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What are the most common benign vulvovaginal cysts Where are Bartholin glands and ducts located What is the role of Bartholin glands Bartholin ducts cysts, epidermal, sebaceous, and apocrine sweat gland cysts Deep in the labia majora at about four and eight o clock positions They are not palpable in healthy women As a homologue to the male bulbourethral glands, they secrete mucus to provide moisture for the vagina Infection can cause inflammation and obstruction of the main duct of Bartholin glands leading to cystic dilation They may enlarge up to 1 3 cm and are usually asymptomatic Bartholin gland abscesses Pain, dyspareunia, and difficulty ambulating or sitting Physical examination may reveal swelling, erythema, edema, and a large fluctuant mass in the medial labia majora This is usually because of infection or swelling
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What may Bartholin gland cysts develop into When symptomatic, what are the acute symptoms and signs of Bartholin gland cysts and abscesses
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4: General Gynecology
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Asymptomatic cysts need no intervention or antibiotic treatment Symptomatic cysts are incised and drained, and a catheter is placed to form a tract for the drainage of glandular secretions (Word catheter) If this procedure fails, then a marsupialization can be done (the creation of a new ductal orifice) The most definitive procedure for a Bartholin cyst after failure of all previous methods is complete excision of the gland
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What microbes are commonly implicated in Bartholin gland abcesses How are Bartholin gland abscesses managed and treated
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Escherichia coli, Neisseria gonorrhoeae, Chlamydia trachomatis, and several anaerobes An aspirate and culture of the abscess should be done Treatment includes antibiotics such as ceftriaxone and clindamycin, and surgical drainage of the pus (with possible supplementation of a Word catheter)
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For the following descriptions, list the most appropriate type of cyst or cystrelated condition 1 Occurring mostly beneath the labia majora, this cyst occurs when the sebaceous gland duct becomes obstructed They are multiple, smooth, and palpable masses that are generally asymptomatic Acute infection can be treated with incision and drainage 2 These cysts are lined by squamous epithelial cells and contain oily material They occur in the setting of vulva surgery or arise from obstruction of pilosebaceous ducts They are usually small, solitary, and asymptomatic 3 Apocrine sweat gland cysts are mainly found in the labium majus and become functional after puberty They are usually small, multiple, and extremely pruritic This disease occurs when keratin obstructs the duct 1 Sebaceous cyst
2 Epidermal cyst
3 Fox-Fordyce disease
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Section II: Topics in Gynecology
4 This condition occurs with chronic infection of the apocrine glands and is manifested by multiple painful, pruritic, and subcutaneous abscesses It may be treated with antibiotics or incision 5 This cystic vulvar tumor is a rare congenital anomaly and located near the urethral meatus It can be treated with partial excision 6 Occlusion of a persistent processus vaginalis may cause this hydrocele or cystic tumor 7 These lateral vaginal wall cysts result from dilation of the mesonephric duct remnants 8 This is a benign outgrowth of normal skin More of a solid tumor than a cyst, it must be removed when it causes discomfort
4 Hidradenomas
5 Skene duct cyst
6 Cyst of the canal of Nuck
7 Gartner duct cyst
8 Acrochordon (skin tag)
PYODERMAS AND OTHER NONSEXUALLY TRANSMITTED INFECTIONS OF THE VULVA AND VAGINA
What are the specific types of pyodermas What is the most common bacterial etiology for all of these pyodermas How does impetigo manifest Cellulitis, impetigo, folliculitis, furuncles, and carbuncles Staphylococcus aureus Vesicles and pustules form in an area that was recently traumatized They often rupture and form a characteristic golden crusting Erythromycin or dicloxacillin (oral) An infection of the hair follicles It can occur with exposure to whirlpools/ hot tubs, antibiotic therapy, and shaving of pubic hair The lesions are multiple, 5 mm, cluster in groups, erythematous, and pruritic Warm saline compresses and topical antibiotics Furuncules: a painful nodular lesion that involves the hair follicle and drains pus
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