Bartholin'sgland cystClinical finding:Asymptomatic;Acystexistwith a clearborderTreatmentExcision or Mausupialization.Incision and drainageThis technique consists of traditional incision, drainage, irrigationand packing.Packing should be removed 2 days after the procedure.This technique requires multiple, painful packing changes and has ahigher rate of abscess recurrence.PrognosisIf abscesses are properly drained and reclosure is prevented, mostabscesses have a good outcome.Recurrence rates are generallyreportedtobelessthan20%
11 Bartholin’s gland cyst Clinical finding: ❖ Asymptomatic; A cyst exist with a clear border Treatment ❖Excision or Mausupialization.Incision and drainage ❖This technique consists of traditional incision, drainage, irrigation, and packing. Packing should be removed 2 days after the procedure. This technique requires multiple, painful packing changes and has a higher rate of abscess recurrence. Prognosis ❖If abscesses are properly drained and reclosure is prevented, most abscesses have a good outcome.Recurrence rates are generally reported to be less than 20%
ComplicationsThe most common complication of treatment of Bartholin abscess isrecurrence.Rarecase reports exist of necrotizing fasciitis afterabscessdrainage.Atheoretical risk exists fordevelopment of toxic shock syndrome withpackingNonhealing wounds may occur. Bleeding, especially in patients with acoagulopathy,maybeacomplicationCosmetic scarringmayresult
12 ❖Complications ❖The most common complication of treatment of Bartholin abscess is recurrence. Rare case reports exist of necrotizing fasciitis after abscess drainage. ❖A theoretical risk exists for development of toxic shock syndrome with packing. ❖Nonhealing wounds may occur. Bleeding, especially in patients with a coagulopathy, may be a complication. ❖Cosmetic scarring may result
Laboratory StudiesIn otherwise healthy, afebrile adults, blood tests are not necessary toevaluateanuncomplicated abscess orcystSexually transmitted disease (STD) testing should be available at therequest of the patient; however, Bartholin abscesses are very rarelycaused by sexuallytransmitted pathogensCultures are rarely useful in treatment of abscess; furthermore, routineculturingof drainedfluid is not recommended
13 ❖Laboratory Studies ❖In otherwise healthy, afebrile adults, blood tests are not necessary to evaluate an uncomplicated abscess or cyst. ❖Sexually transmitted disease (STD) testing should be available at the request of the patient; however, Bartholin abscesses are very rarely caused by sexually transmitted pathogens. ❖Cultures are rarely useful in treatment of abscess; furthermore, routine culturing of drained fluid is not recommended
LaboratoryStudiesIn otherwise healthy, afebrile adults, blood tests are not necessary toevaluate an uncomplicated abscess or cystSexually transmitted disease (STD) testing should be available at therequest of the patient, however, Bartholin abscesses are very rarelycausedbysexuallytransmittedpathogensCultures are rarely useful in treatment of abscess, furthermore, routineculturing of drained fluid is not recommended
14 ❖Laboratory Studies ❖In otherwise healthy, afebrile adults, blood tests are not necessary to evaluate an uncomplicated abscess or cyst. ❖Sexually transmitted disease (STD) testing should be available at the request of the patient; however, Bartholin abscesses are very rarely caused by sexually transmitted pathogens. ❖Cultures are rarely useful in treatment of abscess; furthermore, routine culturing of drained fluid is not recommended
MedicationSummaryMedications used in the treatment of Bartholin abscesses includetopical and local anesthetics.Antibiotics for empiric treatment of STDsare advisable in the doses usually used to treat gonococcal andchlamydial infections. Ideally,antibiotics should be started immediatelypriorto incision and drainage
15 ❖Medication Summary ❖Medications used in the treatment of Bartholin abscesses include topical and local anesthetics. Antibiotics for empiric treatment of STDs are advisable in the doses usually used to treat gonococcal and chlamydial infections. Ideally, antibiotics should be started immediately prior to incision and drainage