Carbon-dioxide laser vaporization of the Bartholin gland cyst: a retrospective analysis on 200 cases.

STUDY OBJECTIVE: To evaluate the effectiveness of carbon-dioxide laser vaporization as definitive treatment for Bartholin gland cyst.

DESIGN: Retrospective analysis (Canadian Task Force classification II-3).

SETTING: University teaching hospital.

PATIENTS: A consecutive series of 200 patients with monolateral or bilateral Bartholin gland cyst.

INTERVENTIONS: A standardized technique of cyst vaporization performed by carbon-dioxide laser in outpatient setting and local anesthesia.

MEASUREMENTS AND MAIN RESULTS: Records of all patients were reviewed for anamnestic information, anatomic parameters, intraoperative and postoperative outcomes, and follow-up data. Seven patients having bilateral cyst were treated in a single session; 207 procedures were performed. The cyst mean size was 6.3 +/- 2.3 cm (95% CI 5.93-6.67). All treatments were completed in outpatient regimen and local anesthesia with a median operative time of 17 minutes (range: 7-45). Three (1.5%) cases of intraoperative major bleeding were observed. The cure rate of a single laser treatment was 95.7%. The 9 patients with recurrent disease observed during follow-up underwent carbon-dioxide laser reintervention by the same therapeutic strategy with a 100% cure rate after 2 or 3 treatments.

CONCLUSION: Carbon-dioxide laser vaporization of Bartholin gland cyst represents a safe and effective procedure with complete healing and positive follow-up outcomes. Further randomized trials should be conducted to confirm these findings and to establish the best surgical strategy.