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Is Bartolin Gland Removal Surgery Safe?

Posted on Thu, 14 Aug 2014

Question: Hello. 2 years ago my OB practitioner found a bartholin cyst. It never gave me problems and was small at the time. Earlier this year at my regular checkup she noted it to be much larger and suggested I see my OBGYN about getting it removed. The week I was scheduled to go in it abcessed. It was excruciating. After a week of abx I had a marsupialization with word catheter placement. The catheter came out the same night of surgery and when I went back for my 4 week follow up the cyst was still there. This is the only time I've ever had treatment for the cyst. Now my OBGYN says the only thing left to do is remove the gland. I've thoroughly researched this surgery and thus am thoroughly scared now. Everything I read says it is a last resort and has an extensive difficult recovery. I've yet to read one good recovery story. Is this really my next plan of action? Could he not do the marsupialization again or even just drain it? Also, my husband and want to start trying to have a second child. How will that cyst affect my pregnancy? Should I have something done before stopping my BC? The cyst right now us about the size of a walnut. I take daily hot baths. Some days it's more uncomfortable than others and some days I don't even feel it. It's only abcessed once 2 months ago since the failed surgery. What should I do??

Answered by Dr. Soumya (4 hours later)

Brief Answer:
3 months gap

Detailed Answer:
Hello

Welcome to healthcare magic.

I understand the pain you are going through due to incomplete removal of bartholin abscess.

Bartolin gland removal or a re surgery can only be done after a minimum gap of 3 months. The wound needs time to heal so that tissue planes can be defined during surgery.

Meanwhile you can keep trying for pregnancy.

This cyst wont cause problem in getting pregnant or during delivery. Dont worry about it.

I hope your doubt is cleared.

Regards
Dr. Soumya

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Soumya (1 hour later)

Im sorry I think i may have mislead you. I had the surgery in February of this year. I webt for follow up 4 weeks later and it was still there. (Which wouldve been in March) Hes had me on "watch" since then. It abcessed once again 2 months ago. I only took abx then, no procedures, and the abcess cleared. It is still about the size of a walnut...some days are uncomfortable...some days I cant feel it at all. I go for my next follow up in September. Is gland removal really my next step? Is that necessary or is there is anything else to do? In other words...where do I go from here? Do I do what he suggests? Just need another opinion...

Answered by Dr. Soumya (5 hours later)

Brief Answer:
Gland drainage / Excision possibilities

Detailed Answer:
Hello,

I am glad you mentioned the dates of previous procedure. That helps. My comments are as follows:

Marsupialization surgery was performed and word catheter was placed. This procedure was as per the required treatment guidelines. However unfortunately the bartholin cyst has recurrence rate of approximately 5 to 15 percent. Recurrent infection is another complication occurring after surgery. This is what you are facing.

First you need to get the infection cleared before going for any surgery. This is usually done by sending the bartholin cyst abscess for culture and sensitivity. I hope you were treated with antibiotics based on culture and sensitivity tests.

Now as far as bartholing gland removal is concerned, this surgery is recommended only after due consideration to the fact that no other method of treatment is possible to drain the gland and prevent infection. There is an option to try a second marsupialization and catheter placement provided the glad is not badly infected and drainage is still an option. Without a physical examination I have limited resources to understand whether or not a second marsupialization is necessary. You should take your doctors call here. If you haven't discussed about repeating marsupialization feel free to discuss about it. If the gland is badly infected and the drainage is not an option, the doctor will not accept and would advice on gland excision surgery only which suits the condition if the gland is badly infected.

I understand excision is a invasive one, but do not worry. There are patients who get this surgery done and surgery is successful.

To summarize, if doctor examining you feels the drainage possibility is less, then gland excision is the option left. There are no other options.

Let me know if you need any more information or clarification.

Regards,
Dr. Soumya.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Soumya (7 hours later)

Thank you very much. I dont think theres any infection right now. And my doc didnt discuss any different options of draining it. That was my concern. I did not want to jump straight to gland removal if there was another option first. I will discuss this with him at my follow up. Thank you for the second opinion. I feel much better.

Answered by Dr. Soumya (2 hours later)

Brief Answer:
Please write review

Detailed Answer:
Hello

I am glad that my answers were of help. Please remember to write a review.

Regards
Dr. Soumya

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj