Marsupialization - What To Expect?

Marsupialization is a surgical procedure that is a characterized by removal of tissue cysts in a precise manner to ensure little to no risk of cyst recurrence. The procedure involves adequate removal of cysts, followed by suturing of tissue edges in order to create an empty pocket that allows easy drainage of any residual or accumulated fluid.

Indications Of Marsupialization?

Following are primary indications of Marsupialization:

• Bartholin's gland cysts – these are small glands (pea-sized) that are responsible for secreting lubricating fluid to keep the vaginal canal moist during the act of sexual intercourse. Any long-standing inflammatory or infectious disorder of female genital tract can aggravate the risk of developing Bartholin duct cysts.
• Pilonidal cysts – these cysts occur at or around the tail-bone region and are caused by in-grown hair due to prolong sitting or inactivity. It is noteworthy that pilonidal cysts occur more frequently in males as compared to females.
• Anal fistulas as well as intestinal fistulas are also managed by marsupialization

Generally, the procedure is very safe and is not associated with major risks. It is ideally recommended for patients who are experiencing recurrent episodes of blocked tubes or cysts or if the lesion is associated with severe pain. It is imperative to mention that marsupialization is not the primary treatment option, and is usually indicated when other treatments have failed to alleviate symptoms. The surgery is not indicated if there is an active abscess at the cyst site.

What Should You Know About Marsupialization?

The Marsupialization procedure is usually performed under local anesthesia as an out-patient procedure, but may be performed under general anesthesia. The complete procedure takes about 15 -20 minutes. After the procedure, your surgeon may loosely pack the surgical site with gauze packs to stop the bleeding and to soak any fluids. Complete healing may take about 2 weeks.

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Intersitial Cystitiabout 2 weeks.[/caption]

After-Care After Marsupialization Procedure

In order to minimize the risk of contracting infection and to allow speedy healing, follow these simple tips:

• It is highly recommended to abstain from sexual intercourse for a period of up to 4 weeks after the procedure.
• Keep the affected area clean and dry
• Avoid tight underclothing – wear breathable cotton undergarments
• Take all the prescribed medications and see you doctor at follow up appointments
• Drink ample water
• Avoid excessive workout or exercise

Side Effects And Complications After Marsupialization Procedure

The risk of complications of adverse effects is uncommon if all the cautions are maintained – below are some complications:

• Infection
• Moderate to severe pain
• Bleeding
• Cyst recurrence

Some extremely rare but serious complications that warrants emergent and urgent care are:

• Coughing of blood
• Difficulty in breathing
• Loss of consciousness
• Chest tightness or pain

References

• Limongelli, P., Brusciano, L., del Genio, G., Tolone, S., Bosco, A., Docimo, G., & Docimo, L. (2016). Marsupialization compared to open wound improves dressing change and wound care management after fistulectomy for low transsphincteric anal fistula. International journal of colorectal disease, 31(5), 1081-1082.
• Reif, P., Elsayed, H., Ulrich, D., Bjelic-Radisic, V., Häusler, M., Greimel, E., & Tamussino, K. (2015). Quality of life and sexual activity during treatment of Bartholin's cyst or abscess with a Word catheter. European Journal of Obstetrics & Gynecology and Reproductive Biology, 190, 76-80.