Impact of Treatment Modality on Pain, Sexual Function, and Psychological Well-Being in Patients With Bartholin's Duct Cyst and Abscess: A Prospective Observational Cohort Study.

BACKGROUND Bartholin's duct cyst and abscess are common benign vulvar conditions. Optimal treatment varies according to recurrence, pain, and patient-centered outcomes. Comparative evidence regarding Word catheter placement, silver nitrate, and marsupialization is limited. MATERIAL AND METHODS This prospective observational cohort study included 111 women diagnosed with Bartholin's duct cyst or abscess between December 2020 and May 2021. Patients underwent treatment according to clinical practice, physician preference, and patient choice. Pain intensity (primary outcome), sexual function, and psychological status were evaluated using the Visual Analog Scale (VAS), Female Sexual Function Index (FSFI), and Hospital Anxiety and Depression Scale (HADS), respectively. Recurrence and postoperative analgesic requirements were also evaluated. Assessments were performed before treatment and on postoperative day 1, week 1, and month 1. RESULTS All treatment modalities were associated with significant reductions in pain intensity according to the VAS (all P<0.001). In the Word catheter group, significant changes were observed in VAS (P<0.001), HADS-anxiety (P<0.001), and FSFI (P=0.044) scores. In the silver nitrate group, significant improvements were observed in VAS (P<0.001) and HADS-anxiety (P=0.026) scores; FSFI score alterations were not statistically significant (P=0.209). In the marsupialization group, significant improvement was observed in VAS scores (P<0.001); FSFI (P=0.412) and HADS-anxiety (P=0.236) score alterations were not statistically significant. CONCLUSIONS Word catheter placement, silver nitrate, and marsupialization had distinct effects on pain relief and psychological outcomes; sexual function outcomes were comparable. Treatment selection should consider patient-centered outcomes and clinical resolution.