Bartholin's Cyst Research Articles

A RARE CASE OF VULVAL FIBROID DURING PREGNANCY PRESENTING LIKE BARTHOLIN’S ABSCESS

Introduction: - Fibroid are commonly found in uterus and cervix but rarely may found other sites (broad ligament, ovary, Vulva, vagina etc). Here we are presenting a rare case of Vulval Fibroid. Case Report: - A 25 years old woman G4P3L3 with 37 weeks pregnancy presented to OPD with complaint of severe pain at perineal region. There was history of fall in bathroom 1 month ago. On examination there was a swelling at right vulvo-vaginal junction of 4x4 cm, (probably bartholin cyst) with firm smooth surface, with no signs of acute inflammation, for that Incision and drainage was done and an organized mass was resected out. On histopathlogical examination, it was found to be a leiomyoma with myxoid degeneration. Discussion :- fibroids rarely presents with pain and inflammation and on the other hand bartholin’s cyst or abscess mostly presents with pain and inflammation, so detailed history and examination with broad suspicion are the keys to differentiate between Bartholin’s cyst and vulval fibroids.

Solitary Vulvar Involvement of Ovarian Non-Hodgkin Lymphoma Mimicking Bartholin's Abscess on 18F-FDG PET/CT.

A 49-year-old woman was diagnosed with diffuse large B-cell lymphoma of the left ovary. Two months after the hysterectomy and bilateral salpingo-oophorectomy operation, the patient was referred to 18F-FDG PET/CT for staging. A mass lesion measuring 2.8 × 3 cm with intense 18F-FDG uptake was observed at right labium majus, which could be considered as a Bartholin's cyst or abscess. The lesion was excised, and non-Hodgkin lymphoma involvement of vulva was revealed by histopathology.

Surgical management options for Bartholin’s gland abscess

Bartholin's glands, also known as greater vestibular glands, are two mucus-secreting glands located in the posterolateral wall of the vagina opening. The function of these glands is to produce mucus that moisturizes the vestibule of vagina. When the outflow path from the gland is blocked, a cyst forms. When the abscess is formed usually it is infections with a polymicrobial background.The most common symptoms of a Bartholin's gland cyst or abscess include pain in the vulva, swelling, difficulty walking, dyspareunia, and fever.The procedure of choice in this case is surgery. The operator can choose from among many possible options, among others there is simple incision and drainage of the cyst, marsupialization, a Word catheter, silver nitrate application, alcohol sclerotherapy, excision and laser CO2 and, as a last resort, surgical removal of the gland.The aim of this study is to review the most common surgical procedures used in Bartholin's gland cyst or abscess.

Interpreting body MRI cases: classic findings in pelvic MRI.

The high contrast resolution provided by magnetic resonance imaging (MRI) compared to all other modalities allows the interpreting radiologist to make a specific diagnosis for many common and uncommon findings. In some cases, the diagnosis can be so certain that there is no differential diagnosis. In this article, we review the most classically recognized findings when interpreting MRI of the pelvis including the following: Ovaries: Simple cyst, hemorrhagic cyst, corpus luteum, dermoid, fibroma/fibrothecoma. Uterus: C-section scar, adenomyosis, endometriosis, fibroid, congenital uterine anomalies. Cervix: nabothian cyst, cervical cancer. Vagina/Vulva: Gardener's duct cyst, Bartholin's gland cyst. Urethra: skene gland cyst, urethral diverticulum. Prostate: utricle cyst, Mullerian duct cyst, benign prostatic hyperplasia, prostate cancer.

Clitoral leiomyoma in a premenopausal woman: a case report

BackgroundExtrauterine leiomyomata is an uncommon lesion that can lead to several problems of differential diagnosis, especially when localized in the external genitalia. There are few reports in the English literature and a novel association with Alport’s syndrome has been investigated since the 1980s.Case presentationHere, we describe the case of a premenopausal woman who presented with an indolent swelling of the right interlabial fossa that resulted in a Bartholin cyst. In addition to this cyst, a benign leiomyoma of the right side of the clitoris was also found and removed. Our patient refused any further examination, although she was informed that genetic counselling could be organized to rule out an association with Alport’s syndrome.ConclusionsExtrauterine leiomyomata localized in the external genitalia is an uncommon lesion arising from smooth muscle cells around vascular epithelium or erectile tissue. Since an association between extrauterine leiomyomata and Alport’s syndrome has been described, genetic testing can be proposed to these patients. Upper intestinal tract symptoms such as dysphagia should prompt a gastroenterological evaluation as an association with an esophageal leiomyomatosis has been described.

Clinical and epidemiological study of non-venereal genital diseases in females

<p class="abstract"><strong>Background:</strong> Dermatoses which are not sexually transmitted are referred to as non-venereal dermatoses of external genitalia. Venereal and non-venereal dermatoses tend to be confused and it is associated with guilt feeling in affected patients. The aim of the study was to study the incidence of non-venereal lesions of the genitalia and to know the incidence of non-venereal lesions of the genitalia in association with dermatoses of other parts of the body.</p><p class="abstract"><strong>Methods:</strong> This was a cross-sectional, clinical and observational study in 250 female patients attending dermatovenereology OPD of Vydehi Hospital, Bengaluru with non-venereal genital lesions for a period of 18 months. cases having venereal diseases were excluded from the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> The study included 250 female patients with non-venereal genital lesions. Twenty-five different types of non-venereal dermatoses were observed. Inflammatory disorders were most common accounting for 128 patients (51.2%). Among inflammatory disorders lichen simplex chronicus was seen most followed by lichen sclerosus. Candidiasis was found to be more common among infections and infestations. Vitiligo was the commonest pigmentary disorder seen in our study. Other cases noted include epidermal inclusion cyst, Bartholin cyst and fibroepithelial stromal polyp. Pre malignant conditions like Bowenoid papulosis and malignant lesions like squamous cell carcinoma are also seen.</p><p class="abstract"><strong>Conclusions:</strong> This study helps in understanding the importance of diagnosis of non-venereal dermatoses and to differentiate it from venereal causes.</p><p> </p>

Association of Bartholin cysts and abscesses and sexually transmitted infections.

Bartholin gland cysts or abscesses account for many gynecologic visits in the emergency department (ED). Previous smaller studies have suggested a link between Bartholin cysts/abscesses and sexually transmitted infections (STIs), but few studies have involved the ED. We retrospectively identified patients aged 18years or older seen in 1 ED between January 2012 and March 2017 who had urinalysis and urine culture and/or were tested for gonorrhea, chlamydia, or trichomonas by nucleic acid amplification testing. Univariate and multivariate analyses were used to evaluate associations between Bartholin cysts/abscess and demographics, laboratory findings, and ED diagnoses. Data were collected for 75,000 ED patients; 64 patients had a diagnosis of Bartholin cyst or abscess, 40 of whom were also tested for Neisseria gonorrhoeae or Chlamydia trachomatis. Ten percent of patients with a Bartholin cyst/abscess were infected with N gonorrhoeae, compared with 3% of those without a Bartholin cyst/abscess (P=.008). The rates of C trachomatis and Trichomonas vaginalis infections were 13% and 26%, respectively, among patients with a Bartholin cyst/abscess, compared with 8% and 30%, respectively, among those without a Bartholin cyst/abscess (P>.05 for both). On regression analysis, only increased urobilinogen level (β, 0.31; odds ratio, 1.36; 95% CI, 1.11-1.66; P=.003) and infection with N gonorrhoeae (β, 1.69; odds ratio, 5.40; 95% CI, 1.43-20.35; P=.01) were associated with a Bartholin cyst/abscess. Clinicians in the ED should consider testing patients with a Bartholin cyst/abscess for gonorrhea.

Evaluation of treatments for Bartholin's cyst or abscess: a systematic review.

No consensus on the management of symptomatic cysts or abscesses of the Bartholin's gland exists. To assess the effectiveness and safety of surgical interventions for a symptomatic Bartholin's cyst or abscess. We searched bibliographical databases from inception to April 2019. Randomised trials evaluating a surgical intervention for the treatment of a symptomatic Bartholin's cyst or abscess. Eight trials, reporting data from 699 women, were included. Study characteristics and methodological quality were recorded for each trial. Summary estimates were calculated using random-effects methods. When considering the recurrence of a symptomatic Bartholin's cyst or abscess, the evidence was consistent with notable effects in either direction (risk ratio [RR] 0.76; 95% confidence interval [CI] 0.41-1.40) when comparing marsupialisation with incision, drainage and insertion of a Word catheter. Limited inference could be made when comparing marsupialisation with incision, drainage and silver nitrate insertion (RR 1.00; 95% CI 0.57-1.75), and incision, drainage and cavity closure (RR 0.25; 95% CI 0.01-4.89). There was limited reporting of secondary outcomes, including haematoma, infectious morbidity and persistent dyspareunia. Current randomised trial evidence does not support the use of any single surgical intervention for the treatment of a symptomatic cyst or abscess of the Bartholin's gland. PROSPERO: International Prospective Register of Systematic Reviews; CRD42018088553. Further research is needed to identify an effective treatment for #Bartholin's cyst or abscess. @jamesmnduffy.

Vulvar Leiomyomatosis: A Diagnostic Challenge Case Report

Introduction: Vulvar leiomyomas are rare and usually misdiagnosed as Bartholin’s cyst on initial presentation. Leiomyoma of vulva accounts for only 0.03% of all gynecological neoplasm. Definite diagnosis is based on surgical excision of the tumor. The aim of this report is to introduce a case of leiomyoma of the vulva which was initially misdiagnosed as Bartholin’s cyst. Case Presentation: We present a case of a 36-year old virgin female (BMI>30) who was referred to the clinic with a 5-year history of left labial mass which was initially diagnosed as Bartholin’s cyst. The mass was removed and the pathologist confirmed that the final diagnosis was vulvar leiomyoma. Conclusion: Vulvar leiomyoma is usually misdiagnosed with Bartholin cyst and distinguishing between benign and malignant forms is confusing, so it is a diagnostic challenge. Surgical excision is the treatment of choice in all smooth muscle tumors of the vulva. Continuing follow-up after treatment is highly recommended.

A 19 cm Angiomyxoma of the Vulva in a 45-Year-Old Woman: A Case Report

Angiomyxoma is a rare, benign, locally infiltrative mesenchymal tumor that occurs in women at reproductive age. We present a 45-year-old female's case with a four years history of vaginal growth which has been progressively increasing in size. The patient was misdiagnosed of Bartholin's duct cysts and was asymptomatic. Aggressive angiomyxoma is a frequently misdiagnosed tumor that tends to recur locally. The prefix “aggressive” was added to emphasize this tumor characteristic. The diagnosis was based on histopathological and immuno-histochemical results. Treatment involves surgery that should aim wide local excision. However, over the years alternative treatment was proposed, in particular, hormonal therapy based on the female hormone receptors of this mesenchymal tumor. Application of imaging method, like ultrasounds, could be useful both for differential diagnosis and to evaluate the tumor before surgery. The frequent local recurrence of this disease requires a long-term follow-up.

Anaesthetic management of obstetric and nonobstetric emergencies during pregnancy

Background: Obstetric anaesthesia is considered to be one of the higher risk areas of anesthetic practice. The present study is done to know the various anesthetic techniques in management of obstetric emergencies and their complications. Materials & Methods: This was a descriptive study of 100 pregnant patients coming for emergency surgeries. Intraoperative complications such as hypotension, bradycardia, failed spinal, high spinal, seizures, difficult intubation and aspiration were recorded. Results: 78% of the obstetric emergencies were lower segment caesarean section, 16% was surgery for ectopic pregnancy, 3% hysterectomy for postpartum hemorrhage, 1% bartholin cyst excision, 1% I and D and 1% cervical encirclage. 90% of caesarean sections received subarachnoid block. 8% of cases received general anaesthesia and 2% of case subarachnoid block was converted to general anesthesia. 17 cases previous caesarean section in labour, in 13 cases thick meconium stained liquor with foetal distress, in 6 cases failure to progress, in 5 cases cephalopelvic disproportion, in 5 cases premature rupture of membranes and in 4 cases breech presentation in labour. Hypotension was present in 20 cases, bradycardia in 2 cases and failed spinal in 2 cases. Conclusion: Authors concluded that single shot subarachnoid block is the most common method of anaesthesia for emergency caesarean sections. Chickenpox is a worldwide disease and is no respecter race or class. The incidence increases in spring & winter months in the temperate zones. In the tropics, the peak incidence is during winter and early spring. The disease in fact started is helping the virus to spread rapidly.

Surgical management of Bartholin cysts and abscesses in French university hospitals

Objectives: To assess the methods used to manage Bartholin gland abscesses and cysts in French university hospitals.Method: Data for this descriptive, cross-sectional study with self-reported data were collected between January and March 2018 by an online questionnaire. The 11 items of the questionnaire assessed the surgical techniques known and used, the type of hospitalization, and the non-surgical management to treat Bartholin gland abscesses and cysts.Results: Overall, 116 obstetrics-gynecology residents responded to the online questionnaire. The three best-known techniques were incision and drainage, marsupialization, and excision of the Bartholin gland. Only 3% of the physicians knew about other techniques. Most participants reported that their unit treated 2–6 Bartholin gland abscesses monthly and fewer than 2 cysts. The most frequent treatment for abscess was incision-drainage (87%), followed by marsupialization (13%). The most widely used treatment for the cysts was gland excision (68.5%) followed by marsupialization (22.5%). In both cases, management generally took place on an outpatient basis (92.9%).Conclusion: This study showed that 87% of the respondents used incision-drainage for Bartholin gland abscesses, although the recurrence and complication rates of this technique have never been evaluated.

A 5-year follow-up of vulval swelling due to extraskeletal myxoid chondrosarcoma: A rare case report.

Vulval extraskeletal myxoid chondrosarcoma (EMC) is a rare cause of vulval swelling, reported <10 times in the literature to date. EMC in this location is frequently misdiagnosed due to its rarity, and patients may incur delays in diagnosis and treatment. We herein present the diagnosis and management of the case of vulval EMC in a 42-year-old Caucasian female patient who presented in 2011 with a swelling on the right labium majus. The tumour was initially misdiagnosed as a Bartholin's cyst and managed conservatively. The tumour was ultimately diagnosed as EMC and treated by radical surgical excision and adjuvant radiotherapy. The aim of the present study was to report the results after a long-term follow-up period and review the available relevant literature.

Gynecologic Emergencies in the Nonpregnant Patient

Nonpregnant patients with gynecologic emergencies often present with pelvic pain that may or may not be unilateral. Many gynecologic emergencies are associated with high morbidity and, occasionally, mortality if left untreated. This review examines the assessment and stabilization, diagnosis, and treatment and disposition of patients with various gynecologic emergencies, including ovarian torsion, cervicitis, pelvic inflammatory disease, uterine fibroids, endometriosis, dysfunctional uterine bleeding, Bartholin cysts, and vulvovaginitis. Figures show an algorithm of gynecologic emergencies, a longitudinal sonogram and a computed tomography (CT) scan showing ovarian torsion, a CT scan and sonogram of a tubo-ovarian abscess, and illustrations of a Bartholin cyst and a Word catheter. Tables list assessment, stabilization, and management guidelines for the subtopics in this review. This review contains 7 figures, 15 tables, and 68 references. Keywords: Ovarian torsion, cervicitis, uterine fibroids, endometriosis, Bartholin’s cyst, vulvovaginitis, sexually transmitted infection, bleeding.

331 Does genital sexual pain matter? An explorative study on reproductive-age women

Genital Sexual Pain (GSP) is a common symptom in reproductive-age women: about 40% of women 20-40 y.o. suffer from pain during sexual activity. Because of the lack of awareness, many women could continue to go on with this symptom without asking help to professionals, increasing the risk of pain chronicization and sexuality impairment. The aim of the present study was to investigate how many reproductive-age women in the general population experience GSP, the characteristics of such pain (duration, location, etiology), how they face the symptom, and their sexual functioning. 653 women aged between 18 and 40 (mean age 25.7±4.37) were recruited with snowball method. Participants completed a socio-demographic questionnaire, the McGill Pain Questionnaire (MPQ), the Female Sexual Functioning Index (FSFI), the Female Sexual Distress Scale (FSDS). 190 women (29.6%) reported GSP in the last 6 months (mean duration of the symptom 16.87±33.75). Pain was located in: vaginal introitus and vestibule (52.1%), lower abdomen/pelvis (44.7%), labia minora/majora (25.3%), clitoris (8.4%), and perineum/anus (5.3%). Most women (75.3%) did not know the cause of the pain, and a quarter of them (24.7%) reported a specific diagnosis (vulvodynia, endometriosis, cystitis, vulvovaginal infections, Bartholin cyst). 58 out of 190 (30.5%) reported GSP as a “sexual problem”. Although 69 (36.31%) and 50 (26.31%) reached clinical scores on FSFI and FSDS, respectively, only13 (7%) were under psychosexual therapy for GSP.

A Large Adenoid Cystic Carcinoma of Bartholin Gland Misdiagnosed and Mistreated as a Bartholin Cyst: A Case Report

A Large Adenoid Cystic Carcinoma of Bartholin Gland Misdiagnosed and Mistreated as a Bartholin Cyst: A Case Report

Asymptomatic Bartholin Cyst: Evaluation With Multidetector Row Computed Tomography.

The aim of this study was to determine the frequency, morphology, and attenuation characteristics of Bartholin cysts on multidetector computed tomography (MDCT) in asymptomatic women. A total of 3280 consecutive MDCT examinations were assessed for Bartholin cysts. The diagnosis was based on shape, contrast enhancement, and anatomical location. Age, laterality, size, and attenuation patterns were recorded. Scans from patients with paravaginal-related symptoms were excluded, and any available follow-up MDCT scans or magnetic resonance images were evaluated. Asymptomatic Bartholin cysts were seen in 17 patients (0.52%) (mean age, 56 years). The mean maximum cyst diameter was 21.8 mm. High-attenuation cysts comprised 47% of cases, all in older (≥50 years) patients. Follow-up MDCT scans showed minimal changes over time. High-attenuation Bartholin cysts are more common than previously thought and are usually seen in older women. The size and attenuation of Bartholin cysts show only minimal changes over time.

“Management of Bartholin Cysts and Abscess” in a Tertiary Care Centre, Jeddah, Saudi Arabia

Objective: To analyse all cases of Bartholin glands pathology (cysts and abscess), and identify the different variable affecting the method of management with Marsupialization or excision. Methods: This study is a cross-sectional retrospective analysis of all cases of Bartholin cysts and abscess admitted and managed at KAUH, from January 2017 to December 2017. Results: 48 patients were analysed: age (32.60 ± 9.9), parity, BMI (26.9 ± 4.98). Out of 48 patients, 25 (52.1%) were diagnosed as Bartholin cysts and 23 (47.9%) as Bartholin abscess. 72.9% (35) patients were managed with Marsupialization, and only 27.1% ended with excision. Comparing age in years, parity and BMI in the cases managed by Marsupialization with those with excision, the only statically significant difference was found in the parity. When comparing the important factors collected, younger subjects less than 35 years old, never being pregnant and BMI less than 30 had more Marsupialization than excision. But age < 35 was statistically significant (Table 1). Abscess and non-recurrent had more Marsupialization but were statistically not significant. Other factors, past medical and surgical history and type of anaesthesia were the same in both groups. Logistic regression performed using the dependent variable for Marsupialization rather than excision with different covariant categorised variable, age less than 35, single, abscess, non-recurrent, and BMI less than 30 (Table 2). Age less than 35 and BMI less than 30 were

Transarterial Embolization of a Bartholin Cyst before Resection

Transarterial Embolization of a Bartholin Cyst before Resection

Endometriotic Foci in Bartholin's Cyst

Background: Endometriosis is a condition in which endometrial glands and stroma grow outside the endometrial cavity. Although endometriotic deposits are most often found within the pelvis, implants may rarely occur at several other sites. Endometriotic implants in the vulva and Bartholin's gland are very unusual. Case: A 35-year-old parous woman presented to the urogynecology clinic of the KK Women's and Children's Hospital, Singapore, with a lump arising through her vagina since a normal vaginal delivery 4 years prior. On examination, a 4 × 4 cm fluctuant, nontender vaginal cyst was noted in the lower one-third of the vagina on the left lateral side, close to an episiotomy scar. She was counseled to undergo excision of the cyst and she consented to do so. The cyst wall was inadvertently ruptured during the procedure, and a thick chocolate-colored fluid poured out from within the cyst. The cyst wall was excised and the dead space and vulval skin were closed. Results: The patient recovered well. The histopathologic examination was consistent with a Bartholin's cyst with endometriotic foci. Conclusions: Vulvar endometriosis should be considered as a possible, although rare cause of cystic masses of the vulva, especially those associated with variability in size and tenderness during the menstrual cycle. Surgical excision and histopathologic examination is necessary to establish a definitive diagnosis. (J GYNECOL SURG XX:1)