Vulvar Disorders
Recommended Reading
ARTICLE: Vulvar cancer
Website: Vulval biopsy
Board Questions
A 24-year-old female presents with progressively worsening vulvar pain for 3 days. On examination a 3Ă—3-cm tender, fluctuant mass is noted on the right labia minora. She had a similar episode of this problem last year.
Which one of the following would be the most appropriate management?
A) Expectant management
B) Fine-needle aspiration
C) Incision and drainage
D) Marsupialization
E) Excision under general anesthesia
ANSWER: D
The most appropriate management of a recurrent Bartholin gland abscess would be marsupialization, which has a 0% recurrence rate at 6 months. Local anesthesia can be used in the office to effectively treat Bartholin gland abscesses and sedation is not required (SOR A). If the Bartholin gland abscess is >5 cm, referral to a gynecologist is recommended. Expectant management, fine-needle aspiration, or incision and drainage would likely lead to recurrence.
