Marsupialization

Marsupialization (from Latin marsupium — pouch, purse) is a reconstructive surgical technique used to treat cystic formations by creating a wide, continuously functioning anastomosis between the cyst cavity and the external environment.

Etiology and pathophysiology

During the traditional linear incision and drainage of the cyst, the wound edges tend to adhere and seal with fibrin quickly, leading to the closure of the opening and recurrence of secretion accumulation. The marsupialization technique involves wide excision of a “window” in the cyst wall, evacuation of contents, and suturing the edges of the cyst capsule to the vulvar mucosa around the entire perimeter of the incision with interrupted stitches. This transforms the closed cavity into an open “pocket,” which eventually epithelializes and narrows, forming a new duct outlet.

Clinical significance

This method is the standard treatment for recurrent cysts and abscesses of the Bartholin gland. Its main advantage over extirpation (complete removal) of the gland is the preservation of the functioning parenchyma of the organ. This ensures the continuation of secretion production necessary for physiological lubrication of the vaginal vestibule, preventing dryness and dyspareunia.