Most patients pain free after surgical removal of Bartholin's glands. (Vulvar Vestibulitis).

PALM BEACH, FLA. -- Up to 97% of patients with vulvar vestibulitis can become totally pain free after surgical excision of the Bartholin's glands, said Dr. Michael Baggish, one of the pioneers of this technique.

"It's my belief that this problem, which I am now seeing in almost epidemic proportions in the United States, stems from dysfunctional mucous glands in the vulva. You can pinpoint this in virtually every case of vestibulitis, and the Bartholin's glands seem to be the most frequently affected," Dr. Baggish noted during an interview.

Other vulvar glands that are less often involved include Skene's, as well as the paraurethral glands, he said at an ob.gyn. meeting sponsored by the University of Chicago.

A more commonly used surgery involves the simple excision of the hymen and perihymenal tissues or photocoagulation of the vestibular dermis and epidermis.

The problem with simple excision is that it simply excises the glandular ducts, leaving the glands themselves still in place.

About 45% of patients report good results with the simple vestibular excision technique, said Dr. Baggish, who is professor of ob.gyn. at the University of Cincinnati.

"Results are objectively better with removing the gland, rather than just excising the skin. It's not a skin-deep problem. If you're going to take the duct of the gland, what happens to the gland? In some cases it will atrophy," he said at the meeting.