Aspiration and alcohol sclerotherapy: a novel method for management of Bartholin's cyst or abscess.

OBJECTIVE: To investigate the efficiency and safety of alcohol sclerotherapy of Bartholin's cyst or abscess by comparing it with silver nitrate insertion.

STUDY DESIGN: Twenty-two patients with unilateral Bartholin's cyst or abscess were randomized into one of the treatment groups according to diameter of cyst or abscess. Group I consisted of 12 patients who were treated with alcohol sclerotherapy and Group II included 10 patients who were treated with silver nitrate insertion. In both groups, treatments were conducted under local anesthesia and in an outpatient setting. The patients were checked for morbidity of operations every 3 days until complete healing was observed and then followed up monthly for over 24 months.

RESULTS: The mean duration of procedure was 7+/-2 min in group I and 15+/-3 min in group II. Healing time was 4.8+/-1.3 days in group I and 9.2+/-2.5 days in group II. In group I although 10 patients showed complete healing without any early or late morbidity; two patients suffered from severe vulval pain, edema and echymosis, and then developed a total cyst necrosis. Healing in these patients completed with mild scar formation. Only one recurrence was documented during 24 months follow-up period. All patients in group II complained labial pain, four of them suffered from severe labial pain, edema, and echymosis. Healing in these patients was completed with moderate scar formation. Follow-up of 24 months revealed no recurrence in this group.

CONCLUSION: Alcohol sclerotherapy of Bartholin's cyst or abscess is as effective as silver nitrate application and is associated with less complication. It may be ideal, safe and attractive treatment modality for this gynecological disease.