Bartholin cyst
Introduction
Introduction to vestibular gland cyst The vestibular gland cyst is a stagnation of the vestibular glandular obstruction, and the gland is continuously secreted to form a retention and inflammatory cyst. The more severe scar tissue that occurs during the vaginal and perineal lateral injury during childbirth obstructs the glandular orifice, and the perineum is sutured to damage the vestibular glandular duct, so that the secretion can not be excluded and accumulate in the glandular cavity, and after acute inflammation and abscess disappear. Cysts can be formed by various factors such as sputum absorption and clearing into clear liquid. The vestibular gland cyst can be secondary to infection and form an abscess. Smaller cysts do not require surgery and are followed up regularly. Larger cysts, with obvious symptoms or recurrent pain, abscess formation should be done by incision and drainage surgery, and gland function can be maintained after surgery. basic knowledge The proportion of illness: 0.001% Susceptible people: women Mode of infection: non-infectious Complications: abscess
Cause
The cause of vestibular gland cyst
The vestibular gland cyst is formed by the obstruction of the vestibular glandular opening and the secretion accumulates in the inferior gland. The reasons for the obstruction of the vestibular gland are:
Vestibular large glandular injury (30%):
Individual cases may result in cystic swelling of the vestibular glandular obstruction due to contraction of the vaginal, perineal lateral laceration, and perineal lateral incision.
Stenosis or atresia (20%):
Congenital gland stenosis or atresia, resulting in poor discharge of fluid in the glandular cavity or discharge, resulting in cyst formation.
Infection (10%):
After the infected vestibular gland abscess subsides, the pus is absorbed, and the mucus in the gland is thick and blocks the gland.
Pathogenesis
The contents of the cyst are transparent mucus, rarely serous, the cyst is single-atrial, the puncture can extract light yellow transparent mucus, sometimes mixed with blood and red or brown-red, which is easy to be mistaken for endometriotic cyst, especially It is more confusing when the wall of the capsule is covered with pseudo-yellow tumor cells.
The early cystic wall of the cyst covers the transitional epithelium. With the increase of cystic fluid and increased pressure, the transitional epithelium can be transformed into a single layer of cubic epithelium or squamous epithelium, or even atrophy. If secondary infection occurs, the cyst wall presents chronic inflammatory connective tissue and even forms granulation tissue. .
Prevention
Vestibular gland cyst prevention
Pay attention to hygiene, avoid infection, try to avoid surgical damage to block the glandular orifice, and congenital glandular orifice closure should be treated surgically.
Complication
Vestibular gland cyst complications Complications
Abscess can form during secondary infection and recurrent episodes can be associated with blockage of the posterior gland.
Symptom
Vestibular gland cyst symptoms common symptoms edema cyst abscess secondary infection
The vestibular gland cysts vary in size, mostly from small to small, slow growth, some can last for several years, mostly single, generally no more than the size of the egg, rarely bilaterally occurring at the same time, if the cyst is small and no infection The patient may have no symptoms, and is often found during gynecological examination. If the cyst is swollen, the patient may feel that the vulva has a feeling of bulging and swelling or discomfort.
Examination showed that the cysts were mostly unilateral or bilateral, and the appearance of the epidermis was normal. The cyst was located at the vestibular gland between the posterior labia and the labial ligament. It was semilunar, oval or round, and the cyst was The lateral side of the labia majora is obviously bulged, the affected labia minora is flattened, the cyst is mobile, and there is no obvious tenderness. When the sexual life is frequent, the cyst is rapidly enlarged. When the infection is secondary, the local redness and swelling, the pain is obvious, and the patient has fever and other body. Symptoms, cysts can develop into abscesses.
Examine
Examination of vestibular gland cysts
Check the location, appearance, size of the cyst, local palpation, local puncture if necessary, and its content and abscess identification. Pathological examination showed that the inner wall of the capsule was covered with cubic epithelium, squamous epithelium or moving epithelium. Abscess is a localized pus accumulation in tissue, organ or body cavity due to necrosis and liquefaction of the diseased tissue during acute infection. There is a complete pus wall around it. The common pathogen is Staphylococcus aureus. The abscess can be caused by an acute suppurative infection, or by a pathogen of a distant source of infection through the bloodstream or lymphatic vessels.
Diagnosis
Diagnosis and differentiation of vestibular gland cyst
diagnosis
The unilateral labia majora cystic mass in women of childbearing age has no obvious symptoms, and there is mucus in the puncture. The effect of sexual stimulation on its size is its characteristics. The pathological examination can confirm the diagnosis, from the location of the cyst and the appearance or partial absence. Characteristics of inflammation and other characteristics, generally not difficult to diagnose, local puncture may be feasible if necessary, and its contents may be differentiated from vestibular gland inflammation and abscess, lymphedema.
Differential diagnosis
Identification with the labia majora and inguinal hernia: the ankle is connected to the groin ring. It can be reset and disappeared when squeezed. When the cough is coughing, it feels the impulse of the mass. When the breath is down, the mass is slightly swollen, and there is a drum sound. When the force is excessive, it is often sudden. appear.
It should also be differentiated from vestibular gland inflammation, endometriotic cyst, paraurethral gland abscess, and lymphedema.
