Bartholin's gland cysts: management with carbon-dioxide laser vaporization

Abstract

PURPOSE: To evaluate the effectiveness, recurrence rate, and complications of carbon-dioxide laser vaporization in the treatment of Bartholin's gland cysts. METHODS: A retrospective study including 127 patients with symptomatic Bartholin' gland cysts submitted to carbon-dioxide laser vaporization at our institution from January 2005 to June 2011. Patients with Bartholin's gland abscesses and those suspected of having neoplasia were excluded. All procedures were performed in an outpatient setting under local anaesthesia. Clinical records were reviewed for demographic characteristics, anatomic parameters, intraoperative and postoperative complications, and follow-up data. Data were stored and analyzed in Microsoft Excel ® 2007 software. A descriptive statistical analysis was performed, and its results were expressed as frequency (percentage) or mean±standard deviation. Complication, recurrence, and cure rates were calculated. RESULTS: The mean age of the patients was 37.3±9.5 years-old (range from 18 to 61 years-old). Seventy percent (n=85) of them were multiparous. The most common symptom was pain and 47.2% (n=60) of patients had a history of previous medical and/or surgical treatment for Bartholin's gland abscesses. Mean cyst size was 2.7±0.9 cm. There were three (2.4%) cases of minor intraoperative bleeding. Overall, there were 17 (13.4%) recurrences within a mean of 14.6 months (range from 1 to 56 months): ten Bartholin's gland abscesses and seven recurrent cysts requiring reintervention. The cure rate after single laser treatment was 86.6%. Among the five patients with recurrent disease that had a second laser procedure, the cure rate was 100%. CONCLUSIONS: At this institution, carbon-dioxide laser vaporization seems to be a safe and effective procedure for the treatment of Bartholin's gland cysts.Resumo OBJETIVO: Avaliar a eficácia, a taxa de recorrência e as complicações da vaporização laser com CO 2 no tratamento dos cistos da glândula de Bartholin. MÉTODOS: Estudo retrospectivo com 127 pacientes que apresentavam cistos sintomáticos da glândula de Bartholin submetidas à vaporização laser CO 2 na nossa instituição de janeiro de 2005 a junho de 2011. Foram excluídas todas as pacientes com abcessos da glândula de Bartholin ou com suspeita de câncer. Todos os procedimentos foram realizados em regime ambulatorial, sob anestesia local. A coleta dos dados foi feita com base na consulta do processo clínico, tendo-se procedido à análise das características demográficas, dos parâmetros anatômicos, das complicações intra e pós-operatórias e dos dados de acompanhamento. Os dados foram armazenados e analisados no software Microsoft Excel ® 2007, e os resultados foram apresentados como frequência (porcentagem) ou média±desvio padrão. As taxas de complicações, recorrência e cura foram calculadas. RESULTADOS: A idade média das pacientes foi de 37,3±9,5 anos (variando entre 18 e 61 anos). Setenta por cento (n=85) delas eram multíparas. A queixa mais frequente foi dor e 47,2% (n=60) das pacientes tinham antecedente...

Incidence, Presentation and Management of Bartholin’s Gland Cysts/Abscesses: A Four-Year Review in Federal Teaching Hospital, Abakaliki, South-East Nigeria

“…The commonest risk factor for bartholin's gland cysts or abscesses among our patients was past history of Bartholin's cyst or abscess disease in (77.8%) of cases followed by past or present history of sexually transmitted infection. This is similar to the findings by John et al, Wechter et al, Figueredo where the commonest risk factor was previous history of Bartholins cyst and abscess with 36.8%, 63%, 47.2% respectively [1] [6] [7]. The finding of previous history of Bartholin abscess or cyst could be due to poor health seeking behavior and self-medication which is common with women in developing countries, this is made worse by rampant poverty and high cost of health care.…”

“…This history was actually got from some of them. The 1.78% rate in our study however is actually less than the 36%, 63% gotten respectively by weschter e'tal and figueredo in their own work [6] [7]. This could be due to the fact that their work was done in more advanced environment where healthcare is easily accessible and their patient were unlikely to embark on self medication and less risky sexual behavior.…”

“…Approximately 2% of women, mostly in their reproductive age would develop Bartholin's gland cyst or abscess at some point in their life [2]- [7]. Abscesses are almost three times commoner than the cysts [3] [8].…”

“…Clearly identified causes for Bartholin's cysts and abscesses are elusive, however the risk profile is similar to those of women at risk for sexually transmitted diseases [7] [9]. Some risk factors include previous history of Bartholin's gland cyst, multiple sexual partners, sexually transmitted infection, medio-lateral episiotomies, vulva trauma [1] [4] [7].…”

“…Clearly identified causes for Bartholin's cysts and abscesses are elusive, however the risk profile is similar to those of women at risk for sexually transmitted diseases [7] [9]. Some risk factors include previous history of Bartholin's gland cyst, multiple sexual partners, sexually transmitted infection, medio-lateral episiotomies, vulva trauma [1] [4] [7]. There is a gradual involution of the gland as from 30 years of age, hence a higher incidence occurs between 20 -30 years while high parity seem to be associated with lower incidence [3] [8].…”