What is Bartholin’s Cyst?

The two Bartholin’s glands are located at the entrance to a woman’s vagina, one on each side. They are small and cannot be seen or felt when they are normal. Their function is to secrete fluid onto the mucosal (inner) surface of the labia-the liplike skin surrounding the vagina.

Problems with the Bartholin’s glands include cysts, which are relatively painless enlargements of the gland, and abscesses, which are infections of the gland. Typically only one of the two glands is affected.

If you have a small, noninfected Bartholin’s cyst, you may not notice it. If the cyst grows, you might feel a lump or mass near your vaginal opening. Although a cyst is usually painless, it can be tender.

A full-blown infection of a Bartholin’s cyst can occur in a matter of days. If the cyst becomes infected, you may experience:

• A tender, painful lump near the vaginal opening
• Discomfort while walking or sitting
• Pain during intercourse
• Fever

A Bartholin’s cyst or abscess typically occurs on only one side of the vaginal opening.

What causes Bartholin’s Cyst?

The Bartholin’s glands are a pair of pea-sized glands found just behind and either side of the lips that surround the entrance to the vagina. The glands aren’t usually noticeable because they’re rarely larger than 1cm (0.4 inches) across.

The Bartholin’s glands secrete fluid that acts as a lubricant during sex. The fluid travels down tiny tubes called ducts, into the vagina. If the ducts become blocked, they can fill with fluid and expand to form a cyst.

It’s often not known why the ducts become blocked, but some cases are linked to sexually transmitted bacterial infections such as gonorrhoea or chlamydia, or other bacterial infections such as Escherichia coli (E. coli).

How is Bartholin’s Cyst diagnosed?

An examination by a doctor can usually diagnose the problem. A Bartholin’s fluid-filled swelling (cyst) and collection of pus (abscess) have a typical appearance. No test is usually needed to make the diagnosis.

Treatments for a Bartholin’s Cyst

If the cyst is small and presents no symptoms the doctor may recommend no treatment – the patient will be asked to report any growth in the size of the cyst. Any lump in the vulval area should be reported, especially if the patient has started the menopause.

If a small cyst causes discomfort, OTC painkillers, warm baths and/or warm compresses against the affected area may help relieve symptoms. A warm bath may also help the cyst to burst.

If an abscess develops, the patient will be prescribed an antibiotic.

The doctor may perform a minor procedure at his/her practice; a catheter is inserted into the cyst and inflated to fix it there. The catheter remains there for 2 to 4 weeks while the fluid is drained and a normal opening is formed.

Marsupialization involves cutting the cyst open and draining the fluid out. The edges of the skin are stitched together while still holding a channel open for the secretions to come through.

Carbon dioxide laser can create an opening so that the cyst is drained.

A needle can be used to drain the cyst (needle aspiration). Sometimes after draining the cyst, the cavity is filled with a 70% alcohol liquid solution for a few minutes before that is drained out.

If the woman has many recurring cysts and does not respond well to any therapies, the doctor may recommend removing the Bartholin’s gland (gland excision).