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The Bartholin's glands are located on each side of the vaginal opening. These glands secrete fluid that helps lubricate the vagina. A Bartholin’s cyst forms when the openings of these glands become obstructed, causing fluid to back up into the gland. If the fluid within the cyst becomes infected, you may develop a collection of pus surrounded by inflamed tissue and this can be very painful.

The marsupialization of a Bartholin’s cyst involves cutting a slit into the cyst and then sewing the edges onto the surrounding skin so the cyst is opened, allowing it to drain freely and preventing it from regrowing.

Purpose
To drain fluid from the obstructed Bartholin’s glands when they are inflamed and reduce the chance of infection.
  1. You will be given all relevant information regarding the procedure and will need to sign consent forms allowing the doctor to treat you.
  2. Be sure to let your doctor know if you have any allergies to medication.
  3. Thoroughly wash and dry your genital area before positioning yourself on the bed for the procedure. Your legs will be placed in stirrups to allow your doctor better access.
  1. The doctor will first perform an internal exam before starting the procedure.
  2. The doctor will clean the affected area with an antiseptic solution and then administer a local anesthetic around the cyst. When the area is numb, the doctor will place sterile cloths over the area to prevent infection before beginning.
  3. An incision will be made in the cyst and the sides will be opened to drain it completely. The cysts will then cleaned out with an antiseptic solution.
  4. The sides of the cyst will then be sewn into the surrounding skin, leaving it open. A piece of gauze may be placed lengthwise to allow pus and mucus to drain more easily and so the wound is better ventilated.
  5. You will return to the hospital daily for dressing changes and/or will see the doctor one week after the procedure for a follow-up appointment.
  1. Avoid sexual intercourse for at least seven days after the procedure.
  2. Keep the area as clean as possible. If you are menstruating, changing your sanitary pad often.
  3. Avoid wearing tight-fitting underwear as this can cause recurrence of the cyst.
  4. Carefully follow the doctor’s instructions and always keep all scheduled appointments.

Please return to see the doctor immediately if you experience bleeding from the incision, severe swelling, worsening pain, a high fever, and/or if you notice pus being discharged from your vagina.
 
Recommendations for Travel Before and After the Procedure
Before the Procedure: You should plan to arrive in Thailand at least one to two days before the procedure for treatment planning and for the requisite medical check-up for the procedure.


After the Procedure: You should plan to stay in Thailand for at least one to two days after the procedure and it is recommended you stay in a hotel close to the hospital for convenience in traveling to the hospital after the procedure in the case of complications. You may travel as soon as you are comfortable doing so.

There is always a chance of recurrence so avoid tight-fitting underwear to prevent blockages and cysts that may then become infected.
 
What if the procedure is not performed?
While it is unlikely the cyst will become malignant, it can become severely infected and inflamed, causing enough pain to interfere with daily life.
 
Alternatives
If the Bartholin’s cyst is small and does not bother you or hamper sexual intercourse, no treatment may be necessary. The doctor may prescribe antibiotics in the meanwhile.
 
Last modify: رجب 09, 1444

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