. Gynecology : . Fig. 28.— Cyst of Bartholins shows the characteristic swelling on one side of the introitus. Abscess of Bartholins gland gives the same outward appearance. duct. By careful dissection the cyst may be removed entire. If it is punc-tured, the cyst collapses and the dissection then becomes ragged and is to be remembered that the clean removal of a Bartholins gland or cyst is nota particularly easy operation. The dissection must be carried deeply into the 188 GYNECOLOGY paravaginal tissues, and there is often troublesome bleeding. The operationshould, theref
. Gynecology : . Fig. 28.— Cyst of Bartholins shows the characteristic swelling on one side of the introitus. Abscess of Bartholins gland gives the same outward appearance. duct. By careful dissection the cyst may be removed entire. If it is punc-tured, the cyst collapses and the dissection then becomes ragged and is to be remembered that the clean removal of a Bartholins gland or cyst is nota particularly easy operation. The dissection must be carried deeply into the 188 GYNECOLOGY paravaginal tissues, and there is often troublesome bleeding. The operationshould, therefore, not be attempted under local anesthesia. (See page 589.) Another phase of recurrent Bartholinitis is an inflammatory thickening ofthe gland, which gives considerable discomfort or pain. The gland may not be. Fig. 29.—Labge Cyst of Baetholins from an elderly woman who had carried the tumor for many years. The vulva wasdistorted and the cyst pressed on the urethra so as to interfere with urination. The cyst was dissectedout entire without rupturing it. There was no connection with the inguinal canal. large enough to be discernible on inspection, but can be felt between the thumband forefinger placed just inside the introitus. No matter how small the glandmay feel, if it is giving symptoms it should be excised, for nagging discomfort INFLAMMATIONS 189 of the perineal region, from whatever cause, is liable to be a source of nervousirritation, which may develop serious consequences out of all proportion to thegravity of the original lesion. END O CERVICITIS Before taking up the gonorrheal infections of the endocervix and endometrium it is advis-able to review briefly several important facts about the structure of the cervix and body of theuterus which are not always sufficiently
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