Bartholin Gland Cyst Research Articles

Divertículo uretral femenino. a propósito de un caso

PurposeWe describe the successful repair of a large and complex urethral diverticulum in a female by transvaginal approach. Epidemiology, diagnostic methods, treatments and complications of female urethral diverticula are reviewed. Patients and methodsA 35-year-old woman with a history of postvoid dribbling, dyspareunia and recurrent urinary tract infections for 4 months was refered. Magnetic resonance imaging demonstrated two fluido-filled collections in the pelvis of 3.5 and 1 cm in size respectively which may be a very large and complex diverticulum, however, Bartholin gland cyst could not be rule out. Cystourethroscopy revealed a urethral diverticulum at 10 mm from the bladder neck with two ostia. It was performed transvaginal diverticulectomy and an anterior vaginal wall flap was placed. The published literature on female urethral diverticula was identified using a Pubmed Medline search and analysed. ResultsConvalescence was unremarkable. Suprapubic cystostomy tube was removed 2 weeks after surgery. The patient regained normal voiding. In the published literature there are no agreement neither in the diagnostic nor in the surgical techniques for female urethral diverticula. ConclusionsUrethral diverticula are diagnosed with increasing frequency. However, this entity continues to be overlooked because the symptoms may mimic other disorders. Cystourethroscopy, retrograde urethrograme using a double balloon catheter and recently magnetic resonance imaging may diagnose this disease. The cure rate of urethral diverticula with appropriate surgical management has a range of 86-100%. Complete excision through the anterior vaginal wall is the most successful treatment modality with minimun postoperative complications.

CO 2 laser treatment for Bartholin's gland cyst

CO 2 laser treatment for Bartholin's gland cyst

DYNAMIC HALF FOURIER ACQUISITION, SINGLE SHOT TURBO SPIN-ECHO MAGNETIC RESONANCE IMAGING FOR EVALUATING THE FEMALE PELVIS

We assessed the merit of dynamic half Fourier acquisition, single shot turbo spin-echo sequence T2-weighted magnetic resonance imaging (MRI) for evaluating pelvic organ prolapse and all other female pelvic pathology by prospectively correlating clinical with imaging findings. From September 1997 to April 1998, 100 consecutive women 23 to 88 years old with (65) and without (35) pelvic organ prolapse underwent half Fourier acquisition, single shot turbo spin-echo sequence dynamic pelvic T2-weighted MRI at our institution using a 1.5 Tesla magnet with phased array coils. Mid sagittal and parasagittal views with the patient supine, relaxed and straining were obtained using no pre-examination preparation or instrumentation. We evaluated the anterior vaginal wall, bladder, urethra, posterior vaginal wall, rectum, pelvic floor musculature, perineum, uterus, vaginal cuff, ovaries, ureters and intraperitoneal organs for all pathological conditions, including pelvic prolapse. Patients underwent a prospective physical examination performed by a female urologist, and an experienced radiologist blinded to pre-imaging clinical findings interpreted all studies. Physical examination, MRI and intraoperative findings were statistically correlated. Total image acquisition time was 2.5 minutes, room time 10 minutes and cost American $540. Half Fourier acquisition, single shot turbo spin-echo T2-weighted MRI revealed pathological entities other than pelvic prolapse in 55 cases, including uterine fibroids in 11, ovarian cysts in 9, bilateral ureteronephrosis in 3, nabothian cyst in 7, Bartholin's gland cyst in 4, urethral diverticulum in 3, polytetrafluoroethylene graft abscess in 3, bladder diverticulum in 2, sacral spinal abnormalities in 2, bladder tumor in 1, sigmoid diverticulosis in 1 and other in 9. Intraoperative findings were considered the gold standard against which physical examination and MRI were compared. Using these criteria the sensitivity, specificity and positive predictive value of MRI were 100%, 83% and 97% for cystocele; 100%, 75% and 94% for urethrocele; 100%, 54% and 33% for vaginal vault prolapse; 83%, 100% and 100% for uterine prolapse; 87%, 80% and 91% for enterocele; and 76%, 50% and 96% for rectocele. Dynamic half Fourier acquisition, single shot turbo spin-echo MRI appears to be an important adjunct in the comprehensive evaluation of the female pelvis. Except for rectocele, pelvic floor prolapse is accurately staged and pelvic organ pathology reliably detected. The technique is rapid, noninvasive and cost-effective, and it allows the clinician to visualize the whole pelvis using a single dynamic study that provides superb anatomical detail.

Angiomyofibroblastoma

We report the clinicopathologic features of eight new cases of angiomyofibroblastoma and review the literature on this recently described entity. Most of our female patients had a vulvar mass that clinically was thought to be a Bartholin's gland cyst. The tumors were well circumscribed and measured 2.9 to 11 cm (mean, 5.2 cm). No recurrences or metastases were observed during follow-up, which ranged from 2 months to 4 years. The tumors were characterized by a myxomatous background with prominent vessels surrounded by plump stromal cells. Immunohistochemically, the stromal cells were reactive for vimentin, but staining for desmin was not always present. Angiomyofibroblastoma should be distinguished from aggressive angiomyxoma because the two entities behave differently. Morphologic and immunohistochemical features should also be considered.

Silver nitrate for Bartholin gland cysts

The management of Bartholin cysts by inserting a silver nitrate stick into the cyst cavity was performed in 15 patients. The cyst wall was expelled in 14 (93%) with no recurrence in a year. The only complication was the cauterization of the surrounding mucosa (20%). This technique seems to offer benefit over conventional treatment modalities.

Bartholinitis after vulvovaginal surgery

OBJECTIVES: The object of the study was to determine whether obstruction of the Bartholin gland duct after vulvovaginal surgery is a cause of Bartholin gland infections or cysts. STUDY DESIGN: The records of patients with vulvovaginal surgical procedures performed by me between 1983 and 1997 were reviewed for evidence of a Bartholin gland infection or cyst formation. RESULTS: A postoperative Bartholin gland infection occurred in 2 of 217 patients with posterior colporrhaphy (with or without vault suspension) and 1 of 14 patients with partial vestibulectomy for vestibulitis. No patient had a chronic Bartholin cyst develop. CONCLUSIONS: Bartholin gland infections and Bartholin cysts are uncommon occurrences after surgical procedures that have the potential to obstruct the Bartholin duct. (Am J Obstet Gynecol 1998;178:1143-4.)

High-resolution MR imaging of the vagina.

High-resolution magnetic resonance (MR) imaging with pelvic phased-array and endoluminal coils provides information on vaginal abnormalities heretofore not available with other imaging modalities. Congenital anomalies of the vagina can result from disorders of lateral fusion of the descending müllerian ducts and ascending urogenital sinus, developmental absence of the müllerian ducts, or disorders of vertical fusion. In these conditions, MR imaging can depict the presence or absence of the vagina, cervix, and uterus and help determine whether these structures contain a septum or are duplicated or distended with blood. Gartner duct cysts and Bartholin gland cysts have the same signal intensity characteristics, but the former are located in the anterolateral aspect of the proximal third of the vagina and the latter are in the posterolateral portion of the lower vagina. Entero-, vesico-, and ureterovaginal fistulas result from obstetric and surgical trauma, radiation therapy, or inflammatory bowel disease. MR imaging has great potential for detection and characterization of these fistulas. MR imaging can be used to detect and stage primary and secondary vaginal tumors. However, neither signal intensity nor patterns of enhancement enable confident prediction of the histologic subtype of vaginal malignancy.

Cellular angiofibroma: a benign neoplasm distinct from angiomyofibroblastoma and spindle cell lipoma.

Four cases of a distinctive soft-tissue tumor of the vulva are described. They were characterized by occurrence in middle-aged women (39-50 years), small size (< 3 cm), and a usually well-circumscribed margin. The preoperative clinical diagnosis was that of a labial or Bartholin gland cyst in three of the four cases. The microscopic appearance was remarkably consistent and was characterized by a cellular neoplasm composed of uniform, bland, spindled stromal cells, numerous thick-walled and often hyalinized vessels, and a scarce component of mature adipocytes. Mitotic activity was brisk in three cases (up to 11 mitoses per 10 high power fields). The stromal cells were positive for vimentin and negative for CD34, S-100 protein, actin, desmin, and epithelial membrane antigen, suggesting fibroblastic differentiation. Two patients with follow-up showed no evidence of recurrence. The differential diagnosis of this distinctive tumor includes aggressive angiomyxoma, angiomyofibroblastoma, spindle cell lipoma, solitary fibrous tumor, perineurioma, and leiomyoma. The designation of "cellular angiofibroma" is chosen to emphasize the two principal components of this tumor: the cellular spindle cell component and the prominent blood vessels.

Vulval angiomyofibroblastoma. Clinicopathologic analysis of six cases.

Clinicopathologic, immunohistochemical, ultrastructural, and flow cytometric analyses were performed on vulvar angiomyofibroblastomas in six women (ages 32 to 46 years; average age, 41.3 years). The tumors were all well circumscribed, and measured 2 to 9 cm in greatest dimension. Five tumors were clinically diagnosed as Bartholin's gland cysts. At histologic analysis, the tumors were characterized by alternating hypercellular and hypocellular edematous areas with abundant blood vessels. The hypercellular areas showed a perivascular proliferation of spindle-shaped and round cells, which often formed small nests or epithelioid arrangements, and a short fascicular pattern of spindle cells. The proliferating vessels were thin-walled and capillary-sized. Cellular atypia and mitotic figures were absent. Two tumors contained an adipose element, and one showed a prominent vascular proliferation reminiscent of a capillary hemangioma. At immunohistochemical analysis, the tumor cells were strongly positive for vimentin and desmin. Some cells were weakly positive for HHF35 and alpha-smooth muscle actin. Ultrastructurally, one neoplasm showed fibroblastic differentiation. Flow cytometry revealed three tumors were DNA diploid and two were aneuploid. All tumors were excised, and none have recurred (average follow-up, 28.3 months). These results indicate that angiomyofibroblastomas contain heterogeneous components.

Unusual multiple abnormalities in a bovine reproductive tract

Not all genital disease in cattle, whether congenital or acquired, can be diagnosed by the usual clinical methods. Studies on slaughterhouse materials can be very useful in detecting certain diseases that may be missed by the practicing veterinarian. The examination of 228 bovine reproductive tracts at the slaughterhouse revealed 7 .8% were abnormal on gross examination. In another study of 500 specimens to determine the incidence of ovarian diseases, 2.8% and 1 % of the reproductive tracts exhibited ovarian cysts and paraovarian cysts, respectively. Congenital abnormalities such as Bartholin gland cyst in a cow have also been associated with ovarian cysts of cows. In our two previous surveys, we have not observed multiple abnormalities in the reproductive tracts of cows.&#x0D; The objective of this report is to provide macroscopic description of a Gartner's duct cyst, ovarian cyst, paraovarian cyst and a parametrial abscess as well as hemorrhagic cystitis in the reproductive tract of a cow slaughtered at Irbid slaughterhouse. The macroscopic appearance and histopathologic lesion of a perimetrial mass are also described.

Outpatient management of Bartholin gland abscesses and cysts with silver nitrate.

This study reports results of 52 patients with Bartholin abscesses or cysts who were managed by silver nitrate stick insertion into the cyst or abscess cavity for 48 hours. All patients showed complete healing within 15 days. However, 2 (3.8%) had recurrences within the first 2 months; 1 of these patients was treated with excision and the other by repetition of the same method with no further complaints. Silver nitrate application for Bartholin cysts or abscesses was found to be an effective, simple, inexpensive and the least anaesthetic requiring procedure, which can easily be carried out in the outpatient setting.

Female Circumcision: Three Years' Experience of Common Complications in Patients Treated in Khartoum Teaching Hospitals

SummaryThe acute complications of female circumcision were haemorrhage, infection and vulval trauma, and the late complications urinary tract and genital tract infection, defloration trauma, obstetric complications and psycho-sexual problems. Postcoital trauma and haemorrhage, vulval epidermoid cysts, infected Bartholin's gland cysts and vulval granulation and fibromata were common. Perineal injury during labour was a frequent obstetric problem of circumcised patients delivering at home. About 7 per cent of the total obstetric and gynaecological operations carried out in Khartoum North hospital were to treat direct complications of female circumcision.

Window operation: An alternative treatment method for bartholin gland cysts and abscesses : Cho JY, Ahn MO, Cha KS, et al. Ob Gynecol. 1990;76:886–888

Window operation: An alternative treatment method for bartholin gland cysts and abscesses : Cho JY, Ahn MO, Cha KS, et al. Ob Gynecol. 1990;76:886–888

Window operation: An alternative treatment method for Bartholin gland cysts and abscesses

Recently, we developed the "window operation" as a more effective way to treat Bartholin gland cysts and abscesses. The window operation was used to treat 25 Bartholin cysts and 22 Bartholin abscesses during a 3-year period from October 1, 1986 to September 30, 1989. Under local anesthesia, a small piece of skin including the cyst wall was excised in an oval shape, and suturing was performed along the excised margin. Postoperative antibiotics were given in cases of acute inflammation. A new mucocutaneous junction was observed at the 4-week postoperative checkup. No complications or recurrences have been observed during the study period. The window operation can be an alternative method of treatment for Bartholin gland cysts or abscesses.

Aggressive Angiomyxoma of the Vulva

A case of aggressive angiomyxoma of the vulva is reported. A 43-year-old woman presented initially in 1987 with a left vulvar mass which clinically was thought to be a lipoma or a Bartholin gland cyst. Local excision was performed after a 27-month follow-up without any change in size. The resected tumor measured 2.7 x 2.0 x 2.0 cm and had a smooth, glistening and myxoid cut surface. Histologically, the lesion was composed of spindle-shaped or stellate neoplastic cells, which were loosely textured in the fibromyxoid matrix, and a prominent vascular component characterized by randomly distributed vascular channels of variable caliber. Immunohistochemically, the tumor cells were positive for vimentin, but not for desmin and myosin. The fine structure of the neoplastic cells was compatible with that of fibroblasts rather than myofibroblasts. These findings suggest the fibroblastic differentiation of this tumor. The patient is currently well with no evidence of recurrence, 7 months after excision of the tumor.

Window operation

Recently, we developed the "window operation" as a more effective way to treat Bartholin gland cysts and abscesses. The window operation was used to treat 25 Bartholin cysts and 22 Bartholin abscesses during a 3-year period from October 1, 1986 to September 30, 1989. Under local anesthesia, a small piece of skin including the cyst wall was excised in an oval shape, and suturing was performed along the excised margin. Postoperative antibiotics were given in cases of acute inflammation. A new mucocutaneous junction was observed at the 4-week postoperative checkup. No complications or recurrences have been observed during the study period. The window operation can be an alternative method of treatment for Bartholin gland cysts or abscesses.

Frequent isolation of capnophilic bacteria in aspirate from Bartholin's gland abscesses and cysts

Aspirate samples were obtained from 73 patients undergoing surgery for a Bartholin's gland abscess or cyst. Capnophilic bacteria were isolated from 22% of cases, in contrast to previous reports of sporadic isolation. The three Streptococcus pneumoniae isolates were serotype 3 or 4. The eight Haemophilus influenzae isolates could not be serotyped; six of them were biotype II but the electrophoretic band patterns of their outer membrane proteins were heterogeneous, indicating that non-serotypable strains from the same anatomical site may not be related. Four Neisseria gonorrhoeae isolates and one strain of Neisseria subflava were recovered. The role of capnophilic bacteria in the pathogenesis of infections of the Bartholin's gland remains to be clarified.

Urogenital sinus origin of mucinous and ciliated cysts of the vulva.

The origin of mucinous and ciliated cells in the vulva and the pathogenesis of cysts lined by these epithelia were investigated. Small mucinous glands numbering from one to more than a hundred were encountered in 9 of 19 vulvas (53%) that were consecutively examined at autopsy. Eleven other cysts were encountered clinically. Six were lined by mucinous epithelium, three by pseudostratified cells with cilia plus small foci of mucinous epithelium, and two by ciliated epithelium only. Four of the cysts with ciliated epithelium were otherwise typical Bartholin's gland cysts. It is concluded that glands lined by either mucinous or ciliated epithelia are normal constituents of the vulvar vestibule, are derived from urogenital sinus, and develop into cysts when the neck leading to the vulvar surface becomes inflamed and obstructed.

Microbiological investigation of Bartholin's gland abscesses and cysts

Percutaneous aspirates from intact Bartholin's gland cysts (12) and abscesses (34) were examined for bacteria and genital mycoplasmas. Aspirates from 10 of the 12 patients with Bartholin's gland cysts were sterile. Aspirates from the other two cysts contained organisms that are part of the vaginal microbial flora. Of the 34 abscesses, 24 (70.6 per cent) contained bacteria. Eight abscesses contained gram-negative rods in pure culture and four contained gonococci in pure culture. Twelve abscesses contained one or more vaginal organisms including anaerobic gram-negative rods (eight isolates), anaerobic gram-positive cocci (eight), Staphylococcus epidermidis (four), and microaerophilic streptococci (three). Although most of the patients had genital mycoplasmas isolated from vaginal cultures, Mycoplasma hominis was isolated from only one and Ureaplasma urealyticum from none of the aspirates.

Office treatment of Bartholin's gland abscess or cyst

An office method of treating Bartholin's gland abscess and Bartholin's gland cyst is shown. The cyst lining is destroyed by means of the Post cautery through a small incision, and illustrations are given to demonstrate the method.