Overview

Bartholin Cyst Marsupialization is a surgical procedure to treat recurrent or symptomatic Bartholin gland cysts or abscesses by creating a permanent opening for drainage.

Marsupialization is crucial for preventing recurrence of Bartholin cysts and abscesses. It is a simple and effective outpatient procedure.

Learn more in our comprehensive RxDx OBG Course

Indications

✓
Recurrent Bartholin Cyst

Multiple recurrences

✓
Bartholin Abscess

Symptomatic abscess

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Symptomatic Cyst

Pain, discomfort

✓
Failed Conservative Management

Ineffective previous treatment

✓
Patient Preference

Informed choice

Contraindications

Absolute Contraindications

✗ Patient refusal
✗ Active vulvar malignancy

Relative Contraindications

✗ Coagulopathy
✗ Severe infection

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient consent, anesthesia, sterile technique, and proper positioning.

Step-by-Step Procedure

Step 1: Patient Preparation

Explain procedure, obtain consent, position patient.

⚠️ Common Mistakes to Avoid:

  • Inadequate consent
  • Poor positioning

💡 Pro Tip:

Position patient in lithotomy position.

Step 2: Anesthesia

Administer local or general anesthesia.

⚠️ Common Mistakes to Avoid:

  • Inadequate anesthesia
  • Wrong type

💡 Pro Tip:

Use appropriate anesthesia.

Step 3: Incision

Incise cyst wall to allow drainage.

⚠️ Common Mistakes to Avoid:

  • Wrong site
  • Inadequate drainage

💡 Pro Tip:

Incise at mucosal surface.

Step 4: Evacuation

Evacuate cyst contents and irrigate cavity.

⚠️ Common Mistakes to Avoid:

  • Incomplete evacuation
  • Retained debris

💡 Pro Tip:

Irrigate thoroughly.

Step 5: Marsupialization

Suture cyst wall to mucosa to create permanent opening.

⚠️ Common Mistakes to Avoid:

  • Loose sutures
  • Poor approximation

💡 Pro Tip:

Use absorbable sutures.

Step 6: Hemostasis

Ensure adequate hemostasis.

⚠️ Common Mistakes to Avoid:

  • Bleeding
  • Hematoma

💡 Pro Tip:

Check for bleeding before completion.

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Post-procedure Care

Post-procedure care involves wound care, pain management, and monitoring for recurrence.

Complications & Management

Complication Incidence Signs Management Prevention
Bleeding 2-5% Hemodynamic instability Hemostasis, transfusion Careful technique
Infection 3-8% Fever, wound erythema Antibiotics Sterile technique
Recurrence 5-10% Reappearance of cyst Repeat procedure Proper marsupialization
Dyspareunia 2-5% Painful intercourse Pelvic floor therapy Gentle technique

Clinical Pearls

💡

Incise at mucosal surface for best results.

🎯

Irrigate cavity thoroughly.

⚡

Use absorbable sutures for marsupialization.

🔍

Check for bleeding before completion.

📊

Provide wound care instructions.

🎨

Monitor for recurrence.

⚠️

Monitor for complications post-procedure.