Bartholines Absence Extraction

What is Bartholines absence extraction?

You may have a swelling on one side of the vulva at the opening of the vagina. The swelling is a build up of liquid under the skin and the liquid is made in glands called Bartholin's glands. A cyst can develop from one of the glands or the ducts. It can be chronically inflamed and painful. Bartholin glands cysts develop from dilation of the duct following blockage of the duct opening. Bartholin gland cysts tend to grow slowly and non-infected cysts are sterile.

With Bartholines absence extraction, the doctor makes a small surgical cut on the cyst to help drain it completely. A catheter is inserted to help draining while the gland heals. Recovery is usually fast and brings rapid relief to sufferers. Removal of a Bartholin gland does not seem to compromise sexual function.

Why is it done?

Asymptomatic Bartholin gland cysts in individuals under the age of 40 may not require treatment. Some physicians advocate removal (excision) of all Bartholin gland cysts in individuals over 40 due to the possibility of cancer.

Although small cysts are usually asymptomatic, they may become enlarged or infected and cause significant pain. If the cyst becomes infected and is not treated initially with a broad-spectrum antibiotic, an abscess may form on the gland. If the abscess is not treated early with sitz baths until the abscess comes to a point, incision and treatment may be more difficult. A secondary infection may develop called bartholinitis, which is an inflammatory condition of one or both Bartholin's glands caused by bacterial infection.

What to expect after the surgery?

  • Recovery is usually complete after treatment. You will have a sanitary pad held on with elasticated net pants. Any packing in the wound will be taken out after 24 hours or so. There may be some staining with old blood during the first day or two. You can put a new sanitary pad on as often as you like.
  • The vulva will feel a little painful for 24 hours or so after the operation. You will be given painkilling tablets to control this, and antibiotics if there was any infection. Injections are given for severe pain if needed. Take shallow baths three times a day to keep the vulva clean and to help healing.
  • You can wash the wound area as soon as you wish. Soap and tap water are entirely adequate. Salted water is not necessary.
  • You will be able to drink within an hour or two of the operation as long as you are not feeling sick. The next day you should be able to manage small helpings of normal food. You should plan to leave hospital the day of your operation.
  • You should be able to return to a light job after about one week, and any heavy job within two weeks.
  • You can start sexual relations again when you feel comfortable, usually after a week or two.

What are the risks of the surgery?

This operation is a minor one. Complications are very rare.

  • Severe infection can slow healing down.
  • Very rarely there is bleeding from the wound, which needs stitches or packing.
  • Sometimes the swellings refill or appear in a different part of the vulva. These can always be treated again.
  • There is sometimes some bleeding after two weeks or so. This will settle down.
  • If the same gland gets swollen again and again, then, it may be, that at some stage (when there is no swelling and you are well) it has to be removed completely. This requires another operation under general anaesthetic. The skin is cut around the gland and the gland is removed along with the skin, which lies on top of it. The wound (which is about an inch long) is then closed with dissolvable stitches. It is a relatively simple and successful operation with very low chances for complications.

What are the alternatives to the surgery?

If infection is causing your symptoms antibiotics may help, but the cyst often remains troublesome. Drawing off the liquid or pus with a needle can reduce the swelling but it will usually return.