What is marsupialisation?
Marsupialisation is a surgical procedure performed to treat Bartholin’s cyst. In this surgery, the Bartholin’s gland is cut open and the edges of the skin are sutured (not to each other) to form a continuous surface. This keeps the cut open and drains the puss (abscess) from the swollen gland.
Bartholin’s cyst refers to a condition when one of the Bartholin’s gland is filled with fluids and swells. Bartholin’s cysts are present on either side of the vagina in the labia. They secrete lubricating fluids to make intercourse easy when a woman is aroused. Around 2% of women develop Bartholin’s cyst. Symptoms of Bartholin’s cyst include a lump, usually on one side of the vagina near the entrance, swelling at the opening of the vagina, pain and discomfort while having sex etc.
Visit Bartholin’s Cyst – Causes, Symptoms & Treatment to learn more about Bartholin’s cyst.
Marsupialisation procedure is also performed to treat other types of cysts such as Skene duct cyst that develops near the opening of the urethra.
Who can undergo marsupialisation surgery?
Marsupialisation may be performed as a last option to treat Bartholin’s cyst. This surgery may be recommended by your gynecologist if:
- The cyst keeps coming back after treating with medicines
- The cyst is too big and doesn’t let you sit, stand or work comfortably including hindering sexual intercourse
- The cyst is swollen and is oozing puss (abscessed)
- If the cyst is infected and you are running a fever and in pain.
In case of women who are over 40 years, if the cyst looks bumpy to the gynecologist, a biopsy may be recommended to rule out/confirm the presence of cancer cells.
Performing marsupialisation surgery
This is a simple surgery wherein the cyst will be cut open and the ends of the skin will be sutured so that the cut doesn’t close and remains open to drain the puss or fluids inside it. This performed as an outpatient procedure and doesn’t require any hospitalization. You will be allowed to leave the clinic or clinic soon after the surgery if full body anesthesia is not administered. Usually, local anesthesia is given before performing the procedure.
After administering anesthesia, the cyst and the area surrounding the vaginal opening will be cleaned and sterilized. The cyst will be cut open and all the puss or fluids will be drained out. Once the puss is drained, the edges of skin are sutured and then a gauze piece will be used to stop bleeding. Usual time taken to perform marsupialisation surgery is around 15 minutes or less.
Recovering from the surgery
Antibiotics will be given that needs to be religiously taken to prevent any possible infection. The site is highly prone to infection due to the fact that it is located near the urethral opening and the incision made remains open.
A little bit of bleeding and draining of puss should be expected for a few weeks. The area needs to be cleaned at regular intervals and kept clean. Your gynecologist will let you know what to use to clean the area and how well the area needs to be kept for quick recovery.
Don’t dos when recovering from marsupialisation surgery
- Having vaginal sex
- Using tampons or menstrual cups
- Application of any chemicals or gels near the vaginal area
- Using soaps and bathing gels made with strong chemicals.
If the puss keeps draining and if more blood seems to be coming through the incision made and if there is a fever, contacting your gynecologist is the immediate thing to be done. Complications after the surgery can include infection at the site, pain and scarring.
Remember this simple fact – Whenever you are injured or hurt and have a wound that is bleeding or draining puss while healing and if you run a fever, that means, your body is infected and you must get treated immediately to get well and for the injury to heal on time. Ignoring this simple fact may lead to complications in your health.
Alternative treatments to marsupialisation surgery
As said, treating Bartholin’s cyst is possible without a surgery unless no other treatment options work. Initially after diagnosing Bartholin’s cyst, your doctor may recommend to soak the cyst in warm water for 10 minutes, 3 to 4 times a day. Soaking the cyst in warm water makes the skin soft and easy to break. This helps in draining the abscess easily. Once the puss is drained out, you may be required to hold a gauze piece against the cyst to stop bleeding (if any).
If the cyst is just growing in size and not opening up, your doctor may make a tiny incision and insert a small catheter called ‘word catheter’. This will help in draining the fluids that gets collected in the cyst.
Pain killers and antibiotics will be prescribed after the initial diagnosis.