Marsupialization for the management of Bartholin's gland abscesses: A systematic review and meta-analysis.

BACKGROUND Bartholin's gland abscesses are common among reproductive-age women and are managed through various surgical interventions, including marsupialization, Word catheter placement, and incision and drainage (I&D). However, the optimal treatment remains undefined due to a lack of consensus and comparative efficacy data.

OBJECTIVES To evaluate the effectiveness of marsupialization, Word catheter placement, and I&D for managing Bartholin's gland abscesses, focusing on recurrence rates, healing times, complications, and patient satisfaction.

SEARCH STRATEGY A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. Databases searched included PubMed, Web of Science, Cochrane Library, and Google Scholar up to May 2024. Keywords such as "Bartholin's gland abscess" and "surgical management" were used.

SELECTION CRITERIA Studies were included if they reported recurrence rates, healing times, complications, and/or patient satisfaction after surgical management of Bartholin's gland abscesses. Exclusions included non-English studies, case reports, reviews, and studies with incomplete data.

DATA COLLECTION AND ANALYSIS Nine studies involving 1180 patients were analyzed. Pooled odds ratios (ORs) and confidence intervals (CIs) were calculated, with heterogeneity assessed using I2 statistics.

MAIN RESULTS Across 9 studies (n = 1180), marsupialization (incision-and-suture technique) demonstrated the lowest recurrence (pooled ≈8.3%) and the shortest healing time (≈4.3 ± 1.1 weeks), together with the highest patient satisfaction (median visual analog score [VAS] 4/5), compared with Word catheter (recurrence ≈18.8%; healing ≈6.7 ± 1.8 weeks; VAS 3/5) and I&D (recurrence ≈34.5%; healing ≈7.5 ± 2.0 weeks; VAS 2/5). Complication rates were lowest with marsupialization and highest with I&D.

CONCLUSIONS Marsupialization emerges as the globally superior option for Bartholin's gland abscesses, providing the most favorable balance of recurrence, healing time, complications, and patient satisfaction versus Word catheter and I&D. Future trials should adopt uniform outcome definitions and follow-up schedules to consolidate these findings.