A woman presents with a fluctuant non tender swelling at the introitus. The best treatment is

Ans. is a i.e. Marsupilisation Fluctuant non tender swelling at the introitus suggests a diagnosis of baholins cyst. Baholins cyst 7 It is the commonest cyst of vulva. Baholins cyst are produced from accumulation of secretions of Baholins gland. The cyst may develop either in the duct (more common) or in the gland Aetiology : cyst formation occurs due to the obstruction of the main duct or opening of an acinus. The cause of obstruction is usually fibrosis which follows either infection or trauma. It was formerly believed that the infection was invarialy gonococcal but almost any orgnaism can be responsible. Left Baholins gland is more often affected than the right. Presentation : Usually presents as a unilateral swelling that bulges across the vaginal introitus. Size of the cyst rarely exceeds hens egg. Swelling is present characteristically on the inner side of the junction of the anterior 2/3rd with posterior 1/3rd of the labium majus. The swelling is fluctuant and usually non tender. May present with discomfo, dyspareunia or infection. Treatment of choice is Marsupialization : Marsupialization is the gratifying surgery for Baholins cyst. It is preferred over traditional exicision operations.