The ambulatory surgical management of Bartholin duct cysts

Marsupialization of Bartholin duct cysts was performed in the emergency department (ED) under pudendal anesthesia. Nineteen symptomatic cysts were treated surgically using techniques suitable for outpatient facilities. Pudendal anesthesia was adequate in all but two patients in whom supplemental local infiltration was used. One-third of the patients experienced unilateral lower extremity numbness following the pudendal block. Symptoms had completely subsided approximately 20 minutes after the procedure, and there were no sequelae. The average length of time of the procedure was 25 minutes. All patients were discharged from the ED within 30 minutes of completion of the procedure. In all patients examined one week postoperatively, the residual pouch had shrunk to less than half its original size and the apertures were patent. There have been no problems with bleeding, infection, pain or dyspareunia. In a follow-up survey, no recurrent cysts were reported. This problem can be treated safely in the ED with good results.