DEPARTMENT OF DERMATOVENEROLOGY

MEDICAL FACULTY
HASANUDDIN UNIVERSITY

SEPT 2014

BARTHOLINS CYST

BY :
Tri Hariadi
Muhammmad Rido
Azhar Safaat

C111 09 111
C111 10 299
C111 10 308

ADVISOR :
dr. Nurul Rumila Roem
SUPERVISOR :
Dr. A.M. Adam Sp.KK(K) FINDSV
PRESENTING AS A TASK ON CLERKSHIP
DEPARTMENT OF DERMATOVENEROLOGY
HASANUDDIN UNIVERSITY
MAKASSAR
2014

INTRODUCTION
Bartholins duct cysts and gland abscesses are
common problems in women of reproductive age.
Bartholins glands are located bilaterally at the
posterior introitus and drain through ducts that
empty into the vestibule at approximately the 4
oclock and 8 oclock positions. These normally peasized glands are palpable only if the duct becomes
cystic or a gland abscess develops.

DEFINITION
Bartholin cysts is if a bartholin duct gets blocked, fluid
builds up in the gland. These cysts can range in size from a
pea to a large marble. They usually grow slowly. If the
bartholin gland or duct gets infected, its called a bartholin
gland abcess.

BARTOLIN
S GLAND

The most common

cystic growths in the
vulva,,occur in the labia majora.

EPIDEMIOLOGY
Approximately 2% of
women of reproductive
age will experience
swelling of one or both
Bartholin glands.

These diseases
typically occur in
women between the
ages of 20 and 30
years.

Etiopathology
Obstructional of the distal Bartolins duct
May result in the retention of secretions, with
resultant dilation of the duct and formation of a
cyst
The cyst may become infected, and an abscess
may develop in the gland

Symptoms of cyst bartolins

Symptoms of a cyst that is not
infected include

A painless lump
in the vulva
area
Redness or
swelling in the
vulva area

Discomfort
when walk, sit,
or have sex

Symptoms of an infected cyst include

Fever and
chills
Pain the gets
worse and
make it hard to
walk,sit,or
move around

Drainage from
the cyst
Swelling in the
vulva area

Treatment
The treatment of a bartholins duct depends on the

patients symptoms. An asymptomatic cyst may require

no treatment.

The treatment of bartholins duct cyst

with symptomps

Incision and
drainage

Word
catheter

marsupializat
ion

MARSUPIALIZATION TEHNIQUE
Marsupialization or pouch formation, used especially for
eksteriorisasi cyst surgery with resection of the anterior wall of
the stitching on the edges and slice the rest of the cyst to the
nearest edge of the skin, thus forming a pouch which was
previously a closed cyst.

EQUIPMENT AND MATERIALS

sterile gloves
iodine solution
Lidocaine (Xylocaine), 1% or 2%
25-gauge, 1-inch needle with 5 mL syringe for Inject

lidocaine
Scalpel 11
Two small hemostats to hold the cyst wall
Gauze pads, 4x 4 inch
Hemostat to break loculations
Small needle threaded with 2-0 absorbable sutures
needle holder
scissors

1. Examination of the is done to determine the extent of the

abscess.
2. Drawn then sewn labia, and vaginal entrance is visible, and the
incision is made above the vaginal mucosa and vaginal entrance
brings the gland wall.

3. Cyst wall and contents therein diincisi visible.

4. The content abscess removed

5. process conducted insisi

6. Take the contours of asbestos and wall abscess
held with Allis clamps

7. Cyst wall sutured with absorbable 3.0 sewing thread to the skin
introitus medial lateral vaginal mucosa
8 . Cyst wall sutured with absorbable 3.0 sewing thread to the
skin introitus medial lateral vaginal mucosa

INDICATIONS AND CONTRAINDICATIONS

MARSUPIALIZATION TEHNIQUE
Indication Marsupialization Tehnique:
Bartolini cysts are symptomatic
Handling Word Catheter unsuccessful
Doctor as a first choice treatment
Contraindication Marsupialization Tehnique :
Not performed when the abscess
Not performed when there is an active
infection due loca predispose to secondary
infection

Diagnosis
Anamnesis and
Acute pain, around the tissue of labia
physical examination minora is inflammation and edema, we
can find the fluctuated mass in palpation.

Further examination

Pap smear, bacterial culture , MRI

Differential diagnosis
1. Epidermal inclusion cyst

Location :usually in labia

mayora. Benign, mobile,
nontender. The cause of
trauma or obstruction from
polisebaseus duct.

2. Vestibuli mucosa cyst

Location : labia minora, vestibuli,

periclitoral area. Diameter less for 2
cm, flat surface, location in
superficial, soliter or multiple,
usually asymptomatic.

3. Hidradenoma papilliferum

Location : between in labia mayora

and labia minora. Benign, late
progression, small nodule (2 mm 3cm)

4. Skenes duct cyst

Location : near of meatus

urethra in vestibuli. Benign,
asymptomatic. If its big can
impact to obstruction of
urethra, then urine retention.

Complication
Bartholin gland abcess

Adenocarcinoma
of Bartholins
gland

COMPLICATION
S

Bleeding specially
coagulopathy patient

Scar

Prognosis
If the abcess have been drainaged well so we

can prevent to relapse. Prognosis is good.

There is a high rate of recurrence (2-25%).

THANK YOU