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. Journal of Minimally Invasive Gynecology (2008) 15, 327–331 © 2008 AAGL. All rights reserved.