Bartholin's Glands

What is a Bartholin's Gland Cyst?
When the duct leading to the vagina from these glands becomes blocked, all the mucus they produce becomes trapped within the gland itself, creating a cyst.
Around 2% of women of childbearing age develop a Bartholin's gland cyst. Girls usually do not have this problem because these glands do not start functioning until puberty. Similarly, cysts are less common after menopause, as the glands tend to atrophy with age.
When the cyst is small, it often goes unnoticed as it is painless.
When it grows larger than 1 cm in diameter, a woman may notice the appearance of a lump inside her labia minora. In these cases, it is usually palpable but remains painless.
Cysts larger than 3 cm can cause discomfort upon touch and pain during sexual intercourse.

When Are We Dealing with an Episode of Bartholinitis?
When the fluid trapped in the Bartholin's gland cyst becomes contaminated with bacteria, it becomes purulent.
This complication is called an abscess of the Bartholin's gland.
Abscesses do not always occur after noticing the cyst and are more frequent. This infected swelling produces intense symptoms such as pain, swelling, redness, and local warmth.

Treatment
Unlike the cyst, which is usually asymptomatic and does not require specific treatment, a Bartholin's gland abscess requires medical intervention.
The treatment for this infection involves draining the purulent fluid and administering appropriate antibiotics. Most of the germs causing this infection are sexually transmitted.

In Which Patients Is Surgical Treatment Indicated?
It is indicated in patients who:
- Experience recurrent infections of the Bartholin's gland.
- Have a chronic Bartholin's gland cyst that causes discomfort due to its location and size.
- Require a biopsy due to suspicion of another existing pathology.

Advantages of Performing Bartholinectomy or Laser Marsupialization Surgery
- It is performed in an outpatient setting in the doctor's office.
- It is done under local anesthesia.
- Shorter healing time and earlier medical discharge.
- The laser simultaneously cuts and coagulates with fewer sutures needed.
- Better cosmetic results.

What Is the Procedure Like?
The surgical treatment of Bartholin's gland cyst has been simplified thanks to the latest laser technology. The Diode laser generates a precise cut and coagulation using laser fiber. This allows for hemostasis, edge coaptation, and a reduced need for sutures.
An incision is made at the most hidden edge of the cyst, with the subsequent vaporization of the capsule, enlarging the gland's exit orifice, which serves for proper lubrication during sexual intercourse.