Bartholin cystectomy

Vestibular gland cystectomy for the surgical treatment of vestibular gland cysts. The vestibular gland is located in the lower third of the labia majora on both sides, and is susceptible to infection due to the characteristics of the anatomical site. Inflammation occurs mostly in women of childbearing age and is often infected with a variety of bacteria. More unilateral infection, local redness and swelling in the acute phase, tenderness, with systemic fever, inguinal lymphadenopathy. When an abscess is formed, the mass can reach the size of the egg, fluctuate, and the surface of the skin becomes thinner and can be broken by itself. The vestibular glandular duct is blocked by inflammation, or the pus is absorbed after acute inflammation, or the catheter can cause cyst formation due to trauma, and repeated infection can gradually increase it. The vestibular gland cyst is separated from the vagina by the muscles around the vagina and the perineal body. Therefore, the cyst often protrudes to the outside of the labia majora, has no adhesion to the vaginal wall, and has a certain degree of freedom in the labia majora. The vestibular gland cyst should be distinguished from the inguinal hernia in the labia majora. The latter is connected to the inguinal ring. The mass increases when the abdominal pressure is applied, and can be reduced by the hand. Abscess simple incision and drainage can only temporarily relieve the symptoms, and the incision often relapses and causes recurrence. Treatment of diseases: vestibular gland cysts Indication The vestibular gland cyst is not acutely infected, and it is feasible for the treatment of vestibular gland cysts. Contraindications Acute infection of the vestibular gland cyst or abscess formation. Preoperative preparation 1. If there are skin diseases such as dermatitis and eczema on the inside of the vulva and thigh, they should be treated first, and then surgery should be performed after the cure. 2, the operation time should be selected 5 to 7 days after menstruation. 3, 3 to 5 days before surgery, warm water bath 1 / d, 0.1% benzalkonium bromide (Xin Jieer) liquid flushing vulva and vagina, 1 / d, 1 morning surgery. 4, soft food before 2 days of surgery, fasting the morning of surgery. 5, according to the condition, preoperative 1d enema or 2d preoperative to give laxatives, such as senna leaf 15g on behalf of tea, or liquid paraffin 30ml orally, and clean enema 1d before surgery. The enema was not given on the morning of the operation to prevent the stool from being contaminated. 6, go to the operating room before self-solving urination, emptying the bladder. Surgical procedure 1. Incision The labia minora is everted, at the junction of the outer skin of the hymen and the mucosa, a longitudinal incision is made from the weak part of the cyst, and the length depends on the size of the cyst. 2, peeling off the cyst Lift the edge of the mucosal incision and use the handle or finger to peel off the connective tissue between the cyst wall and the mucosa. From shallow to deep, until the bottom of the cyst, be careful not to peel the cyst wall and vaginal mucosa. After the cyst is partially peeled off, it is more convenient to peel off by lifting it with your left hand. If there is adhesion, scissors can be used for sharp separation. Because of the movement of the labia and veins, the blood supply is rich in the deeper part. If there is bleeding, it should be ligated and stopped in time. When peeling to the bottom, the root of the cyst is clamped, cut, and ligated, and the cyst is completely cut. 3, suture submucosal tissue After the cyst was removed, the residual cavity was carefully examined for no bleeding. The suture was sutured with a 2-0 chrome gut. Do not leave a dead space to avoid hematoma formation. Put a rubber drain strip if necessary. If the residual cavity is close to the urethra or rectum, the catheter should be catheterized or anal examination for damage. 4, suture incision Trim excess mucosa, align and suture with 4-0 silk or absorbable lines. The catheter is indwelled, covered with sterile gauze and pressed with a cotton pad.