Management of Bartholin duct cysts and abscesses: a systematic review.

OBJECTIVE To review systematically the literature, published in English, on recurrence and healing after treatment of Bartholin duct cysts and abscesses. DATA SOURCES We searched PubMed, EMBASE, CINAHL, LILACS, Web-of-science, the Cochrane database, and POPLINE from 1982 until May 2008. We searched the internet, hand-searched reference lists, and contacted experts and authors of relevant papers to detect all published and unpublished studies. METHODS OF STUDY SELECTION We included any study with at least 10 participants, addressing either frequency of recurrence or healing time after treatment of Bartholin duct cyst or abscess. We followed MOOSE (meta-analysis of observational studies in epidemiology) guidelines. Of 532 articles identified, 24 studies (5 controlled trials, 2 cohort studies, and 17 case series) met all inclusion criteria. Study size ranged between 14 and 200 patients. TABULATION, INTEGRATION, AND RESULTS The interventions included: (1) Silver nitrate gland ablation, (2) cyst or abscess fenestration, ablation, or excision using carbon dioxide (CO(2)) laser, (3) marsupialization, (4) needle aspiration with or without alcohol sclerotherapy, (5) fistulization using a Word catheter, Foley catheter, or Jacobi ring, (6) gland excision, and (7) incision and drainage followed by primary suture closure. The reported frequency of recurrence varied from 0% to 38%. There was no recurrence after marsupialization in available studies. Recurrence after other treatments varied, and was most common after aspiration alone. Healing generally occurred in 2 weeks or less. CONCLUSION There are multiple treatments for Bartholin duct cysts and abscesses. A review of the literature failed to identify a best treatment approach. TARGET AUDIENCE Obstetricians & Gynecologists, Family Physicians LEARNING OBJECTIVES After completion of this article, the reader should be able to identify seven different treatments for Bartholin duct cysts or abscesses, contrast treatment choice complications and recurrence risks for the different options for treatment of Bartholin duct cysts or abscesses, and point out the limited quality and quantity of data upon which to choose best practices.