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DRCOG MCQs for Circuit C Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Bartholin's glands are paired greater vestibular glands in the posterior ends of the labia minora. An abscess may arise from a retention cyst, which becomes secondarily infected with Escherichia coli, Staphylococcus or gonococcal organisms. Treatment requires marsupialization.
Equipment, surgery and practical procedures
Published in T. Justin Clark, Arri Coomarasamy, Justin Chu, Paul Smith, Get Through MRCOG Part 3, 2019
T. Justin Clark, Arri Coomarasamy, Justin Chu, Paul Smith
Marsupialisation involves incising and draining the abscess followed by suturing the edge of the infected cyst cavity to the labial skin edges using interrupted, dissolvable sutures to lay it open, reducing the chance of recurrence.
Cysts of the jaws, face and neck
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Large dentigerous cysts may be treated with marsupialization when enucleation and curettage might otherwise result in neurosensory dysfunction or predispose the patient to an increased chance of pathologic fracture post-operatively. Some patients who are not candidates for general anaesthesia may also be treated with a marsupialization procedure in an office setting under local anaesthesia. This permits decompression of the large dentigerous cyst with a resultant reduction in the size of the cyst and bony defect. At a later date, the smaller cyst can be removed as part of a smaller scale surgery.
The spectrum of orbital dermoid cysts and their surgical management
Published in Orbit, 2020
Jasmina Bajric, Gerald J. Harris
Recurrent dermoid cysts form if all epidermal elements are not excised at the time of primary resection. It may be difficult or impossible to excise certain orbital dermoid cysts – cysts that are extremely large, referred to as ‘giant’ dermoid cyst, or those deep in the orbit and adjacent to vital structures such as the optic nerve or superior orbital fissure.4,13,31–33 In such cases, some have advocated evacuating cyst contents to allow for easier dissection around the lesion.4,13 Some have even advocated chemical ablation, with or without surgical excision.7,8,15,34 However, concern over inciting inflammation, particularly surrounding vital orbital structures, and the risk of recurrence have made this approach a poor option. Intentional marsupialization of cyst contents to the skin surface was recommended by some, as an alternative to aggressive surgery that would risk post-operative functional deficits.15 However, others have argued that this approach creates a potential for infection, and thus recommended against it.13 In our experience, marsupialization of a cyst into the maxillary sinus may be a viable option for lesions not amenable to complete resection, without increasing the risk of infection.
The Skene’s gland cyst that was not: an atypical presentation of a leiomyoma
Published in Journal of Obstetrics and Gynaecology, 2020
Erich T. Wyckoff Facog, Girard M. Cua, Leora Lieberman, Ashwin S. Akki
A physical exam revealed an enlarged, non-tender, right-sided 3 cm mass located in the area of the right Skene’s gland; tense and fluid-filled on palpation and consistent with a Skene's gland cyst. The patient was scheduled for incision, drainage, and marsupialisation of the cyst. During the procedure, the cyst was incised, but no cyst fluid was encountered and the mass appeared to be solid and homogeneously glandular. The decision was made to remove the mass in its entirety. A figure of eight 2-0 Vicryl was used to close the deep level of tissue, and the skin was closed with interrupted 3-0 Vicryl sutures. The mass was grossly pink-tan, irregular and rubbery. Cut sections of the mass revealed homogenous pink-tan tissue without haemorrhage or necrosis. The representative sections revealed a nodular or whorled lesion comprised of spindle cells arranged in fascicles and containing eosinophilic cytoplasm and elongated; cigar-shaped nuclei with no atypia. Normal Skene’s gland acini or remnants were not identified within the mass. The spindle cells were strongly reactive to smooth muscle actin and Desmin but non-reactive to S100, CD34, HMB45 and Melan A, supporting the diagnosis of a Leiomyoma (Figure 1(b)). At the patient’s postoperative visit one month later, the incision was determined to be well-healed and the patient had no further issues.
Syringocele: a retrospective study and review of the literature
Published in Scandinavian Journal of Urology, 2019
Frederikke Eichner Sørensen, Martin Skott, Yazan F. Rawashdeh, Hans Jørgen Kirkeby
The adult patients presented with more various symptoms than the children. Five of the 11 adult patients presented with obstructive voiding symptoms, five presented with perineal pain or dysuria, three presented with urethral discharge or post-void dribbling and two presented with UTI. Diagnostic testing in the adult patients was seen to be more inconsistent. Uroflowmetry was performed in 45% of the adult patients, 45% underwent a MRI, and only 27% underwent a retrograde urethrography and interestingly none of the adults had a VCUG done. Two of the 11 adult patients were managed conservatively due to the proximity of the syringocele to the external urinary sphincter. They received instructions on post-void compression of the urethra to minimize post-void dribbling. Nine of the adult patients underwent endoscopic marsupialization. In the children the procedure was performed with a cold knife and in the adults the marsupialization was performed with a monopolar knife (Collin’s knife) (Figure 2). None of the patients developed post-operative urethral stricture. Three of the adult patients were lost to follow-up. One adult patient had persisting symptoms with pain and urinary incontinence. He was re-operated on with closure of the bladder neck and diverted by vesico-appendico-cutaneostomy [9]. Eighty-six per cent of the adult patients had minimal to no symptoms after the treatment.