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Abstract: The patient presented to the clinic with swelling and pain at the vulva, and a palpable mass, which was not treated at home. The examination revealed that the patient’s labia majora were swollen and a cystic mass was palpable, with no obvious abnormalities in the bilateral adnexa, and she was diagnosed with a Bartholin’s gland cyst. Under local anesthesia, the patient underwent a Bartholin’s gland cyst stoma. The operation went very well, and the swelling of the labia majora was reduced.
Basic information】Female, 35 years old
Type of disease】Bartholin’s cyst
Hospital】Shengjing Hospital of China Medical University
Date of consultation】August 2019
Treatment plan】Surgical treatment (Bartholin’s gland cyst ostomy) + intravenous infusion (cefotaxime sodium for injection) + oral medication (Ornidazole tablets)
Treatment period】10 days of hospitalization
Treatment effect] The patient’s perineum swelling was reduced and he recovered well.
I. Initial consultation
The patient, a 35-year-old female, reported that she found swelling and pain in her vulva three days ago, and there was a vulvar lump when she was touched. At first, she did not pay any attention to it, so she did not take any treatment. However, in the past 3 days, she found that the pain had gradually increased, and now the pain was unbearable, so she came to our hospital for consultation.
The patient complained of irregular menstruation, reduced menstrual flow and prolonged menstrual cycle in recent years. Physical examination of the patient revealed swelling of the labia majora, the presence of palpable cystic mass, high local skin temperature, patency of the vagina, atrophy of the cervix and no obvious abnormality of both adnexa, and the preliminary diagnosis was bacillary gland cyst.
II. Treatment history
After admission, we performed a detailed examination of the patient and found that the patient’s vulvar cleanliness was Ⅲ degree, and the routine blood test did not show any significant abnormality, but a 2×2 cm mass was seen at the mouth of the patient’s Bartholin’s gland.
After obtaining the consent of the patient and his family, an incision of about 1 cm was made on the surface of the Bartholin’s gland cyst to squeeze out the pus from the cyst, and then the cavity was flushed out with iodophor and a drainage strip was placed to drain the newly generated pus and provide pressure to stop the bleeding. Postoperatively, the patient was given injectable cefotaxime sodium and ornidazole tablets to prevent infection of the vulvar surgical opening.
III. Treatment effect
After a period of hospitalization, the patient complained that the chill and fever had disappeared, and her mental state, sleep, diet, urination and defecation were all normal, and physical examination showed that the swelling of the labia majora had basically subsided, and the perineal wound was free of redness and exudation, so the patient recovered well. At the time of discharge, the patient was advised to take a light diet, forbid intercourse, pay attention to the cleanliness of the perineum, and change medication regularly.
IV. Notes
The operation went very well, and the patient’s labia majora was basically swollen and the cystic cavity was healed, and the healing was good. However, since the disease is prone to recurrence, the patient still needs to pay attention to a light diet after discharge, forbid spicy, stimulating and greasy food, do not smoke or drink alcohol, eat more fresh vegetables and fruits, drink more water, eat easily digestible food rich in protein, and pay attention to the cleanliness of the vulva area, change underwear regularly, wash the vulva area regularly, pay attention to the wound, if there is any discomfort such as blood oozing, redness and swelling, etc. If there is any discomfort such as blood oozing, redness and swelling in the wound, you must consult a doctor in time.
V. Personal insight
Bartholin’s cyst, also known as vestibular gland cyst, is a common type of gynecological disease. In this case, the patient developed a Bartholin’s cyst due to an infection, causing swelling and pain in her perineum. After being admitted to the hospital and treated with surgery plus medication, the patient’s swelling and pain disappeared and a good treatment result was obtained.
During an attack of Bartholin’s gland cyst, the patient should pay attention to rest, while keeping the local area clean. Oral antibiotic treatment can be given after determining the pathogenic bacteria, and surgical treatment can also be performed, both of which can obtain better treatment results.