[Therapy of inflammatory changes in Bartholin's glands].

INTRODUCTION: Bartholin's glands are bilateral structures whose function begins after puberty, so the diseases of these glands are most common during the reproductive period. Management of the inflammatory changes--abscess and cyst can be invasive and conservative, and quite often the changes become chronic, due to the failure of techniques. The aim of the study was to assess efficacy of various therapeutic approaches in the treatment of the inflammatory changes of Bartholin's glands.

MATERIAL AND METHODS: The study was done at the Department of Obstetrics and Gynecology, Clinical Centre in Novi Sad, during the period 1993-1996, at the Dept. of Inflammatory Gynaecological Diseases. The total of 129 patients was treated. The first two years were analyzed retrospectively while during the years 1995 and 1996 a prospective study was done. The analysis of the therapeutic results was done according to the immediate efficacy of the therapeutic approach, incidence of recurrence, length of hospitalization and use of antibiotics.

RESULTS: A total of 129 patients was treated, the mean age was 35.4 years. Cysts were treated in 14.7% and abscess in 85.3% of cases. Therapeutic approaches were different during different years. During 1993 and 1994 in majority of cases incision and complete extirpation of the glands were done, and rarely marsupialization, alone or in combination with silver nitrate (AgNO3). In 1995 and 1996 in a majority of cases incision of the gland was performed, together with the AgNO3 application (94.3% in 1995, 64% in 1996). In 1995 total gland extirpation was performed (5.7%) while in 1996 in 9 cases (36%) incision was done. The length of hospitalization was longer in earlier years, the shortest being when incision and AgNO3 application was performed (3.1/2.4 days). The use of antibiotics was significantly lower in the years when incision and AgNO3 were used.

DISCUSSION: Our results are in concordance with the results of similar studies except for the fact that in our group the changes were seen more often in the age group 30-39 years. The parity was of no significance. The recurrence of the disease when this method is applied is the same as in other studies--around 3%, whereas the complications were rare. The length of hospitalization and the cost of the antibiotic therapy is of great significance as well, and they can be brought to minimum by employment of this method.

CONCLUSION: The therapeutic approach of incision and AgNO3 application in therapy of inflammatory changes of Bartholin's glands is an efficient, safe, simple and cheap method, which can easily be applied in ambulatory conditions.