Why is Bartholin Cyst Removal Surgery Required?
Bartholin cysts grow on the vaginal walls due to an injury, infection, or sexually transmitted disease (STD). A cyst may enlarge and induce extreme pain, discomfort, and even fever and chills when infected. Bartholin cysts also carry a high chance of infecting the surrounding tissues.
The condition can lead to severe infections when left untreated or neglected for a long time. The cysts can accumulate with bacteria and pus and become an abscess. Such a condition is called bartholinitis. If such an infected Bartholin cyst popped into a female's body, she might face blood poisoning called septicemia. Bartholinitis requires immediate surgical intervention, otherwise, life-threatening complications can arise quickly.
Preoperative Preparation
Proper planning before the Bartholin cyst removal surgery is crucial to ensure that there are no complications during and after the treatment. Some of the necessary pre-operative steps are as follows:
Detailed discussion with patient: Gynecologists perform Bartholin gland cyst treatment and discuss every aspect of the surgery with the patient to keep them well-informed. The patient learns all the pros and cons of the Bartholin cyst surgery. The doctor also informs the precautionary measures to observe before and after the surgery. The patient is also asked to sign a consent form before surgery.
Screening tests: The patient undergoes a series of tests before surgery to examine their overall well-being. An average level of blood cells and blood sugar is mandatory. The doctors also confirm the patient's blood group to keep the blood ready in any emergency. Blood tests are crucial to understanding bleeding and clotting time for the patient. They also undergo ECG to evaluate heart functions. X-rays are also performed to check lungs and visualize any abnormal changes in the shape or size of the heart.
Pre-surgery Medication: The doctor prescribes mild sedatives to allow the patient to sleep and relax without pain. Sedatives and antibiotics help in keeping away any post-surgery infection. The patient also needs to inform the doctor if they are already on any medication to avoid any side-effects.
Day Before Surgery
Usually, the doctor advises the patient to get hospitalized a day before the surgery to ensure that the treatment is delayed. This also helps the patient to adapt to the hospital where they will undergo surgery and stay for a day or two more to get stable post-surgery.
The patient is given light meals and is strictly advised not to eat or drink anything after dinner on the night before surgery. It is done because, after the administration of general anesthesia, the intestines relax completely, which may lead to the leakage of intestinal contents into the anus or the food pipe and give rise to unexpected risks during the procedure. The patient is also prescribed laxatives and antacids to keep away such problems.
Methods/Techniques of Bartholin Cyst Removal Surgery
Open surgery: Open surgery for Bartholin's cyst is complicated and invasive. The surgeon makes an incision on the lower abdomen and carefully separates the underlying muscles, blood vessels, and connective tissues. As the surgeon has accessed ovaries and the cyst, they remove them by cutting or burning them through the laser device—further, they stitch back together the separated muscles and tissues using surgical thread.
Surgical Drainage: This procedure involves surgically draining the cyst by incision. During the surgical drainage, the surgeon uses local or spinal anaesthesia to numb the area to be operated on and makes a minor incision to allow the pus (infectious material) to drain out. Afterwards, the surgeon may use a small rubber tube (drainage pipe) to aid in fuller drainage over the next few weeks. Once the cysts are entirely drained, the doctor removes the tube. However, minor changes in the surgical drainage may happen depending on different cases.
While for some patients, an open drainage site is the best-suited treatment, for others, carefully packed surgical gauze and antibiotic solution are to be changed regularly. The surgeon decides the best-suited approach to treatment. Usually, In India, the average cost of this Bartholin cyst treatment lies within the range of INR 8,000- INR 12,000
Marsupialization: Marsupialization is the best treatment for painful and recurring Bartholin cysts. This Bartholin cyst surgery is also carried out under the effect of anaesthesia, local or general. The surgeon first makes a minor incision to drain the cyst during the procedure. Further, the doctor makes the incision slightly larger to make a 'kangaroo-pouch' (temporary) on the vaginal lips. This pouch or passage aids in complete drainage of the Bartholin cyst over next few weeks to ensure permanent relief and the gland does not clog.
Usually, the average cost of marsupialization in India, is around INR 25,000 - INR 35,000.
Bartholin Gland Removal: When the Bartholin cyst develops frequently and causes excruciating pain, it may be a sign of cancer. Bartholin gland removal is the most effective treatment in such cases. However, the occurrence of such a condition is almost rare. The average cost of Bartholin gland removal surgery is approx INR 30,000 - INR 40,000.
Post Surgery
Proper care, rest, and nourishment for a few days post-Bartholin cyst excision and treatment are essential to ensure speedy healing with almost nil complications. The post-surgery care starts from the time the patient is shifted to the recovery room in the hospital. They are usually observed for 24-48 hours after the procedure.
Immediate care in the hospital: As the effect of anesthesia wears off, the patient becomes conscious. The doctor conducts a physical exam, checks the incision area, and ensures it is covered, clean, and dry. The patient is given anything to eat immediately post-surgery. They are given saline or glucose through IV. Gradually, as bowel movements become regular, they can orally consume nutritious food.
Care at home: Once the patient gets discharged and returns home, the utmost emphasis lies in keeping the wound dry and clean and changing dressing regularly as recommended by the doctor. The patient should avoid putting strain on the lower body and only gradually resume their active lifestyle. In case there is any bleeding, unusual pain, or a discharge, immediately consulting the doctor is neccessary.
Physical movement: A patient fully recovers within a few weeks only. During the recovery, the doctor advises them to refrain from excessively strenuous activities that can pressure the abdominal muscles. Hence, lifting heavy weights, running, jumping, etc., are avoided to ensure a smooth recovery without scarring or bleeding.
Medication and follow-up: Medications minimize the chances of infection. Doctors may also prescribe some blood-thinning medicine to prevent blood clots from forming. Regular follow-ups are integral to monitoring recovery and proper healing of the incision. The doctor removes the stitches (in not dissolvable) once the incision heals significantly.
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Risks and Complications
Just like any other surgical treatment, there are some pros and cons associated with Bartholin cyst removal surgery as well. Sometimes, there may even arise complications during the post surgery recovery period. Some of the risks and complications are given below:
- Heavy bleeding
- Persistent pain and infection
- Scarring
- Recurring abscesses
- Swollen vaginal lips (around the vaginal opening)
- Abnormal vaginal discharge
These are the commonly reported complications after Bartholin gland cyst surgery. However, the cases are post-operative risks, and complications are very low when you choose the right doctor and procedure for relief. The patient must know about the risks before undergoing any surgery.
The Bartholin cyst removal surgery offers long-term relief. If a female experiences the symptoms again, it is best to consult their gynaecologist immediately, without any negligence.
