An Out-patient Method of Marsupialization for Recurrent Bartholin's Abscesses.

Marsupialization is a simple method of treatment for Bartholin's cysts and abscesses which aims at restoration of glandular function and prevention of recurrence. Davies (1948) was the first to use a method of treatment which aimed at restoration of glandular function. In 25 cases of Bartholin's cysts an incision was made close to the hymen in the region of the duct and a permanent sinus preserved by packing the cavity with iodoform gauze twice daily for 3 or 4 weeks. This method was not always successful because stenosis often occurred as a result of retraction of the cyst wall following resolution. Jacobson (1950) was the first to describe the operation of marsupialization in which he constructed a new mucocutaneous junction by suturing the cyst lining to the skin. In this operation part of the area of cyst wall was exposed by dissecting skin flaps before opening the cyst, a procedure which is no longer thought to be necessary. Nineteen cases were reported with good results. Wilder (1955) then reported a series of 32 cysts and 48 abscesses successfully treated by marsupialization. Following this, Tancer, Rosenberg, and Fernandez (1956) reported eleven cases of Bartholin's cysts successfully treated, and Blakey (1958) reported eight cases of cysts and six of abscesses all successfully treated by this method. Jacobson (1960) reported a second series of 140 patients who had had 152 cysts marsupialized with only four recurrences. Siganos (1961) described successful use of this treatment in ten cases of cysts and two of abscesses. Johnson (1961) then performed the operation successfully under pudendal nerve block and found it particularly useful in cases in which both sides were involved.