Sequelae of Bartholin's gland removal

Many people have never heard of Bartholin glands, let alone know where they are. If there is no lesion or infection, no treatment is required. But if blockage occurs and affects the body, measures need to be taken. Everyone knows the word breast. When breast cancer develops, it needs to be removed. Bartholin glands are located near the genitals and can be treated with surgery. But if after the operation, you find pain during sex. This may be because the surgery was not successful.

Bartholin's gland cyst incision and drainage + marsupial suturing is a constructive procedure that preserves gland function and prevents recurrence. It can provide adequate drainage and prevent recurrence, and the gland function remains the same after surgery. Constructive surgery is the opposite of destructive surgery. Bartholin's gland cysts are prone to recurrence, and the traditional surgical method is cystectomy, which is sure to prevent recurrence after the surgery. However, the function of the gland is also lost, and it will not secrete fluid during intercourse, causing vaginal dryness and pain, so it is called a destructive surgery.

The Bartholin glands are located in the deep posterior 1/3 of the labia majora on both sides, and the gland duct opens between the hymen and the labia minora. Due to the characteristics of the anatomical location, when the vulva is contaminated by sexual intercourse, childbirth or other situations, the gland duct opening is blocked, causing Bartholin gland cysts or abscesses. The main pathogens are Staphylococcus aureus, Escherichia coli, Streptococcus aureus, and Enterococcus aureus. With the increase in the incidence of sexually transmitted diseases, Neisseria gonorrhoeae and Chlamydia trachomatis have become common pathogens [1]. There are many treatment methods, but the recurrence rate is high. Sun Yourong et al. [2] reported a treatment method such as local injection of sclerosing agents, but the patients experienced a burning sensation, or cysts or nodules appeared on the local skin again. The current treatment method is still mainly surgical. Cystectomy is difficult to perform, causes severe damage, and affects glandular secretion function and sexual life, so it is not often used by clinical physicians. Domestic scholars have proposed that [3] when making a stoma on a Bartholin gland cyst, the incision should be at the junction of the cyst surface mucosa and the skin, and the length of the incision should be the same as the cyst.

This conventional ostomy has the following disadvantages:

① The opening of the Bartholin gland shifts to the junction of the skin and mucosa at the posterior end of the labia minora, which is exposed to the outside and easily leads to recurrence of local infection;

② The larger the Bartholin gland cyst, the larger the surgical incision, which may cause the lower end of the patient's labia minora to be divided into two flaps, affecting sexual life［4］. The principle of conventional ostomy incision is that it should be equal to the size of the cyst cavity. If the incision is too small, drainage will be poor, affecting the efficacy. If the incision is too large, the patient will feel pain, the drainage strip will easily fall off, the incision will easily close and relapse, and the drainage strip must be replaced daily after surgery, causing local pain to the patient and a long hospital stay. Since the rubber drainage strip of the improved ostomy has been knotted and fixed, the drainage effect is good, which is conducive to the disappearance of inflammation. The patient can be discharged from the hospital on the second day after the operation. The patient's hospitalization time is short, the movement is convenient, and it is easy to accept. The operation time is short, the operation steps are simple, the incision is small, and no sutures are required. The surgical materials are simple and economical, there are few complications, the recurrence rate is low, there is no local scar formation, it does not affect sexual life, and the gland function can be retained.

The current symptoms are considered to be those with minor sequelae. Guidance: Generally, clinical advice is to continue treatment in a timely manner and take routine anti-inflammatory measures.