Vestibular gland cyst abscess

Vestibular gland cyst abscess ostomy for 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

Smaller vestibular gland cysts can be observed, large or repeated infection should be a vestibular gland cyst abscess ostomy. The operation is simpler, less bleeding, not easy to damage adjacent organs, quick recovery, no scarring, less recurrence, and can maintain the function of the vestibular gland. If there is an abscess formation, this operation can be performed directly.

Contraindications

Conservative treatment should be performed first when an abscess or cyst has not formed in the acute inflammatory phase of the vestibular gland.

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 was given 2 days before surgery, and fasted on the morning of surgery.

5. According to the condition, pre-operative 1d enema or 2d pre-operative laxative, such as senna leaf 15g 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 to self-defease and empty the bladder.

Surgical procedure

Incision

The labia minora is everted, at the junction of the outer skin of the hymen and the mucosa, and the longitudinal incision is made from the weak part of the cyst. The length depends on the size of the cyst, generally 0.5 to 1 cm from the upper and lower ends of the cyst, and the incision is appropriate. Mucosa and cyst wall. The contents are discharged (if pus is used for bacterial culture), and the cyst is rinsed with physiological saline.

2. Stitching

Use a forceps to lift the edge of the valgus, so that the surrounding mucosal incision edge is aligned, and the suture is sutured with a 2-0 chrome gut or a 4-0 silk thread. The open cyst wall completely covers the vaginal vestibular mucosa wound margin, and a new duct opening is formed at the center of the stoma to prevent the gland tube opening from being re-occluded. The Vaseline or saline gauze is placed in the wound cavity for drainage, and the wound cover is covered with sterile gauze (if it is an abscess, it is not necessary to suture).

3. Comparison with ordinary electric knife or ring electrode

The use of a common electrosurgical knife or ring-shaped electrode (EEP) to partially remove the wall of the capsule at the junction of the skin and the mucosa has similar effects. In comparison, this method has less bleeding, shorter operation time, and more smooth drainage.