02-20-2008, 12:10 PM
A 26-year-old woman comes to the physician because of a lump in her vagina. The lump is
nontender but is uncomfortable when she walks. She states that for the last 6 years this lump
has appeared about once a year. When it occurs she goes to the doctor who puts a catheter
into it, which is taken out in a few weeks. She has no other medical problems. She is sexually
active with two partners. Examination shows a cystic mass approximately 4 cm in diameter on
the right side of the vagina near the hymeneal ring. The mass feels like a discrete cyst. The
rest of the pelvic examination is unremarkable. Which of the following is the most appropriate
next step in management?
1.Expectant management
2.Oral antibiotics
3.Intravenous antibiotics
4.Incision and drainage
5.Bartholin's cyst marsupialization
nontender but is uncomfortable when she walks. She states that for the last 6 years this lump
has appeared about once a year. When it occurs she goes to the doctor who puts a catheter
into it, which is taken out in a few weeks. She has no other medical problems. She is sexually
active with two partners. Examination shows a cystic mass approximately 4 cm in diameter on
the right side of the vagina near the hymeneal ring. The mass feels like a discrete cyst. The
rest of the pelvic examination is unremarkable. Which of the following is the most appropriate
next step in management?
1.Expectant management
2.Oral antibiotics
3.Intravenous antibiotics
4.Incision and drainage
5.Bartholin's cyst marsupialization