His and Her Health

Can anyone offer any information on the reason why most doctors don't remove the bartholin's glands during a vestibulectomy? As I understand it, the vestibulectomy remove sonly the minor vestibular glands. But a few prominent vulvar specialists also remove the bartholin's glands because they believe much of the pain originates there, and leaving them in (but just cutting off the ducts) can lead to residual pain and other complications, such as cysts.

<small>[ 10-26-2005, 03:08 PM: Message edited by: Moderator ]</small>

I have performed over 200 vestibulectomies and only two women had problmes with their Bartholin's glands after surgery. Removal of the Bartholin's glands is a much bloodier and more invasive procedure with a much longer recovery. I am not sure of which specialists you are speaking about, but I do not know of any who routinely excise the Bartholin's glands.

Jessica Thomason in Milwaukee and Michael Baggish in Cincinnati routinely remove the bartholin's glands. They are reporting 98% long-term success rates versus 90% for vestibulectomies. How much longer is the recovery?

Also... Wouldn't you remove the bartholin's glands if a patient's pain seemed to be in the area of the glands?

Dr. Goldstein,

You stated that the removal of the Bartholin's Glands is a much bloodier and more invasive, but the article I read stated that "Because Bartholins’ glands removal is done by a very precise microsurgical technique, surgery has a very low morbidity rate and produces little change in vulvar anatomy.". It would seem that if the incesion is so small there would be less scaring or bleeding.

Personally, since I have "deep lancinating pain radiating out of the Bartholin's fossa", it seems that surgery is my only option. And since I tend to scar up with keloid scars, I don't want to do surgery that would have large areas of incensions.

I am currently seeing a doctor in Cincinnati...I'm in the period of "conservative treatment" (low-oxalate diet, rinsing with water after I urinate, Elavil and calcium citrate) but I go back on the 27th to talk about surgical options if it hasn't helped (which from tampon use, seems like it hasn't). I know he does a lot of the bartholin's gland removal. The difference in recovery time is something I've been trying to find as well, but so far have had no luck.

<small>[ 10-14-2008, 04:40 PM: Message edited by: Moderator ]</small>

JES, Is there any way you can provide your e-mail address in your profile? I would really like to contact you regarding this subject but don't see your e-mail listed?

Feel free to e-me. My address is listed in my profile.

Thanks,
Deeice

Very few vulvar specialists actually think that the cause of vestibular pain is inflammation of the Bartholin glands. The minority of surgeons who advocate the removal of the glands during vestibulectomy do so because of the very small percentage of women who develop Bartholin cysts after vestibulectomy. Terms like "microsurgical technique" sound great but the gland can be very large and if this tissue is removed the recovery can be quite long.

<small>[ 11-27-2008, 09:47 AM: Message edited by: Moderator ]</small>

I had surgery done a few years ago by Dr. Goldstein...very successful I would say but i did have the marble size cyst and have had it since...yesterday I woke up in excrutiating pain it is swollen to the size of a walnut and not sure what to do...should i need to get it taken care of ASAP. How will my local gyno go about taking care of this. I can not imagine the pain of a needle going into it, it is too painful!

Have you tried to contact Dr. Goldstein at his office.The number is in the post above yours.

Bartholin gland cyst are very easily taken care of with the insertion of a Word catheter.

I don't care if you have a magic wand, quoted success rates of 99% are just not believable. Maybe decreased sensitivity on a q-tip test can be 99% but there is absolutely NO WAY that 99% are having pain free sex, not a chance.

My bartholin glad ruptured, now it has been a few weeks and it is back to a marble size cyst...My Gyno told me that my option was to have the glad taken out. Is that a bad option?