. Baseline characteristics of studies were extracted. A total number of 290 manuscripts collected were available for the review process. Studies included in a previous systematic review were not duplicated. In total, details of 367 patients were collected, as follows: histological features, clinical presentation, treatment, recurrent rate, treatment of recurrence and outcome. About 35% of Bartholin gland carcinoma were squamous cell carcinoma. Almost 50% of patients presented with advanced stage. The therapeutic approach was mainly surgery, and in 61% of those women lymph node assessment was performed. Recurrence occurred in 21% of cases. Bartholin gland cancer remains a challenge for gynecologic oncologists. Guidelines, centralization to referral centers and standardized therapy are needed.
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Affiliation(s)
- Camilla Turetta
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Roberta Mazzeo
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Giuseppe Capalbo
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Salvatora Miano
- Medical Oncology Unit, University Hospital of Siena, Siena, Italy
| | - Robert Fruscio
- Gynecological Unit, Department of Medicine and Surgery, University of Milan-Bicocca, Fondazione IRCCS San Gerardo, Monza
| | - Violante Di Donato
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesca Falcone
- Department of Gynecologic Oncology, Istituto Nazionale Tumori, IRCSS, "Fondazione G. Pascale", Naples, Italy
| | - Giorgia Mangili
- Department of Obstetrics and Gynecology, San Raffaele Scientific Institute, Milan, Italy
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Innocenza Palaia
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
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Li HY, Ding DC. Huge Bartholin’s cyst managed by primary marsupialization: A case report. World J Clin Cases 2023; 11:7732-7737. [DOI: 10.12998/wjcc.v11.i31.7732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 09/22/2023] [Accepted: 10/17/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND We report on the case of a 21-year-old female who could not walk due to a huge Bartholin's cyst occupying the right vulvar region. The patient was treated by marsupialization of the Bartholin’s cyst and postoperative antibiotic therapy.
CASE SUMMARY A 21-year-old female without a medical history of sexually transmitted diseases presented to our outpatient clinic with complaints of a painful vulvar lump and a green-yellowish discharge for 4 d. A large Bartholin’s cyst, 10 cm in diameter, was suspected over the right side of the vulva. She was advised to be admitted to the ward for intravenous antibiotic treatment and to perform marsupialization several days later. However, the patient requested immediate surgery because of time limitations. The patient underwent marsupialization under local anesthesia. The procedure was well-tolerated. After making the incision, a significant amount of malodorous pus (approximately 30 mL) was removed from the abscess. The patient was followed up for 1 wk postoperatively. The Bartholin’s cyst regressed, and the surgical wound healed well.
CONCLUSION Our case shows that an initial marsupialization followed by oral antibiotic therapy can be an appropriate treatment option for a large Bartholin’s cyst. However, depending on the patient’s condition, a suitable treatment, either cystectomy or marsupialization, can be considered.
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Affiliation(s)
- Hao-Yu Li
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan
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11
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Wadia R, McHenry A, Abi-Raad R, Hui P. TP53 Mutation-driven Stratified Mucin-producing Carcinoma Coexisting With Squamous Cell Carcinoma of the Vulva: A Case Study. Int J Gynecol Pathol 2023; 42:555-560. [PMID: 37255422 DOI: 10.1097/pgp.0000000000000961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Associated with high-risk human papillomavirus infection, invasive stratified mucin-producing carcinoma is a recently characterized adenocarcinoma of the cervix. It often occurs in association with adjacent stratified mucin-producing intraepithelial lesion. Differentiated vulvar intraepithelial neoplasia and related invasive squamous cell carcinoma often arise in background vulvar lichen sclerosus with TP53 mutation as the underlying molecular signature. We present a unique case of vulvar invasive stratified mucin-producing carcinoma-like component coexisting with invasive squamous cell carcinoma in a 64-year-old woman. Both neoplastic components were proven TP53 -driven processes arising in the background of differentiated vulvar intraepithelial neoplasia and lichen sclerosus. The invasive stratified mucin-producing carcinoma-like component behaved aggressively in this case, evidenced by the presence of lymphovascular invasion and inguinal lymph node metastasis.
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Affiliation(s)
- Roxanne Wadia
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
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12
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Komatineni N, Paul KG. Vulvar Leiomyoma Masquerading as Bartholin Cyst: A Case Report of Unveiled Diagnosis and Surgical Management. Cureus 2023; 15:e47845. [PMID: 38021802 PMCID: PMC10679966 DOI: 10.7759/cureus.47845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Vulvar leiomyomas are rare benign tumors originating from smooth muscle cells of the vulvar tissue. We present the case of a 44-year-old female patient complaining of a painless vulval mass for 12 years, gradually increasing from 1x1 cm to 5x4 cm. Clinical assessment initially suggested a Bartholin cyst because of its non-tender and non-fluctuant nature. However, surgical intervention revealed an unexpected diagnosis of vulvar leiomyoma, measuring 5x5x4 cm. The patient underwent successful excision and repair under spinal anesthesia. This case underscores the significance of meticulous clinical evaluation and accurate histopathological examination in distinguishing vulvar masses. Accurate diagnosis guides appropriate management, and long-term follow-up prevents complications and recurrence. This report highlights the diagnostic challenges of rare vulvar lesions and the importance of a comprehensive approach to their evaluation and treatment.
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Affiliation(s)
- Nandini Komatineni
- Obstetrics and Gynaecology, Varun Arjun Medical College and Rohilkhand Hospital, Shahjahanpur, IND
| | - Krishna Gopal Paul
- Obstetrics and Gynaecology, Varun Arjun Medical College and Rohilkhand Hospital, Shahjahanpur, IND
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13
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Choudhury S, Dora AK, Gautam G, Pushpalatha K. Bartholin Gland Cyst Mimicking Rectocele: Common Pathology at an Uncommon Location. Cureus 2023; 15:e45607. [PMID: 37868521 PMCID: PMC10588677 DOI: 10.7759/cureus.45607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Vaginal cysts are often encountered in gynaecological outpatient settings. These are usually asymptomatic in their initial course but become symptomatic when their size increases or they get infected. While evaluating such cases, clinical examination plays a vital role in ruling out their differential diagnoses. Imaging studies can complement clinical findings. However, in some instances, the nature of vaginal cysts may not be determined preoperatively until histopathology examination reveals it. We report here a rare case of a posterior vaginal wall cyst that presented as a mass protruding through the vagina. The clinical dilemma was the characterization of the cyst, owing to its huge size and rare location. The cyst was managed surgically by excision, and to our surprise, histopathological examination revealed it as a Bartholin gland cyst in the posterior vaginal wall, rare in its location.
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Affiliation(s)
- Satish Choudhury
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Arun K Dora
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Gargi Gautam
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - K Pushpalatha
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
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14
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Li YR, Ding DC. Hemorrhagic Bartholin's cyst in a woman using anti-platelet medication: A case report and review of the literature. World J Clin Cases 2023; 11:5755-5761. [PMID: 37727722 PMCID: PMC10505996 DOI: 10.12998/wjcc.v11.i24.5755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/30/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND We report the case of a postmenopausal female with a hemorrhagic Bartholin's cyst who has been using an antiplatelet medication. CASE SUMMARY A postmenopausal woman, 84 years of age, had a medical history of hypertension, diabetes mellitus, coronary artery disease (three-vessel disease), chronic kidney disease (stage 3), and dementia. The patient has been taking clopidogrel, an antiplatelet medication, for several years. She presented at our outpatient clinic complaining of painful swelling over her left vulva for several days. A Bartholin's cyst over the left vulva was suspected, and the patient underwent marsupialization under local anesthesia, which was well-tolerated. During the incision procedure, bright-red blood with some blood clots was discharged, and a hemorrhagic Bartholin's cyst was observed. There was no recurrence of the hemorrhagic Bartholin's cyst during the 6-mo subsequent follow-up period. CONCLUSION Hemorrhagic Bartholin's cysts rarely occur. We report the case of a postmenopausal female with a hemorrhagic Bartholin's cyst who had been on antiplatelets and was successfully treated with marsupialization. No recurrence was noted during the 6-mo follow-up period. Older females taking antiplatelets should be cautious of bleeding when presenting with a Bartholin's cyst.
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Affiliation(s)
- Yi-Rong Li
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 970, Taiwan
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 970, Taiwan
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15
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Ford C. An overview of the female reproductive system. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:420-426. [PMID: 37173086 DOI: 10.12968/bjon.2023.32.9.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This is the first of two articles providing an overview of the female reproductive system. This article looks at the internal organs associated with the female reproductive system, as well as the vulva. The author describes the relevant pathophysiology and provides an outline of disorders associated with these reproductive organs. The role of health professionals in managing and treating these disorders is discussed, and the importance of providing women-centred care highlighted. A case study and care plan is used to illustrate the importance of individualised care, including history taking, assessment of the presenting symptoms, treatment strategies, health education and advice on follow-up actions. A second article will provide an overview of breasts.
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Affiliation(s)
- Claire Ford
- Assistant Professor, Adult Nursing, Department of Health and Life Sciences, Northumbria University, Newcastle upon Tyne
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16
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Benabderrazik B, Chaouche I, Haloua M, El Bouardi N, Alami B, Alaoui Lamrani YM, Maaroufi M, Boubbou M. Pelvic cellulitis, a rare complication of bartholinitis: report of two cases. Radiol Case Rep 2023; 18:563-566. [PMID: 36457796 PMCID: PMC9705381 DOI: 10.1016/j.radcr.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 11/27/2022] Open
Abstract
Pelvic or pelviperineal cellulitis is a rare but serious complication of bartholinitis and can be life-threatening. It is described of polymicrobial nature. The diagnosis of pelvic cellulitis remains essentially clinical with signs of local inflammation. The interest of imaging, CT in particular, is to assess the extent of the infection and abcess. In this report, we describe 2 cases of pelvic cellulitis complicating a bartholin's abscess caused by negative gram bacilli in 2 diabetic women in their sixties.
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17
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Mustaqe P, Ibra A, Verras GI, Iliopoulos F, Tchabashvili L, Tasios K, Leivaditis V, Bouchagier K, Mulita F. Encapsulated Hematoma of the Bartholin's Glandule. Mater Sociomed 2023; 35:339-341. [PMID: 38380288 PMCID: PMC10875947 DOI: 10.5455/msm.2023.35.339-341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/15/2023] [Indexed: 02/22/2024] Open
Abstract
Bartholin's glands are important organs of the female reproductive system. These glands have the function of producing an alkaline mucoid secretion, which helps in vaginal and vulvar lubrication. There are several types of lesions that can be identified in these anatomical structures, where in most cases presented for medical examination, cysts and abscesses predominate. This is the presentation of a clinical case of a 55-year-old patient, who is presented to the surgeon for her complaints. Once the woman is examined, diagnosed, and treated adequately, she is taken into consideration for presenting her case in this study, while maintaining confidentiality. The presented clinical case provides a clinical framework not easy to establish an accurate diagnosis of a Bartholin gland cyst. Careful physical examination by the surgeon and careful preparation with electrosurgery verified the cyst-hematoma left and just above the posterior fornix, where some material was taken from the cyst capsule and hematoma and sent for histological examination. The histological response concluded with cystic hematoma of the Bartholin gland. Cystic lesions of the vagina are relatively common and usually represent a benign condition. Ways of managing Bartholin gland cysts vary depending on the discomfort they bring to the patient as well as the size or even the anatomical extent of the cystic lesion. However, the physical examination, with a careful inspection by the surgeon, combined with the imaging examinations, requires a biopsy examination, which is the confirmation of the diagnosis.
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Affiliation(s)
| | - Artemis Ibra
- Surgical Department, University Hospital of Tirana, Tirana, Albania
| | | | | | | | | | - Vasileios Leivaditis
- Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, Kaiserslautern, Germany
| | | | - Francesk Mulita
- Surgical Department, University Hospital of Patras, Patras, Greece
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18
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Velikonja L, Giovannetti O, Adams MA, Tomalty D. Innervation of the human vulvar vestibule: A comprehensive review. Clin Anat 2023; 36:18-27. [PMID: 36216779 DOI: 10.1002/ca.23966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 12/14/2022]
Abstract
Pain of the vulvar vestibule, including provoked vestibulodynia, is prevalent among women, yet challenging to treat due to its multifactorial etiology. Recent evidence indicates a neuroproliferative subtype in which hypersensitivity of the vulvar vestibule is due, in part, to hyperinnervation. Detailed knowledge regarding the innervation of the vulvar vestibule is crucial to understanding and treating pain conditions impacting this region. The purpose of this review is to consolidate the current evidence regarding the innervation of the human vulvar vestibule and discuss the implications of this innervation for pathological conditions affecting this tissue. A comprehensive review of the literature was conducted using keywords including vulvar vestibule, innervation, and vestibulodynia to identify articles concerning the innervation of the vulvar vestibule. Fifteen studies published between 1998 and 2017 were reviewed. Evidence from immunohistochemical investigations support that the vulvar vestibule has nociceptive, mechanosensory, sympathetic, and parasympathetic innervation. In pathological samples, hyperinnervation supports the neuroproliferative etiology of provoked vestibulodynia. Additionally, there is some evidence supporting the role of the pudendal nerve in vulvar vestibule innervation, although no cadaveric studies have been reported to date. Progress has been made in our understanding of the innervation of the vulvar vestibule, though further research into the origin of sensory and autonomic innervation of this region is needed. Advancing the knowledge of vulvar vestibule innervation is crucial towards improving our understanding of the function of this tissue, in addition to informing the etiology and management of pain syndromes impacting this region.
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Affiliation(s)
- Leah Velikonja
- Department of Biomedical and Molecular Science, Queen's University, Kingston, Canada
| | - Olivia Giovannetti
- Department of Biomedical and Molecular Science, Queen's University, Kingston, Canada
| | - Michael A Adams
- Department of Biomedical and Molecular Science, Queen's University, Kingston, Canada
| | - Diane Tomalty
- Department of Biomedical and Molecular Science, Queen's University, Kingston, Canada
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19
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Wiśniewska-Ś Lepaczuk K, Pieczykolan A, Grzesik-Ga Sior J, Wdowiak A. A Review of Aesthetic Gynecologic Procedures for Women. PLASTIC AND AESTHETIC NURSING 2022; 42:226-237. [PMID: 36469394 DOI: 10.1097/psn.0000000000000479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Aesthetic gynecologic surgery is gaining popularity among women and physicians. Aesthetic genital surgery for women encompasses both minimally invasive and open surgical procedures. Cosmetic genital procedures for women described in this article include perineoplasty, vaginoplasty, vaginal rejuvenation, labiaplasty, G-spot enlargement, Bartholin gland surgery, clitoral hoodoplasty, clitroplasty, hymenoplasty, and mons pubis plastic surgery. Based on a review of the literature for each procedure, the article discusses procedural methods and techniques, indications for implementation, potential consequences and side effects of the procedure, nursing implications, patients' motives for undergoing the procedure, and positions of scientific institutions relative to the procedure.
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Affiliation(s)
- Katarzyna Wiśniewska-Ś Lepaczuk
- Katarzyna Wiśniewska-Ślepaczuk, BND, MMid, is a PhD student, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Agnieszka Pieczykolan, MMid, is a PhD student, Department of Midwifery Development, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Joanna Grzesik-Ga˛sior, MMid, is a PhD student, Department of Midwifery, Carpathian State College in Krosno, Krosno, Poland
- Artur Wdowiak, MD, PhD, DSc, is a gynecologist, obstetrician, and andrologist, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Agnieszka Pieczykolan
- Katarzyna Wiśniewska-Ślepaczuk, BND, MMid, is a PhD student, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Agnieszka Pieczykolan, MMid, is a PhD student, Department of Midwifery Development, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Joanna Grzesik-Ga˛sior, MMid, is a PhD student, Department of Midwifery, Carpathian State College in Krosno, Krosno, Poland
- Artur Wdowiak, MD, PhD, DSc, is a gynecologist, obstetrician, and andrologist, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Joanna Grzesik-Ga Sior
- Katarzyna Wiśniewska-Ślepaczuk, BND, MMid, is a PhD student, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Agnieszka Pieczykolan, MMid, is a PhD student, Department of Midwifery Development, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Joanna Grzesik-Ga˛sior, MMid, is a PhD student, Department of Midwifery, Carpathian State College in Krosno, Krosno, Poland
- Artur Wdowiak, MD, PhD, DSc, is a gynecologist, obstetrician, and andrologist, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Artur Wdowiak
- Katarzyna Wiśniewska-Ślepaczuk, BND, MMid, is a PhD student, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Agnieszka Pieczykolan, MMid, is a PhD student, Department of Midwifery Development, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
- Joanna Grzesik-Ga˛sior, MMid, is a PhD student, Department of Midwifery, Carpathian State College in Krosno, Krosno, Poland
- Artur Wdowiak, MD, PhD, DSc, is a gynecologist, obstetrician, and andrologist, Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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20
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Kohlhauser M, Pirsch JV, Maier T, Viertler C, Fegerl R. The Cyst of the Canal of Nuck: Anatomy, Diagnostic and Treatment of a Very Rare Diagnosis-A Case Report of an Adult Woman and Narrative Review of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1353. [PMID: 36295514 PMCID: PMC9609622 DOI: 10.3390/medicina58101353] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 08/25/2023]
Abstract
The cyst of the canal of Nuck is an extremely rare female hydrocele, usually occurring in children, but also in adult women. It is caused by pathology of the canal of Nuck, which is the female equivalent to the male processus vaginalis. Due to its rarity and the lack of awareness among physicians, the cyst of the canal of Nuck is a seldom-encountered entity in clinical practice and is commonly misdiagnosed. We report on a case of cyst of the canal of Nuck in a 42-year-old woman, who presented with a painful swelling at her right groin. In addition, we conducted a review of the current available literature. This review gives an overview of the anatomy, pathology, diagnostics, and treatment of the cyst of the canal of Nuck. The aim of this review is not only to give a survey, but also to raise awareness of the cyst of the canal of Nuck and serve as a reference for medical professionals.
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Affiliation(s)
- Michael Kohlhauser
- Department of Surgery, State Hospital Weiz, Styrian Hospital Association (KAGes), 8160 Weiz, Austria
| | - Julian Vinzent Pirsch
- Department of Surgery, State Hospital Weiz, Styrian Hospital Association (KAGes), 8160 Weiz, Austria
| | - Thorsten Maier
- Radiological Center Weiz, Institute for CT and MRI Weiz OG, 8160 Weiz, Austria
| | - Christian Viertler
- Diagnostic and Research Institute of Pathology, Medical University of Graz, 8010 Graz, Austria
| | - Roland Fegerl
- Department of Surgery, State Hospital Weiz, Styrian Hospital Association (KAGes), 8160 Weiz, Austria
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21
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ERDOĞAN G, ŞİMŞİR C. Office-based management of Bartholin cysts and abscesses: a comparison of three surgical methods. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1006426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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22
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Joseph KS, Choudhrie L, Gunny RJ, Choudhrie A. Management of Bartholin Gland Adenocarcinoma in a Rural Hospital in Central India. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2021. [DOI: 10.1007/s40944-021-00600-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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23
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Abstract
Aesthetic gynecologic surgery is gaining popularity among women and physicians. Aesthetic genital surgery for women encompasses both minimally invasive and open surgical procedures. Cosmetic genital procedures for women described in this article include perineoplasty, vaginoplasty, vaginal rejuvenation, labiaplasty, G-spot enlargement, Bartholin gland surgery, clitoral hoodoplasty, clitroplasty, hymenoplasty, and mons pubis plastic surgery. Based on a review of the literature for each procedure, the article discusses procedural methods and techniques, indications for implementation, potential consequences and side effects of the procedure, nursing implications, patients' motives for undergoing the procedure, and positions of scientific institutions relative to the procedure.
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24
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Santo N, Muhlis M, Iswanty M, Idrus I, Massi N. Bartholin’s Abscess with Bacterial Vaginosis Coinfection Successfully Treated with a Modified Word Catheter and Combined Antibiotics. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Bartholin’s abscess is an infection of the Bartholin gland that often occurs in women of childbearing age. The prevalence of Bartholin’s abscess is 2% in the female population worldwide. Patients often complain dyspareunia with a high recurrence rate. Bacterial Vaginosis (BV) is a syndrome of changes in the vaginal ecosystem that occurs spontaneously in sexually active women. BV can contribute to the development of a Bartholin’s gland abscess.
CASE REPORT: A 30-year-old woman came with the chief complaint of a 5 cm × 5 cm erythematous, tender, and mobile mass on the right side of the labia majora. In addition, the patient also experienced recurrent vaginal discharge. The patient was diagnosed with Bartholin’s abscess with BV coinfection that was successfully treated with a modified word catheter and combination of antibiotics that showed no recurrence.
CONCLUSION: Combination of modified word catheter and antibiotics can be a simple yet effective way in treating Bartholin’s abscess.
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25
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Sally R, Shaw KS, Pomeranz MK. Benign "lumps and bumps" of the vulva: A review. Int J Womens Dermatol 2021; 7:383-390. [PMID: 34621949 PMCID: PMC8484947 DOI: 10.1016/j.ijwd.2021.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 04/18/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022] Open
Abstract
Vulvar dermatology represents a challenge for many providers. Given that the vulva is both a gynecologic and dermatologic organ, patients with cutaneous lesions involving the vulva may present to primary care, gynecology, or dermatology. Particularly within dermatology, the vulva remains understudied, which can lead to anxiety among providers regarding appropriate next steps in the diagnosis and management of vulvar lesions. Thus, the purpose of this review is to highlight commonly encountered anatomic variants and benign neoplasms of the vulva, distinguish them from key pathologic mimickers, and provide guidance to practicing dermatologists on what may constitute normal vulvar variations.
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Affiliation(s)
- Rachel Sally
- The Ronald O. Perelman Department of Dermatology, NYU School of Medicine, New York, New York
| | - Katharina S Shaw
- The Ronald O. Perelman Department of Dermatology, NYU School of Medicine, New York, New York
| | - Miriam Keltz Pomeranz
- The Ronald O. Perelman Department of Dermatology, NYU School of Medicine, New York, New York
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26
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Cazorla-Luna R, Ruiz-Caro R, Veiga MD, Malcolm RK, Lamprou DA. Recent advances in electrospun nanofiber vaginal formulations for women's sexual and reproductive health. Int J Pharm 2021; 607:121040. [PMID: 34450222 DOI: 10.1016/j.ijpharm.2021.121040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/17/2021] [Accepted: 08/21/2021] [Indexed: 12/22/2022]
Abstract
Electrospinning is an innovative technique that allows production of nanofibers and microfibers by applying a high voltage to polymer solutions of melts. The properties of these fibers - which include high surface area, high drug loading capacity, and ability to be manufactured from mucoadhesive polymers - may be particularly useful in a myriad of drug delivery and tissue engineering applications. The last decade has witnessed a surge of interest in the application of electrospinning technology for the fabrication of vaginal drug delivery systems for the treatment and prevention of diseases associated with women's sexual and reproductive health, including sexually transmitted infections (e.g. infection with human immunodeficiency virus and herpes simplex virus) vaginitis, preterm birth, contraception, multipurpose prevention technology strategies, cervicovaginal cancer, and general maintenance of vaginal health. Due to their excellent mechanical properties, electrospun scaffolds are also being investigated as next-generation materials in the surgical treatment of pelvic organ prolapse. In this article, we review the latest advances in the field.
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Affiliation(s)
- Raúl Cazorla-Luna
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; Departamento de Farmacia Galénica y Tecnología Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Roberto Ruiz-Caro
- Departamento de Farmacia Galénica y Tecnología Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - María-Dolores Veiga
- Departamento de Farmacia Galénica y Tecnología Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - R Karl Malcolm
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
| | - Dimitrios A Lamprou
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
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27
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Abstract
Urethral and periurethral masses in women include both benign and malignant entities that can be difficult to clinically differentiate. Primary urethral carcinoma is rare and the optimal treatment modality may vary depending on the stage at presentation. Because cancer-free survival is poor, clinicians shouldhave a high index of suspicion when evaluating a urethral mass. Some benign-appearing urethral masses may be safely observed. Surgical resection is an effective option that should be used based on patient preference and symptoms, and for suspicious lesions.
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28
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Goklu MR, Tunc S, Andan C, Aksin S. Approach to Bartholin's abscesses and recurrences under office conditions. J Gynecol Obstet Hum Reprod 2021; 50:102186. [PMID: 34144244 DOI: 10.1016/j.jogoh.2021.102186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/12/2021] [Accepted: 06/13/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study is to investigate the various treatment methods and recurrence rates regarding Bartholin's gland abscesses under office conditions in our clinic. METHODS In our study, the data of 155 patients who applied to the gynaecology and obstetrics clinic of our hospital between January 2017 and November 2020 and had Bartholin's abscess that was treated with surgical methods under office conditions were analyzed retrospectively. RESULTS Of the 155 patients included in the study, 111 underwent incision drainage, 22 underwent marsupialization, and 22 underwent incision drainage+ silver nitrate. Bartholin's abscess was localized on the right side in 48.4% of the patients and on the left side in 51.6% of the patients. Recurrence was detected in 53 of 155 patients included. Recurrence was detected in 39.6% of the patients who underwent incision drainage in the first treatment, 31.8% of those who underwent marsupialization, and 9.1% of those who underwent incision+silver nitrate. The difference in success, based on recurrence rates, was found to be statistically significantly in favour of silver nitrate (p<0.05). In secondary treatments for recurrent cases, marsupialization or incision+silver nitrate treatment was effective in over 90% of cases, while incision drainage was effective in 30% of patients. CONCLUSION The findings of our study show that silver nitrate application led to a lower recurrence rate than the other two methods. In view of this, we recommend that marsupialization or silver nitrate be preferred, especially in the treatment of recurrent cases.
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Affiliation(s)
- Mehmet Rifat Goklu
- TC Ministry of Health, Health Sciences University, Gazi Yasargil Diyarbakır Training and Research Hospital, Obstetrics and Gynecology, Diyarbakir, Turkey
| | - Seyhmus Tunc
- TC Ministry of Health, Health Sciences University, Gazi Yasargil Diyarbakır Training and Research Hospital, Obstetrics and Gynecology, Diyarbakir, Turkey
| | - Cengiz Andan
- TC Ministry of Health, Health Sciences University, Gazi Yasargil Diyarbakır Training and Research Hospital, Obstetrics and Gynecology, Diyarbakir, Turkey.
| | - Serif Aksin
- TC Ministry of Health, Health Sciences University, Gazi Yasargil Diyarbakır Training and Research Hospital, Obstetrics and Gynecology, Diyarbakir, Turkey
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29
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Local Genital Arousal: Mechanisms for Vaginal Lubrication. CURRENT SEXUAL HEALTH REPORTS 2021. [DOI: 10.1007/s11930-021-00305-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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30
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Akrivi S, Varras M, Anastasiadi Z, Pappa C, Vlachioti A, Varra VK, Varra FN, Balasi E, Akrivis C. Primary vulvar leiomyosarcoma localized in the Bartholin's gland area: A case report and review. Mol Clin Oncol 2021; 14:69. [PMID: 33680460 PMCID: PMC7890440 DOI: 10.3892/mco.2021.2231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 01/14/2021] [Indexed: 01/14/2023] Open
Abstract
Vulvar sarcomas located in the Bartholin's gland area are extremely uncommon mesenchymal vulvar tumors. These neoplasms can be mistaken as Bartholin' gland benign lesions such as cysts or abscesses, leading to a delay in the diagnosis of underlying malignancy. Currently, only a few cases of these aggressive cancers have been reported in the literature. A 42-year-old female patient without any previous complaint presented to Obstetrics and Gynecology Department of ‘G. Chaztikosta’ General Hospital due to a vulvar lump in the area of the left Bartholin's gland with a 6-month history of progressive swelling. Pelvic examination showed a solid mass of 6.5-cm in maximum diameter, localized in the left Bartholin's gland. The patient underwent wide local excision and histopathological examination of hematoxylin and eosin-stained sections indicated intersecting fascicles of spindle cells, with moderate to severe atypia. The number of mitoses was up to 8 per 10 high power fields. The neoplasm to its greatest extent was circumscribed and in places had an invasive growth pattern. Tumoral necrosis was not seen. Involved Bartholin' gland by the tumor was identified. The tumor extended focally to the surgical margin. The neoplastic cells showed positive staining for smooth muscle actin, desmin, HHF35, caldesmon, vimentin and estrogen and progesterone receptors. Immunohistochemistry was negative for S100, myoglobulin, keratin 116, CD117, CD34 and CD31. The patient denied further surgery or/and local radiotherapy, although the mass was >5-cm and a focally infiltrative surgical margin was found. During the close follow-up, no local recurrences or metastases were observed 53 months after surgery. In conclusion, wide local tumor excision with free surgical margins is a good option of surgery for vulvar leiomyosarcomas. In recurrences, a new extensive surgical resection of the lesion and radiotherapy are suggested. Ipsilateral lympadenectomy is indicated when there is a pathologic lymph node. Chemotherapy is provided in cases of distal metastases.
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Affiliation(s)
- Stella Akrivi
- Department of Obstetrics and Gynecology, Royal Jubille Maternity Hospital, Belfast Trust, Belfast BT12 6BA, UK
| | - Michail Varras
- Fourth Department of Obstetrics and Gynecology, 'Elena Venizelou' General Hospital, Athens 11521, Greece
| | - Zoi Anastasiadi
- Department of Obstetrics and Gynecology, 'G. Chatzikosta' General Hospital, Ioannina 45001, Epirus, Greece
| | - Christina Pappa
- Department of Obstetrics and Gynecology, 'G. Chatzikosta' General Hospital, Ioannina 45001, Epirus, Greece
| | - Aikaterini Vlachioti
- Department of Obstetrics and Gynecology, 'G. Chatzikosta' General Hospital, Ioannina 45001, Epirus, Greece
| | | | - Fani-Niki Varra
- Department of Pharmacy, Frederick University, Nicosia 1036, Cyprus
| | - Eufemia Balasi
- Pathology Department, 'G. Chatzikosta' General Hospital, Ioannina 45001, Epirus, Greece
| | - Christos Akrivis
- Department of Obstetrics and Gynecology, 'G. Chatzikosta' General Hospital, Ioannina 45001, Epirus, Greece
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31
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Rotem R, Diamant C, Rottenstreich M, Goldgof M, Barg M, Greenberg N, Sheizaf B, Weintraub AY. Surgical Treatment of Bartholin's Gland Abscess: Is Word Catheter Superior to Marsupialization? J Minim Invasive Gynecol 2021; 28:1211-1215. [PMID: 33460773 DOI: 10.1016/j.jmig.2021.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/10/2020] [Accepted: 01/09/2021] [Indexed: 10/22/2022]
Abstract
STUDY OBJECTIVE Bartholin's gland abscess may occur in up to 2% of the women. Surgical drainage using the Word catheter application or marsupialization is the treatment of choice in the management of Bartholin's gland abscess. We aimed to compare the abscess recurrence rates between these 2 surgical methods. DESIGN A retrospective cohort database study. SETTING A university-affiliated, high-volume teaching hospital in southern Israel. PATIENTS All women who were surgically treated for Bartholin's gland abscess. INTERVENTIONS Different clinical and postoperative characteristics were retrieved from the patients' records. A univariate analysis was conducted, and p <.05 was considered significant. MEASUREMENTS AND MAIN RESULTS During the study period, 321 women were admitted to our center with Bartholin's gland abscess and were managed surgically. Of these, 215 (67%) were treated using the Word catheter and 106 (33%) by drainage and marsupialization. No differences were found in clinical and microbiologic features between the study groups. In addition, recurrence rates as well as recurrent admissions did not differ significantly. Postoperative complications were similar between the groups. CONCLUSION Our study reassures that both the Word catheter application and marsupialization are appropriate and safe when treating Bartholin's gland abscess.
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Affiliation(s)
- Reut Rotem
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem (Drs. Rotem, Rottenstreich, and Barg); Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva (Drs. Diamant, Goldgof, Greenberg, Sheizaf, and Weintraub), Israel
| | - Chagit Diamant
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem (Drs. Rotem, Rottenstreich, and Barg); Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva (Drs. Diamant, Goldgof, Greenberg, Sheizaf, and Weintraub), Israel
| | - Misgav Rottenstreich
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem (Drs. Rotem, Rottenstreich, and Barg); Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva (Drs. Diamant, Goldgof, Greenberg, Sheizaf, and Weintraub), Israel.
| | - Maggie Goldgof
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem (Drs. Rotem, Rottenstreich, and Barg); Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva (Drs. Diamant, Goldgof, Greenberg, Sheizaf, and Weintraub), Israel
| | - Moshe Barg
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem (Drs. Rotem, Rottenstreich, and Barg); Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva (Drs. Diamant, Goldgof, Greenberg, Sheizaf, and Weintraub), Israel
| | - Noa Greenberg
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem (Drs. Rotem, Rottenstreich, and Barg); Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva (Drs. Diamant, Goldgof, Greenberg, Sheizaf, and Weintraub), Israel
| | - Boaz Sheizaf
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem (Drs. Rotem, Rottenstreich, and Barg); Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva (Drs. Diamant, Goldgof, Greenberg, Sheizaf, and Weintraub), Israel
| | - Adi Y Weintraub
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem (Drs. Rotem, Rottenstreich, and Barg); Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva (Drs. Diamant, Goldgof, Greenberg, Sheizaf, and Weintraub), Israel
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32
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Niggli S, Bausch K, Mijuskovic B, Nuñez DG, Vosshenrich J, Schaefer DJ, Seifert HH, Feicke A. Bartholin gland cyst in a transgender male: case report of a rare occurrence. Transl Androl Urol 2020; 9:1773-1777. [PMID: 32944538 PMCID: PMC7475659 DOI: 10.21037/tau-20-733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This case report highlights the importance of a wide differential diagnosis in transgender patients. A 77-year-old transgender (female-to-male) with recurrent urinary tract infections (UTI) and obstructive voiding difficulties presented with a perineal cyst. Further examinations, including computed tomography (CT) and puncture, revealed that the patient had a symptomatic Bartholin gland cyst, a phenomenon that normally only affects women. In his gender confirmation surgery (GCS) 30 years before, the patient’s female labia minora and Bartholin glands were used to lengthen the urethra for the phalloplasty. This explains the unusual location and the prolonged time to the correct diagnose. We decided to perform an incision of the fluid collection from perineal. A follow-up sonography after one month revealed a remaining cyst size of 6 mL, which was assumed to be residual fluid or newly produced liquid; however, the patient has not had any UTIs since the incision of the cyst. Our case seems to be the first description of a symptomatic Bartholin gland cyst in a trans man. This stresses the importance of an expanded understanding of sex/gender concepts, and underlines one of the many possible diagnostic pitfalls when treating trans people.
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Affiliation(s)
- Salome Niggli
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Kathrin Bausch
- Medical Faculty, University of Basel, Basel, Switzerland.,Department of Urology, University Hospital Basel, Basel, Switzerland
| | - Barbara Mijuskovic
- Medical Faculty, University of Basel, Basel, Switzerland.,Center for Gender Variance, Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
| | - David Garcia Nuñez
- Medical Faculty, University of Basel, Basel, Switzerland.,Center for Gender Variance, Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
| | - Jan Vosshenrich
- Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Dirk Johannes Schaefer
- Medical Faculty, University of Basel, Basel, Switzerland.,Center for Gender Variance, Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
| | - Hans Helge Seifert
- Medical Faculty, University of Basel, Basel, Switzerland.,Department of Urology, University Hospital Basel, Basel, Switzerland
| | - Antje Feicke
- Medical Faculty, University of Basel, Basel, Switzerland.,Department of Urology, University Hospital Basel, Basel, Switzerland.,Center for Gender Variance, Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
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33
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Heijink T, Bogers H, Steensma A. Endometriosis of the Bartholin gland: a case report and review of the literature. J Med Case Rep 2020; 14:85. [PMID: 32605643 PMCID: PMC7329502 DOI: 10.1186/s13256-020-02424-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 06/01/2020] [Indexed: 12/29/2022] Open
Abstract
Background In this case report we present a case of endometriosis in the Bartholin gland without surgery in the perineal area. So far, only five cases concerning endometriosis in the Bartholin gland, which may or may not be an isolated finding, have been reported in the literature. Case presentation A 31-year-old Indo-surinamese woman with primary infertility presented at our out-patient clinic with cyclical vulvar pain. On gynecological examination, a cyst of 1 × 2 cm was found in the right gland of Bartholin. A transvaginal ultrasound revealed normal gynecological anatomy and did not reveal any contributing information. Due to the recurring pain of the cyst, surgery was scheduled. During surgery, the marsupialization of the cyst resulted in drainage of a chocolate-colored fluid. Pathological examination revealed stroma lined with non-typical columnar epithelium with hemosiderin pigments, which confirmed a diagnosis of endometriosis in the Bartholin gland. Conclusion Our findings revealed a case of endometriosis outside the pelvis, without any deep intraperitoneal involvement. So far, only five cases concerning endometriosis in the Bartholin gland, which may or may not be an isolated finding, have been reported in literature.
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Affiliation(s)
- Tetske Heijink
- Department of Gynaecology, Erasmus MC, Wytemaweg 80, Rotterdam, 3015 CN, The Netherlands.
| | - Hein Bogers
- Department of Gynaecology, Sint Franciscus Gasthuis, Kleiweg 500, Rotterdam, 3045 PM, The Netherlands
| | - Anneke Steensma
- Department of Gynaecology, Erasmus MC, Wytemaweg 80, Rotterdam, 3015 CN, The Netherlands
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Barcellini A, Gadducci A, Laliscia C, Imparato S, Vitolo V, Preda L, Valvo F. Adenoid Cystic Carcinoma of Bartholin's Gland: What Is the Best Approach? Oncology 2020; 98:513-519. [PMID: 32408297 DOI: 10.1159/000506485] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/13/2020] [Indexed: 11/19/2022]
Abstract
Background and summary: Among all vulvar cancers, primary adenoid cystic carcinoma (ACC) of Bartholin's gland is a very rare tumor characterized by a slow growth, a high local aggressiveness, and a remarkable recurrence rate. Due to its rarity, treatment remains a challenge for oncologists and gynecological surgeons. Key message: The present paper reports clinical, radiological, and histological features of ACC of Bartholin's gland and reviews the literature data on the treatment options with a particular focus on the potential role of particle radiation therapy.
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Affiliation(s)
- Amelia Barcellini
- National Center of Oncological Hadrontherapy (Fondazione CNAO), Pavia, Italy,
| | - Angiolo Gadducci
- Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy
| | - Concetta Laliscia
- Department of Translational Medicine, Division of Radiation Oncology, University of Pisa, Pisa, Italy
| | - Sara Imparato
- National Center of Oncological Hadrontherapy (Fondazione CNAO), Pavia, Italy
| | - Viviana Vitolo
- National Center of Oncological Hadrontherapy (Fondazione CNAO), Pavia, Italy
| | - Lorenzo Preda
- National Center of Oncological Hadrontherapy (Fondazione CNAO), Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Francesca Valvo
- National Center of Oncological Hadrontherapy (Fondazione CNAO), Pavia, Italy
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35
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Illingworth B, Stocking K, Showell M, Kirk E, Duffy J. Evaluation of treatments for Bartholin's cyst or abscess: a systematic review. BJOG 2020; 127:671-678. [PMID: 31876985 DOI: 10.1111/1471-0528.16079] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND No consensus on the management of symptomatic cysts or abscesses of the Bartholin's gland exists. OBJECTIVES To assess the effectiveness and safety of surgical interventions for a symptomatic Bartholin's cyst or abscess. SEARCH STRATEGY We searched bibliographical databases from inception to April 2019. SELECTION CRITERIA Randomised trials evaluating a surgical intervention for the treatment of a symptomatic Bartholin's cyst or abscess. DATA COLLECTION AND ANALYSIS Eight trials, reporting data from 699 women, were included. Study characteristics and methodological quality were recorded for each trial. Summary estimates were calculated using random-effects methods. MAIN RESULTS When considering the recurrence of a symptomatic Bartholin's cyst or abscess, the evidence was consistent with notable effects in either direction (risk ratio [RR] 0.76; 95% confidence interval [CI] 0.41-1.40) when comparing marsupialisation with incision, drainage and insertion of a Word catheter. Limited inference could be made when comparing marsupialisation with incision, drainage and silver nitrate insertion (RR 1.00; 95% CI 0.57-1.75), and incision, drainage and cavity closure (RR 0.25; 95% CI 0.01-4.89). There was limited reporting of secondary outcomes, including haematoma, infectious morbidity and persistent dyspareunia. CONCLUSIONS Current randomised trial evidence does not support the use of any single surgical intervention for the treatment of a symptomatic cyst or abscess of the Bartholin's gland. PROSPECTIVE REGISTRATION PROSPERO: International Prospective Register of Systematic Reviews; CRD42018088553. TWEETABLE ABSTRACT Further research is needed to identify an effective treatment for #Bartholin's cyst or abscess. @jamesmnduffy.
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Affiliation(s)
- Bjg Illingworth
- North West Anglia NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK
| | - K Stocking
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - M Showell
- Cochrane Gynaecology and Fertility Group, University of Auckland, Auckland, New Zealand
| | - E Kirk
- Department of Obstetrics and Gynaecology, Royal Free London NHS Trust, London, UK
| | - Jmn Duffy
- Institute for Women's Health, University College London, London, UK.,Barking, Havering and Redbridge University Hospitals NHS Trust, Essex, UK
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Abstract
The emergency medicine provider sees a broad range of pathology involving the female genitourinary system on a daily basis. Must-not-miss diagnoses include pelvic inflammatory disease and ovarian torsion, because these diagnoses can have severe complications and affect future fertility. Although most patients with abnormal uterine bleeding are hemodynamically stable, it can present as a life-threatening emergency and providers should be adept managing severe hemorrhage. Bartholin gland cysts are common complaints that often require procedural intervention. This article discusses these diagnoses and appropriate evaluation and management in the emergency department.
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Affiliation(s)
- Sarah Mahonski
- Heritage Valley Health System, 1000 Dutch Ridge Road, Beaver, PA 15009, USA
| | - Kami M Hu
- Emergency/Internal/Critical Care Medicine, University of Maryland, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA.
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37
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Nohales F, Calvo P, Garcia-Gamón M, Monfort R, Valle A. La escisión de la glándula de Bartholin como causa de distorsión anatómica y dolor vulvar. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2019. [DOI: 10.1016/j.gine.2019.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Bertholdt C, Andre L, Germain J, Soussoko M, Morel O, Mezan de Malartic C. [Antibiotics in first-line in case of bartholinitis: Retrospective Study of 33 Cases]. ACTA ACUST UNITED AC 2019; 47:713-717. [PMID: 31356891 DOI: 10.1016/j.gofs.2019.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Acute Bartholinitis is a common pathology affecting nearly 2% of women in their lifetime. Many treatments are used, although their effectiveness is not demonstrated in the literature. The main objective was to evaluate the success rate of first-line antibiotic therapy. The secondary objective was to identify factors associated with successful treatment. METHODS We conducted a retrospective unicentric study between January 2014 and June 2018 at the University Hospital Center of Nancy. Inclusion criteria were the presence of acute bartholinitis treated with first-line antibiotic therapy. Exclusion criteria were patients lost to follow-up after initiation of treatment. The primary endpoint was the absence of surgical treatment within 30 days of initiation of antibiotic therapy. Factors associated with successful medical treatment were sought. RESULTS Thirty-three patients were included. The success rate of medical treatment was 48.5% at 30 days. In the case of symptoms that had been evolving for less than 3 days, the success of medical treatment was more frequent (75% vs. 35.3%, P=0.02). Medical treatment was more effective in lesions of less than 2cm (68.7% vs. 23.5%, P=0.01). After adjustment, the only factor associated with successful medical treatment was lesion size≤2cm [ORa=5.31 (1.05-26.81)]. CONCLUSION First-line antibiotic therapy for acute bartholinitis seems effective but should be targeted according to certain eligibility criteria.
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Affiliation(s)
- C Bertholdt
- Pôle de gynécologie-obstétrique, maternité régionale universitaire, CHRU de Nancy, 10, rue du Docteur Heydenreich, 54000 Nancy, France; Unité Inserm U1254, CHRU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
| | - L Andre
- Pôle de gynécologie-obstétrique, maternité régionale universitaire, CHRU de Nancy, 10, rue du Docteur Heydenreich, 54000 Nancy, France
| | - J Germain
- Pôle de gynécologie-obstétrique, maternité régionale universitaire, CHRU de Nancy, 10, rue du Docteur Heydenreich, 54000 Nancy, France
| | - M Soussoko
- Pôle de gynécologie-obstétrique, maternité régionale universitaire, CHRU de Nancy, 10, rue du Docteur Heydenreich, 54000 Nancy, France
| | - O Morel
- Pôle de gynécologie-obstétrique, maternité régionale universitaire, CHRU de Nancy, 10, rue du Docteur Heydenreich, 54000 Nancy, France; Unité Inserm U1254, CHRU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - C Mezan de Malartic
- Pôle de gynécologie-obstétrique, maternité régionale universitaire, CHRU de Nancy, 10, rue du Docteur Heydenreich, 54000 Nancy, France
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39
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Rotem R, Yahoy D, Diamant C, Greenberg N, Rottenstreich M, Sheizaf B, Weintraub AY. Risk factors associated with recurrent referral to the emergency room following surgical treatment of Bartholin’s gland abscess. J OBSTET GYNAECOL 2019; 40:111-115. [DOI: 10.1080/01443615.2019.1606790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Reut Rotem
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem, Israel
| | - David Yahoy
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Chagit Diamant
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Noa Greenberg
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Misgav Rottenstreich
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem, Israel
| | - Boaz Sheizaf
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Adi Y. Weintraub
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
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40
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Grinberg N, Rotem R, Diamant H, Barg M, Sheizaf B, Yohai D, Weintraub AY. Clinical and microbiological features of Bartholin's gland abscess in pregnant and non-pregnant women. J Matern Fetal Neonatal Med 2019; 34:1127-1132. [PMID: 31154884 DOI: 10.1080/14767058.2019.1627320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The data regarding microbiological and clinical characteristics of Bartholin gland abscesses during pregnancy is limited. Given the hormonal and physiological changes during pregnancy we aimed to examine whether a difference exists in the clinical and microbiological features of Bartholin's gland abscess during pregnancy and the puerperium as compared with nonpregnant patients. In addition, we aim to evaluate whether a Bartholin's gland abscess during pregnancy is associated with adverse pregnancy outcomes. STUDY DESIGN A retrospective cohort study was conducted, including all women with Bartholin's gland abscess who were treated surgically between the years 2009-2016 in the Soroka University Medical Center. Various demographic, clinical and microbiological characteristics were retrieved and a comparison was made between patients with a Bartholin's gland abscess during pregnancy and the puerperium (study group) as compared with nonpregnant patients (controls). In addition, obstetrical characteristics of patients in the study group were retrieved. RESULTS Of the 363 women who were treated surgically, 38 (10.5%) were in the study group. Women in the study group were significantly younger (26.8 versus 32.8 p < .001). No differences were found between the groups with regard to the clinical presentation (affected side, fever, leukocytosis and need for antimicrobial treatment) or the selected mode of drainage. In addition, no difference was found in the percentage of positive culture results, nor in the distribution of the pathogens between the groups, in both groups the most common pathogen was Escherichia coli. Yet, among the study group, recurrence of the abscess was more common (13.5 versus 2.15% p = -.067) as evident by significantly higher recurrent referrals to the emergency department and recurrent hospitalizations (28.9 versus 14.8%, p < .05, and 26.3 versus 8.0% p < .001, respectively). Of note, fever after the procedures, pain, discharge and bleeding did not differ significantly between groups. No cases of premature rupture of membranes or chorioamnionitis were noted following treatment. CONCLUSIONS In our cohort, no differences were found between the study groups in the clinical presentation and microbiological features. A significantly higher recurrence rate was noted in the study group. Among pregnant patients no adverse perinatal outcomes were noted.
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Affiliation(s)
- Noa Grinberg
- Faculty of Health Sciences, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Reut Rotem
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Hagit Diamant
- Faculty of Health Sciences, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Moshe Barg
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Boaz Sheizaf
- Faculty of Health Sciences, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - David Yohai
- Faculty of Health Sciences, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Adi Y Weintraub
- Faculty of Health Sciences, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
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41
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Soares R, Reis T, Valido F, Chaves C. Bartholin's gland abscess caused by Streptococcus pneumoniae in a sexually active young woman. BMJ Case Rep 2019; 12:12/4/e228492. [PMID: 31023734 DOI: 10.1136/bcr-2018-228492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Gynaecological infections are frequent in women, particularly in young women during their reproductive time. Anatomophysiologically, Bartholin's gland is greatly susceptible to infections and is characterised by an inherent polymicrobial population. In fact, gynaecological microbiota has a set of agents coming from the perianal region that colonise the vagina and, in particular, Bartholin's gland. Taking this into account, infections caused by agents that do not belong to the genital microbiota are less frequent. Here, we describe a case of a 23-year-old young woman with an abscess in Bartholin's gland caused by Streptococcus pneumoniae.
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Affiliation(s)
- Rui Soares
- Department of Clinical Pathology Service, Instituto Portugues de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal.,Microbiology Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Teresa Reis
- Department of Clinical Pathology Service, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Coimbra, Portugal
| | - Frederico Valido
- Department of Clinical Pathology Service, Instituto Portugues de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
| | - Catarina Chaves
- Department of Clinical Pathology Service, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Coimbra, Portugal
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Dole DM, Nypaver C. Management of Bartholin Duct Cysts and Gland Abscesses. J Midwifery Womens Health 2019; 64:337-343. [DOI: 10.1111/jmwh.12937] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 11/11/2018] [Accepted: 11/14/2018] [Indexed: 12/23/2022]
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Sexual function after Bartholin gland abscess treatment: A randomized trial of the marsupialization and excision methods. Eur J Obstet Gynecol Reprod Biol 2018; 230:188-191. [DOI: 10.1016/j.ejogrb.2018.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/29/2018] [Accepted: 10/03/2018] [Indexed: 12/17/2022]
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Wu JC, Xi ML, Wang YQ, Tang WB, Zhang YQ. Primary small cell neuroendocrine carcinoma of the Bartholin's gland: A case report. Oncol Lett 2018; 16:4434-4438. [PMID: 30197672 PMCID: PMC6126345 DOI: 10.3892/ol.2018.9231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 04/23/2018] [Indexed: 12/11/2022] Open
Abstract
Primary carcinoma of the Bartholin's gland (BG) is a rare malignancy. There are extremely rare cases of small cell neuroendocrine carcinoma (SCNC) of the BG reported in the English literature. A postmenopausal female presented with a 1-month history of increasing pain and swelling on the left vulva consistent with spontaneously bleeding. Pathology identified SCNC that arose in BG. The patient was treated with a radical wide local excision and bilateral inguinal lymph node dissection followed by six courses of chemotherapy. One month after primary treatment, without any pelvic recurrence or abnormal tumor markers indications, distant metastasis of the liver was diagnosed and VI hepatic lobectomy was performed. The patient maintained regular adjuvant chemotherapy every month under outpatient surveillance and has no local recurrence or distant metastasis.
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Affiliation(s)
- Jiang-Chun Wu
- Department of Obstetrics and Gynecology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Mei-Li Xi
- Department of Obstetrics and Gynecology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Yan-Qiu Wang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Wen-Bin Tang
- Department of Obstetrics and Gynecology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Yu-Qin Zhang
- Department of Obstetrics and Gynecology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
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Moreira JR, Oliveira TESD, Tongu EADO, Leite RO, Nogueira GM, Michelazzo MDMZ, Delfiol DJZ, Saut JPE, Headley SA. Bartholin’s gland adenoma in a Saanen goat. CIÊNCIA RURAL 2017; 48. [DOI: 10.1590/0103-8478cr20170214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
ABSTRACT: Tumors affecting Bartholin’s gland are considered rare in human medicine; there are few reports in the veterinary literature, with descriptions occurring only in cows. This article described the clinical and pathological findings associated with Bartholin’s gland adenoma in a goat. Clinically, a 7-year-old pregnant Saanen goat presented bilateral enlargement of the vulva that did not regress spontaneously after parturition. Grossly, these vulvar masses were multilobulated, contained cystic areas from which oozed a whitish fluid. Histopathology revealed an adenoma characterized by the proliferation of irregularly shaped neoplastic epithelial cells that formed tubular to glandular-like structures. These neoplastic cells demonstrated moderate anisokaryosis and evident nucleoli. The intratumoral proliferation index (PI) was estimated by immunoreactivity with the protein ki-67. Further, the glandular-like structures produced a Periodic Acid-Schiff positive secretion. A diagnosis of Bartholin’s gland adenoma was established due to the anatomic location of the neoplastic growths, the histopathological features, and the PI of the tumor.
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Radhakrishna V, Goel R, Parashar G, Santhanakrishnan R. Bartholin's gland abscess in a prepubertal female: A case report. Ann Med Surg (Lond) 2017; 24:1-2. [PMID: 29062477 PMCID: PMC5643079 DOI: 10.1016/j.amsu.2017.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/22/2017] [Accepted: 09/24/2017] [Indexed: 11/19/2022] Open
Abstract
Bartholin's gland abscess is one of the common inflictions of vulva seen in females of reproductive age group with a recurrence rate of up to 38%. Although it's encountered by many Paediatric Surgeons, it's very rarely reported in prepubertal age. Till date, only six cases have been reported to the best of our knowledge. A seven-year-old female child presented with a recurrent labial abscess. She was found to have Bartholin's gland abscess and was treated with partial excision of cyst wall along with the overlying mucosa and drainage. There has been no recurrence for the past six months at follow-up. Bartholin's gland abscess, although rare in children, should be considered as one of the differential diagnosis of a labial swelling. Adequate drainage is essential to prevent recurrence.
Bartholin's gland abscess, although rare in children, should be considered as one of the differential diagnosis of a labial swelling. It has a recurrence rate of up to 38%. Its notorious nature of recurrence can be prevented by partial excision of the cyst wall, incision and curettage, marsupialization, or placement of a word catheter or a rubber drain.
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Asymptomatic Bartholin Cyst: Evaluation With Multidetector Row Computed Tomography. J Comput Assist Tomogr 2017; 42:162-166. [PMID: 28708722 DOI: 10.1097/rct.0000000000000645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to determine the frequency, morphology, and attenuation characteristics of Bartholin cysts on multidetector computed tomography (MDCT) in asymptomatic women. METHODS A total of 3280 consecutive MDCT examinations were assessed for Bartholin cysts. The diagnosis was based on shape, contrast enhancement, and anatomical location. Age, laterality, size, and attenuation patterns were recorded. Scans from patients with paravaginal-related symptoms were excluded, and any available follow-up MDCT scans or magnetic resonance images were evaluated. RESULTS Asymptomatic Bartholin cysts were seen in 17 patients (0.52%) (mean age, 56 years). The mean maximum cyst diameter was 21.8 mm. High-attenuation cysts comprised 47% of cases, all in older (≥50 years) patients. Follow-up MDCT scans showed minimal changes over time. CONCLUSIONS High-attenuation Bartholin cysts are more common than previously thought and are usually seen in older women. The size and attenuation of Bartholin cysts show only minimal changes over time.
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Haghighi L, Zanjani MSH, Najmi Z, Hashemi N. Bilateral Hyperplasia of Bartholin's Gland: A Case Report. IRANIAN JOURNAL OF MEDICAL SCIENCES 2017; 42:412-415. [PMID: 28761210 PMCID: PMC5523051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A 37-year-old woman underwent surgery to remove bilateral vulvar masses. The masses were firm, non-tender, and immobile. Pathologic finding was a well-delineated creamy grayish mass with a homogenous grayish solid surface and mild edema, chronic inflammatory infiltration, and focal dilation of the ducts with squamous metaplasia. The diagnosis was hyperplastic and hypertrophied Bartholin's gland. Hyperplasia is a rare etiology for an enlarged Bartholin's gland. Clinical presentation of Bartholin's gland nodular hyperplasia is rather specific, although inflammatory lesion is the most common cause of swelling of the Bartholin's gland in all age groups. Bartholin's hyperplasia should be considered in cases with a solid mass. Total surgical excision is required for diagnosis. Only a few cases of Bartholin's gland hyperplasia have been reported in the literature. Our patient has been receiving regular follow-up examination and there is no evidence of dyspareunia, perineal pain, and recurrent disease 12 months after surgery.
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Affiliation(s)
- Ladan Haghighi
- Department of Obstetrics and Gynecology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mansooreh SHaabani Zanjani
- Department of Obstetrics and Gynecology, Shahid Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Najmi
- Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Neda Hashemi
- Department of Obstetrics and Gynecology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran,Correspondence: Neda Hashemi, MD; Rasoul-e-Akram Hospital, Niayesh Av. Sattar khan st. Postal Code: 21665-09283, Tehran, Iran Tel/Fax: +98 21 66517342
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Word balloon catheter for Bartholin's cyst and abscess as an office procedure: clinical time gained. BMC Res Notes 2016; 9:13. [PMID: 26740004 PMCID: PMC4702305 DOI: 10.1186/s13104-015-1795-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 12/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Around 2% of women develop a Bartholin's cyst or abscess at least once in their life time. The use of Word balloon catheter as an office procedure for the management of Bartholin's cyst and abscess has been well described and indicates high patient acceptance, low short-term recurrence rates and reduced cost. In most of the reported studies, the reduced costs are attributed to savings from equipment cost, operating theatre costs and health personnel costs. An evaluation of the actual clinical time gained with this office procedure has not been reported and hence the rationale for this study. This study was conducted from December 2011 to January 2014 on 35 patients. An initial retrospective clinical audit of 14 cases of marsupialization under general anesthetic between December 2011 and December 2012 was performed. The findings were compared with a subsequent prospective observational service evaluation of 21 consecutive patients between December 2012 and January 2014. RESULTS Compared to marsupialization under general anesthetic, the mean clinical time gained from admission to insertion of Word balloon catheter as an office procedure is 15 h and 40 min and the mean clinical time gained from admission to discharge is at least 24 h. There were very few minor complications and no major complications in the Word catheter group compared to the marsupialization group. CONCLUSIONS There is a clinically significant time gained with the use of Word balloon catheter as an office procedure compared to marsupialization under general anesthetic for Bartholin's cyst and abscess. The findings from our study could assist other units that want to adopt this procedure justify the efficiency savings in terms of clinical time gained when a business case is submitted. Further studies are needed to investigate and address the underlying causes for the delays encountered when marsupialization under general anesthetic is chosen by patients.
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