Bartholin's Gland – Marsupialization

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SAMPLE EXCERPT
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PRE-PROCEDURE
INDICATIONS
  • Treatment of symptomatic Bartholin's gland duct cyst (painful, growing)
  • Treatment of Bartholin's gland abscess
CONTRAINDICATIONS
  • Any condition that would preclude normal incision and drainage of a vulvar cyst or abscess
  • Small asymptomatic glands do not have to be drained.
EQUIPMENT
  • Sterile gloves and sterile drapes **STERILE TECHNIQUE**
  • 1% to 2% lidocaine for anesthesia
  • 30-gauge, 1½-inch needle (for anesthesia)
  • 3-mL syringe (for anesthesia)
  • No. 11 blade
  • 4-0 Vicryl suture with needle and needle holder
  • Pickups with teeth
  • Small hemostats (2)
  • 4 × 4-inch gauze pads
  • Normal saline for irrigation
  • Antiseptic solution (povidone-iodine if not allergic)
  • Dressing supplies
ANATOMY
  • The Bartholin's glands are located between the hymen and the labia minora, and the ducts open in a groove formed at about 5 and 7 o'clock.
  • Neurovascular supply is provided primarily by the perineal artery and its branches and the pudendal and perineal nerves.

PROCEDURE
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The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
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  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Instruct the patient to perform Sitz baths daily for 3 or 4 days and to return for follow-up in about a week.
  • At the time of follow-up, probe the ellipse for patency.
  • Use of prophylactic antibiotics is unnecessary in most cases.
  • Sutures will absorb and do not have to be removed.
  • Avoid sexual activity at least until after the first postoperative check at 1 week.
COMPLICATIONS
  • Excessive bleeding is rare.
  • Scarring is usually minimal.
  • Surgical wound infection may occur.
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