Sexual medicine · 2026
The effect of Bartholin gland diseases on female sexual function, sexual distress, and genital self-image: a prospective cohort study.
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Dağıstanlı Funda, Yıldız Pınar Fatma, Şafak İhsan, Ekici Mustafa Ayhan
Аннотация
INTRODUCTION: Bartholin gland disease impairs sexual function, yet most studies focus on surgical technique rather than the broader sexual health burden, and none has systematically examined sexual distress or genital self-image in this population. We aimed to characterize the sexual health burden of Bartholin gland disease across four domains: pain (Visual Analogue Scale [VAS]), sexual function (Female Sexual Function Index [FSFI]), sexual distress (Female Sexual Distress Scale-Revised [FSDS-R]), and genital self-image (Female Genital Self-Image Scale [FGSIS]), at two time points (before and after treatment) and to compare findings against matched healthy controls.
METHODS: This prospective cohort study enrolled 25 women diagnosed with a Bartholin gland cyst or abscess (patient group) and 25 age-matched healthy controls at a single training and research hospital. Patients were evaluated twice: at presentation before any treatment (T1) and after symptom resolution (T2). Controls were assessed once. Outcome measures were the VAS (applied to patients only), FSFI (cut-off <26.55), FSDS-R (cut-off ≥11), and FGSIS. Sample size was calculated a priori (d = 0.80, α = 0.05, power = 80%; G*Power 3.1).
RESULTS AND DISCUSSION: Groups were comparable for age (36.1 ± 6.6 vs. 34.2 ± 7.6 years, P = .472), body mass index (BMI), and parity. At T1, 48.0% of patients had clinically significant sexual dysfunction (FSFI <26.55) and 16.0% met the distress threshold (FSDS-R ≥ 11). All four scales improved significantly from T1 to T2 (P < .001 for each). By T2, FSFI (31.72 ± 3.34 vs. 31.11 ± 1.87, P = .187), FSDS-R (1.44 ± 1.69 vs. 0.56 ± 0.65, P = .068), and FGSIS (24.40 ± 2.33 vs. 23.20 ± 1.94, P = .066) no longer differed from controls. Notably, FGSIS was already similar between patients and controls at T1 (22.92 ± 3.28 vs. 23.20 ± 1.94, P = .784). VAS pain scores fell from 5.96 ± 2.64 to 1.04 ± 0.20 (effect size dz = 1.906). T1 FSFI scores did not differ by pathology type (cyst vs. abscess, P = .479) or surgical procedure (P = .866). Strong correlations were observed between FSFI and FSDS-R (r = -0.829, P < .001) and between VAS and FSDS-R (r = +0.561, P = .004). Bartholin gland disease carries a measurable sexual health burden that substantially resolves after treatment. Genital self-image appears to remain intact even during active disease. Systematic screening with FSFI and FSDS-R should be integrated into routine management; surgical decision-making should account for the higher dyspareunia risk associated with marsupialization.
METHODS: This prospective cohort study enrolled 25 women diagnosed with a Bartholin gland cyst or abscess (patient group) and 25 age-matched healthy controls at a single training and research hospital. Patients were evaluated twice: at presentation before any treatment (T1) and after symptom resolution (T2). Controls were assessed once. Outcome measures were the VAS (applied to patients only), FSFI (cut-off <26.55), FSDS-R (cut-off ≥11), and FGSIS. Sample size was calculated a priori (d = 0.80, α = 0.05, power = 80%; G*Power 3.1).
RESULTS AND DISCUSSION: Groups were comparable for age (36.1 ± 6.6 vs. 34.2 ± 7.6 years, P = .472), body mass index (BMI), and parity. At T1, 48.0% of patients had clinically significant sexual dysfunction (FSFI <26.55) and 16.0% met the distress threshold (FSDS-R ≥ 11). All four scales improved significantly from T1 to T2 (P < .001 for each). By T2, FSFI (31.72 ± 3.34 vs. 31.11 ± 1.87, P = .187), FSDS-R (1.44 ± 1.69 vs. 0.56 ± 0.65, P = .068), and FGSIS (24.40 ± 2.33 vs. 23.20 ± 1.94, P = .066) no longer differed from controls. Notably, FGSIS was already similar between patients and controls at T1 (22.92 ± 3.28 vs. 23.20 ± 1.94, P = .784). VAS pain scores fell from 5.96 ± 2.64 to 1.04 ± 0.20 (effect size dz = 1.906). T1 FSFI scores did not differ by pathology type (cyst vs. abscess, P = .479) or surgical procedure (P = .866). Strong correlations were observed between FSFI and FSDS-R (r = -0.829, P < .001) and between VAS and FSDS-R (r = +0.561, P = .004). Bartholin gland disease carries a measurable sexual health burden that substantially resolves after treatment. Genital self-image appears to remain intact even during active disease. Systematic screening with FSFI and FSDS-R should be integrated into routine management; surgical decision-making should account for the higher dyspareunia risk associated with marsupialization.