It might take a few days for the pain and discomfort to go away.
It might take a few days for the pain and discomfort to go away. You may resume the normal activities within 2-4 weeks. The physician might recommend painkillers and antibiotics for the first 24 hours after the surgery. Besides, the patient may experience:
- A small amount of discharge or bleeding for a few weeks, which can be resolved using a panty liner
- Infection around the cyst
For a quick recovery, the patient should follow these instructions:
- One or two sitz bath a day for a few days (sitting over a special container containing warm water and potassium permanganate)
- Avoid engaging in sexual activity for about a month after the surgery
- Avoid using tampons
- Avoid using powders, harsh soaps, or fragranced bathing products
- Avoid activities that require straining
- Wear comfortable, breathable underwear
- Be careful to wipe from front to back to prevent infection
There is a 5-15% chance of cyst recurrence with marsupialization.
What is marsupialization?
Marsupialization involves the opening of Bartholin’s cyst or abscess and then closing it at the edges to form a permanent open pocket or pouch for continuous drainage.
The Bartholin glands are essential organs of the female genitals. They are located on each side of the vaginal opening and are invisible. The main function of the Bartholin glands include:
- Secrete mucus
- Lubricate the vulva and vagina
The Bartholin’s gland is prone to infections and pus formation. The opening of these glands may become obstructed, causing the accumulation of fluid in the gland, which results in the development of the cyst (swelling) in the gland. If the cyst gets infected with bacteria, it may lead to the collection of pus (abscess) surrounded by pus.
Bartholin cyst affects 2% of women, and in rare cases, it may also lead to cancer.
When is marsupialization indicated?
Marsupialisation is indicated in individuals with the following conditions:
- History of recurrent Bartholin gland cyst or abscesses
- Considerable pain or discomfort
- No tolerance to alternative treatments
- Failure of other therapies in cyst treatment
- A large cyst that may interfere with walking, sitting, or sexual activity
How is marsupialization performed?
Marsupialization may be performed under local anesthesia to minimize postoperative discomfort. The physician may make you lie down with the legs separated, flexed, and supported in a raised position (lithotomy). The physician might apply an antimicrobial solution, such as Betadine on the operation site. Next, the physician grasps the cyst with an instrument that prevents blood flow (hemostats). A vertical incision of 1.5-3 cm long is made to drain the infected gland. The physician turns out the cyst wall and moistens it with saline. The edge of the cyst wall is closed to form a permanent open pocket or pouch for continuous drainage. The procedure takes about 10 to 15 minutes to complete.
What are the potential complications of marsupialization?
Complications of marsupialization include:
- Dyspareunia (painful sex)
- Hematoma (pooling of blood near the incision)
- Recurrent abscesses
- Neuropathy (nerve dysfunction)