How should I manage recurrent Bartholin's cysts in a patient who has already undergone incision and drainage?

Appropriate management for recurrent Bartholin's cysts after prior incision and drainage involves marsupialization as the preferred next step. This procedure creates a permanent drainage tract by suturing the cyst wall to the skin, reducing recurrence risk compared to simple incision and drainage alone ¹.

Incision and drainage often provide only temporary relief, with high rates of recurrence because the cyst lining remains intact. Marsupialization addresses this by allowing continuous drainage and preventing re-accumulation of fluid (Ozdegirmenci et al., 2009).

Alternative treatments such as silver nitrate application have been studied but marsupialization remains the standard surgical approach for recurrent cases due to better long-term outcomes (Ozdegirmenci et al., 2009) ¹.

In cases where marsupialization fails or cysts recur multiple times, more definitive surgical options like gland excision may be considered, but these carry higher risks and are reserved for refractory cases ¹.