The document discusses Bartholin glands cysts and abscesses. It begins with an introduction and overview of the anatomy and embryology of the Bartholin glands. It then describes pathological conditions such as cysts and abscesses of the Bartholin glands. The document discusses the clinical presentation and various treatment approaches for Bartholin glands cysts and abscesses, including expectant management, conservative treatment with antibiotics, and more invasive procedures like incision and drainage, catheter placement, marsupialization, and ablative therapies using silver nitrate or alcohol.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
This the second lecture of a series of 3 lectures and deals with the endometrium as it appears during various phases of the menstural cycle, polyps, menopausal bleeding, tamoxifen endometrium, saline sonohysterography etc
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
3. 1 August 2021 Prof. B.V. Sai Chandran CTVS 3
• Introduction
• Anatomy & Embryology
• Function
• Pathological Conditions
• Management
4. 1 August 2021 Prof. B.V. Sai Chandran CTVS 4
• The Bartholin glands are essential organs of the
female reproductive system.
• The glands were first described in the 17th century
by the Danish anatomist, Casper Bartholin
• The Bartholin’s gland corresponds to the
bulbourethral gland of male.
Introduction
5. 1 August 2021 Prof. B.V. Sai Chandran CTVS 5
Anatomy of
Bartholin’s Gland
(Greater Vestibular Gland)
6. 1 August 2021 Prof. B.V. Sai Chandran CTVS 6
Postero- lateral to
vaginal orifice, beneath
the bulbospongiosus
Pea-sized, of
about 0.5 cm and
yellowish-white
@ 4 and 8 O’ clock
in the superficial
Perineal pouch
7. 1 August 2021 Prof. B.V. Sai Chandran CTVS 7
Duct of Bartholins gland
8. 1 August 2021 Prof. B.V. Sai Chandran CTVS 8
Duct of Bartholins gland
Runs downwards & Inwards
to open at the introitus
outside the hymen
@ Jn. of A
2/3
rd and P
1/3
rd
between Hymen & Labium minus
9. 1 August 2021 Prof. B.V. Sai Chandran CTVS 9
Anatomical position of the bulbo-
urethral gland in the male .
11. 1 August 2021 Prof. B.V. Sai Chandran CTVS 11
• Bilateral elongated
masses of erectile tissues
• Beneath the mucous
membrane of the
vestibule.
• Each bulb lies on either
side of the vaginal
orifice in front of the
Bartholin’s gland
• Incorporated within
the bulbocavernosus
muscles.
12. 1 August 2021 Prof. B.V. Sai Chandran CTVS 12
Homologous to the Single Bulb of the Penis and
Corpus Spongiosum in the male.
13. Embryology
• Bartholin’s glands and
Skene’s tubules are
developed from outgrowths
the urogenital sinus (UGS)
Supply:
– External pudendal artery
– Pudendal nerve.
– Superficial inguinal and
pelvic nodes.
Future
Bladder
UGS
Anorectal
canal
15. Histology of Bartholin’s
Glanda:
• It is a compound racemose gland.
• The acini are made up of simple columnar
epithelium.
• the duct ,in its beginning made of cuboidal
epithelium and become transitional and near
its termination made of stratified squamous
epithelium.
17. Functions of Bartholin’s Glands:
• Their primary function is the production of a
mucoid secretion that aids in vaginal and
vulvar lubrication.
• They are homologous to the bulbourethral
(Cowper’s) glands in males.
• Tiny drops
• Basic pH
18. • Colourless and Mucoid
• CharacteristicOdour.
• Produced mainly in response to
sexual excitement to act as a
lubricant for coitus.
• Limited activity after the menopause
Secretion of Bartholin Glands:
19. 1 August 2021 Prof. B.V. Sai Chandran CTVS 19
Pathology of
Bartholin’s Gland
(Greater Vestibular Gland)
20. Pathology (Lesions) of Bartholin’s Gland
1. Inflammatory cysts/abscess
2. Tumors
Nodular Hyperplasia
Endometriosis
Adenoma & adenomyoma
Papilloma
Mucocele
Squamous cell carcinoma
Lymphoepithelioma-like carcinoma
Vulvar leiomyosarcoma
Endometrialadenocarcima
Merkel cell carcinoma
Mucinous adenocarcinoma
Transitional cell carcinoma
Epithelioid sarcoma
Malignant melanoma
Non-Hodgkin’s lymphoma
Human papillomavirus type 16
Paget’s disease
Small cell neuroendocrine
B
E
N
I
G
N
M
A
L
I
G
N
A
N
T
21. 1 August 2021 Prof. B.V. Sai Chandran CTVS 21
Bartholin’s gland Cysts & Abscess
23. Bartholin’s Gland Cysts &
Abscess
• Trauma
• Episiotomy
• Child birth
• No identifiable cause
They are common in occurrence.
Obstruction of the duct
Cystic dilation of the duct
Build-up of mucus
Cyst formation
Infection
Abscess
24. Bartholin’s Gland : CystVs Abscess
Bartholin's abscess
Cultures often show
Polymicrobial infection
Duct cyst is not
required for the
development of
abscess.
The abscesses are
almost 3 times
more common
than duct cysts
25. Brucella melitensis
Chlamydia trachomatis
Escherichia coli
Klebsiella pneumonia
Neisseria gonorrhea & sicca
Aerobes
Pseudomonas aeruginosa
Bacteroides species
Pasteurella bettii
Salmonella panama
Staphylococcus aureus -Panton-Valentine-Leucocidin production
Streptococcus species
Gram Negative
Gram Positive
Bacteriology
26. Childbearing age :
• Onset of puberty (mostly) and increases with age
Clinical Manifestations and Symptoms
27. • May be asymptomatic if the
cyst is small and not
inflamed.
• Incidental finding of small
mass by the physicians in
the gland region
• Larger cyst / cyst with
inflamation
Bartholin’s Duct Cyst – Clinical
Abscesses commonly
present with cellulitis
and lymphangitis.
- severe vulvar pain
- swelling
- difficulty in walking,
sitting and engaging
in sexual intercourse
(dyspareunia).
- Fever may
28. Clinical Presentation
• Tender mass in the lower vestibular region surrounded
by erythema and edema. Grows large enough to
extend to the upper labia
• Skin rupture and spontaneous drain – may happen
• Presenting in the form of inguinal hernia
31. IMAGING STUDIES
MRI and CT Scan may be utilized to examine large
Bartholin’s duct cysts in addition to a physical examination
Asymptomatic cysts may also be examined through MRI
scans
High definition USG is also used to reveal presence of
Bartholin's cyst
32. • Age
• Size
• Symptoms
• Infection+/_
• History of Recurrence
33. 1. Expectant management
2. Conservative.
3. Curative
4. Office/ inpatient
The goal of management is to preserve the
gland and its function
34. • Marsupialization should NOT be used to
treat a gland ABSCESS.
• Broad-spectrum Antibiotic therapy is
warranted only when cellulitis is present.
• Excisional biopsy is only in menopausal or
perimenopausal women with an irregular,
nodular Bartholin's gland mass –to R/O
Adenocarcinoma
35. • ASYMPTOMATIC
• < 40 YEARS
• Small
• Incidentally Found
EXPECTANT MANAGEMENT ( SMALL CYSTS )
36. • Medication and Antibiotics for
abscesses.
• Antibiotic may not be necessary
for healthy women with
uncomplicated abscesses.
• Ceftriaxone, Ciprofloxacin,
Doxycycline & Azithromycin.
• This treatment option should be
restricted to women who have
high risk of complicated infection
such as,
Indications :
• Recurrence
• pregnancy,
• Immunosuppression,
• MRSA risk,
• Widespread cellulitis
• Gonorrhea or chlamydia.
Topical or local anesthetics
such as lidocaine and
bupivacaine are also used to
treat abscesses
CONSERVATIVE MEDICAL
37. MANAGEMENT OF LARGE CYSTS & ABSCESS
Spontaneous rupture: Sitz bath, Anti inflammatory / Antibiotics SOS
Available treatment options
1. Incision and drainage - simple, office procedure, high recurrence rate
2. Needle aspiration - not recommended
3. Ablative therapy - Alcohol / Silver Nitrate
4. Catheter placement – Word catheter / Jacobi Ring Catheter
5. Marsupialization
6. CO2 Laser
38. • Should it be a OT procedure (or) office
procedure such as Word catheter placement?
• Is it strictly a Cyst (or ) Abscess?
• What are the organisms (in case of Abscess) &
wheter the Antibioctics are adequate?
• Is the patient immunocompromised?
• Are there comorbidities delaying postoperative
healing?
• Whether any chance of malignancy?
40. 18- to 20-G needle
Inserted into the cyst at the point of maximal fluctuation
Aspirated until the cyst walls collapse.
Alcohol (70%) - similar volume as the cyst content -injected
- Injected into the cyst
- Left for five minutes, then aspirated.
Healing usually occurs within one week.
41. A clamp is placed into the cyst/abscess,
and the contents are fully drained.
A 5-mm diameter silver nitrate stick,
trimmed to a length of 5 mm is
inserted into the cavity.
A single suture is applied to the skin to
fix the stick in the cavity for continued
drainage.
After 3 days, the stick is removed with
the necrotized tissue using a clamp
Healing time is approximately 2 weeks
42. Results of Alcohol vs. Silver Nitrate Sclerotherapy
Effectiveness and safety almost similar despite
the minor risks of tissue necrosis and scar
formation.
43. Prospective Randomized Study of Marsupialization versus Silver Nitrate
Application in the Management of Bartholin Gland Cysts and Abscesses J Minim
Invasive Gynecol Mar-Apr 2009;16(2):149-52
Conclusion: Marsupialization and silver nitrate application seem to be equally
effective management methods in Bartholin cyst and abscesses, however, silver
nitrate favors complete healing with less scar formation.
•. Mar-Apr 2009;16(2):149-52
•. Mar-Apr 2009;16(2):149-52
44. CATHETER PLACEMENT
Draining the contents of the cyst or abscess and
placement of a catheter for few days.
2 Types of Catheters :
Word Cattheter Jacobi Ring Catheter
47. 7-cm long 8F T tube threaded
20-cm long 2-0 silk suture
5-cm piece of tubing from a
butterfly blood collection set is
threaded with absorbable sutures
(Vicryl) through the lumen
48. An incision is made into
the mucosal surface of the
Bartholin duct abscess.
Adhesions are lysed, and
the abscess can drain.
A hemostat is tunneled
into the abscess cavity and
a second incision is made.
The hemostat is used to
grasp one end of the
Jacobi ring.
The Jacobi ring is pulled
through the abscess
cavity with care that the
suture is not pulled out
of the catheter.
The two ends of the
suture are tied, forming
the closed ring.
… Jacobi Ring Catheter
49. Merits :
• No risk premature expulsion
• Creating 2 drainage tracts.
Ring catheter is left in place up to 4 weeks
Removal is done in the physician’s office by cutting
the suture, then removing the entire tube.
…..JACOBI Ring:
50. The primary outcome: of the study were
successful placement of the catheter and
resolution of the abscess
• Patient satisfaction was higher
with ring Catheter
• No significant clinical or statistical differences
regarding :
― Catheter placement success
(The ease of insertion was
similar for the 2 devices
― Abscess resolution, or
― Recurrence. No recurrence at 6
6months
Secondary outcomes included ease of
insertion, patient satisfaction and
recurrence at 6 months.
Ring Catheter Vs Word Catheter – RCT reports
51. In 1950, Jacobson was the first to describe the technique
MARSUPIALIZATION
52. Indications
1. H/o Recurrence
2. Significant pain or discomfort
3. Failure of other modes of treatment (unresolving or
extremely prolonged delay in resolving )
4. Unable to tolerate Word catheter placement in an office
setting
Complications:
• Scarring due to the removed tissue Lack of Lubrication &
Dyspareunia
53.
54. The WoMan-trial (WOrd versus MArsupialisation) was a
multicentre, open label, randomised controlled trial performed
in 4 university, 12 teaching and two general hospitals
in the Netherlands and in one teaching hospital in England.
in women with a Bartholin duct cyst or gland
abscess, demonstrated similar recurrence rates with both
procedures
.
Word Catheter Vs Marsupialization
55. • Treatment for a symptomatic cyst or abscess of the
• Bartholin gland by both Word catheter and
marsupialisation
• resulted in similar 1-year recurrence rates. Outpatient
• placement of a Word catheter is also well tolerated by
• patients. In our opinion, our data favours treatment of a
• Bartholin cyst or abscess with a Word catheter as this is
• the fastest procedure, relieving pain sooner after
diagnoses,
• with lower costs than when marsupialisation is performed.
56.
57. Merits over the other methods :
CO2 LASER
• Minimal Recurrence,
• No Scar formation - as the Incision on
the cyst is made with CO2 laser and the
wall is vaporized from the inside.
• No Hemorrhage.
• Less chance of persistent drainage
• Vaporizes removes the gland.
• Less discomfort to the patient in the
intra- and postoperative periods
• Simple
• Quick
• As OP Procedure
Demerits Expensive, Facility & skills not available widely
Technical Aspects
58. Procedure with CO2 Laser in the Treatment of a Bartholin Cyst
Exposure of
the cyst to
the right,
with 2%
xylocaine
infiltration
Incision with the
focused laser beam
over the cyst.
Opening
of the
capsule
with
complete
drainage
of the
content
Repair of the
borders with
exposure of the
internal
surface of the
capsule.
Vaporization of the
internal capsule with
unfocussed laser beam
59. Post procedural :
• Sitz-baths with diluted povidone-iodine in water thrice daily,
• Abstain from sexual activity for 2 to 3 weeks.
• Antibiotics and analgesics when signs of infection
• The patients were evaluated 15 and 30 days after procedure
• In the first 2 weeks continuous drainage of mucus,
at the end of the 1st month complete healing
….CO2 Laser
60. The gold standard treatment is surgical removal of the
entire cyst. However, this treatment is NOT performed
often since it affects the physiological vaginal lubrication
and is associated with other complications
Bartholinectomy
• Exeresis of Bartholin gland is a surgical treatment -
an elective procedure, performed in the absence of
infection. Usually performed after failure of other
techniques.
• Requires greater operative time.
Cyst Excision
61. • Modern variations are discussed, including
the use of hydrodissection for excision, as well
as the application of MRI use in devising
treatment for recurrent cysts.
….CYST EXCISION
62. Objective: to examine cases with Bartholin gland excision due to
Bartholin cyst or abscess.
Methods: demographic features, obstetric and medical history
of the patients, location and size of the Bartholin cyst or abscess,
complaints, duration of operation and postoperative
complications.
….GLAND EXCISION
Evaluation of 149 Cases who underwent total excision of the
Bartholin gland due to cyst or abscess - @ Istanbul Kanuni
Sultan Suleyman Training and Research Hospital between
January2011 and December 2016 -
A Retrospective Study
European Archives of Medical Research
63. Results :
• The mean age of the patients was 33.33―7.126 years.
• The gravida and parity mean values were 2.11 and 1.56, respectively.
• Of the patients, 35 were nulliparous, and 108 had vaginal delivery.
• The mean diameter of the cyst was found to be 3.18 cm.
• There were 20 patients with recurrent cases of Bartholin abscesses.
• The mean duration of operation was 22.42 min.
• The most common complaint was pain.
….GLAND EXCISION
European Archives of Medical Research
64. 1 August 2021 Prof. B.V. Sai Chandran CTVS 64
Bartholin’s Gland Carcinoma
65. Carcinomas
• Rare type of gynecological tumor that
• Accounts for 2–7% of vulvar carcinomas.
• The median age 57 years old.
• Incidence is highest among women in their 60’s.
• Benign tumors are rarer than carcinomas
1. Adenocarcinoma
2. Squamous cell carcinoma
3.Transitional Carcinoma
4. Adenoid-cystic Carcinoma
5. Undifferentiated carcinomas
Human papilloma
virus is only related to
squamous cell lesions.
80-90%
10-20%
66. When to Suspect ?
• Bartholin gland involution occurs by 30 years of age
• Hence enlargement occurring after 40 years of age should
raise suspicion for malignancy
• Particularly if the gland is firm, fixed, or irregularly shaped
and painless
• First detection of sentinel node may lead to diagnosis of
adenocarcinoma of Bartholin's gland
..Carcinomas
67. • Diagnosis established by histological examination.
• Drainage and biopsy - to eliminate a biopsy is recommended over
excision
• When malignancy suspected , diagnostic criteria :
– The tumor must be primarily located in the labia
– The surrounding skin must remain undamaged,
– There must be at least a small amount of glandular epithelium
present.
• Metastatic disease is likely due to the vulva's extensive vascular and
lymphatic network
• Early recognition is important because of the risk of local invasion and
metastasis.
..Carcinomas