Bartholin Cyst Removal in Delhi NCR

What are the presenting symptoms for vulval swelling?

Vulval swellings may bother a female even if small in size. It can interfere in normal sexual activity and pain along with inflammation may be disturbing in routine daily activities like walking, gymming, running etc. If infected, it turns into an abscess and may also present as fever. Sometimes very large abscess may rupture resulting in drainage of pus.

What to expect during initial consultation with the doctor?

Dr. Deepti Asthana is the best gynaecologist and cosmetic gynae surgeon and it is important to meet her to understand things. Examination is a very important part of any swelling diagnosis. After taking thorough history, doctor would like to examine your swelling to determine its exact nature. Some swellings are chronic and may not require immediate treatment but some like inflammatory infective ones, may require immediate treatment.
Doctor may prescribe a course of antibiotics and anti-inflammatory drugs initially or may post you directly for cyst excision, depending on the type of swelling.

What are the different possibilities of swelling ?

1. Bartholin’s gland cysts: These are fluid-filled cysts that form on the Bartholin’s glands, which are present on either side of the introitus or the vaginal opening. These are usually the lubricating glands of the perineum and cysts develop when the opening to the gland becomes blocked by the flap of skin that covers it, causing a fluid-filled growth. If left untreated, abscess may form which is an extremely painful condition and requires immediate treatment.
2. Inclusion cysts: These are one of the most common cysts of vaginal wall. Typically, these form on the posterior vaginal wall. They tend to be very small and unlikely to be noticed. They may be caused by injury during childbirth or surgery, most likely due to episiotomy given during the childbirth.
3. Müllerian cysts: These are another common type of cyst that grow anywhere on the vaginal walls and often contain mucus. These are usually due to defective developmental process of female genitalia.
4. Gartner’s duct cysts: These can occur when ducts in a developing embryo do not disappear as they should after a baby is born. The leftover ducts can develop into vaginal cysts over time. These usually form on the upper part of the vagina.
5. Sebaceous cyst: These are formed due to any obstruction to the pilo-sebaceous gland or any trauma to the skin during episiotomy. These are also known as epidermoid cyst or keratin cyst. They are mostly firm, fluctuant, mobile, painless slow growing swellings with a black punctum. They are mostly asymptomatic unless infection occurs that leads to pain and scarring. if there is any associated ulcerative growth, biopsy is required.
6. Lipoma - These are condensation of the fat cells presenting as small swelling between skin and underlying muscle. These are usually painless, slow growing and non inflammatory.

What are the treatment options offered for vulval swellings?

If treatment is needed, one of the following options are advised:

1. Antibiotics - These are usually the first line of treatment and prescribed if a vaginal cyst is infected. If a large abscess has already formed, it would be better to first drain the pus under cover of antibiotics. Antibiotics given according to culture sensitivity of the pus are always better than the blind treatment.
2. Sitz baths - This involves a woman soaking in a tub filled with a few inches of warm water several times a day for 3-4 days. This soaking may help in relief of pain and inflammation. If inflammation and edema is severe, ice application may help.
3. Marsupialization - This involves giving a drainage incision to create a permanent opening. cyst wall is removed as much as possible. A rubber tube may be inserted to promote drainage for a few days after the procedure and to help prevent recurrence. Healing takes place from inside out till complete space is filled up and obliterated.
4. Surgical drainage - This is required for infected or large cysts in order to remove their contents. This is usually done under sedation or general anaesthesia, and doctor makes a small incision on the cyst, which is then drained. All the internal loculi or septations are broken if possible.

Prevention

The growth of vaginal cysts is difficult to prevent. Maintaining adequate hygiene, proper hydration and practising safe sex practises can help in prevention.