From the Research
Marsupialization is indicated for a Bartholin gland cyst abscess as the first-line treatment due to its lower recurrence rate and higher patient satisfaction compared to other methods, such as Word catheter application, as shown in a recent study 1.
Indications for Marsupialization
The following are indications for marsupialization:
- Recurrence after simple incision and drainage
- Large cyst or abscess (typically greater than 3 cm)
- Multiple episodes of infection
- Symptomatic cysts causing significant discomfort, pain during walking or sitting, or dyspareunia
Procedure and Postoperative Care
Marsupialization involves creating a permanent opening by making an incision in the cyst wall, draining the contents, and then suturing the cyst lining to the surrounding vulvar epithelium to create a new gland opening. The procedure is typically performed under local anesthesia with sedation or regional anesthesia and takes approximately 30 minutes. Postoperative care includes:
- Sitz baths 2-3 times daily
- Analgesics as needed
- Abstaining from sexual intercourse for 2-4 weeks
Comparison with Other Methods
A study comparing marsupialization with Word catheter application found that marsupialization had a lower recurrence rate (8.3% vs 18.8%) and higher patient satisfaction 1. Another study found that both Word catheter application and marsupialization were effective treatments, but marsupialization had a lower recurrence rate and higher patient satisfaction 2. However, a more recent study found that marsupialization should be the first-line treatment for Bartholin cysts and abscesses due to its lower recurrence rate and higher patient satisfaction 1.