Bartholin's cyst

Bartholin's glands are two mucus glands located beneath the skin on each side of the vaginal opening that help lubricate the external genitalia. A Bartholin's cyst is an accumulation of fluid in one of these glands. If there's an associated bacterial infection, it can become inflamed.


Causes/associated factors
If a Bartholin's gland becomes obstructed, fluid is retained and a cyst will form. An obstruction may develop due to trauma or an infection. Rarely, sexually transmitted bacteria that cause chlamydia or gonorrhea are to blame. Often, however, the cause is unknown. Bartholin's cysts are most common in women ages 20 to 29.

Symptoms
Normally, you can't see or feel the Bartholin's glands. When a cyst develops, there are typically few symptoms other than a relatively painless lump. Sometimes, however, a cyst can become painful and may even cause discomfort during sex. If the gland becomes infected with bacteria, an abscess (collection of pus) can develop. A Bartholin's abscess is typically very painful, red and swollen.

Diagnosis
The doctor will ask questions about your medical history and do a physical exam. Lab studies, such as a drainage culture, can help the doctor determine what type of bacteria is present in the fluid of the cyst. If you're past menopause, the doctor will make sure an enlarged Bartholin's gland isn't cancerous. (Bartholin's cysts are very rare in postmenopausal women.)

Treatment
If your Bartholin's cyst is only mildly painful or you have just a small abscess, your doctor may recommend warm compresses to the area or a sitz bath (sitting in warm bath water) three to four times a day to promote spontaneous drainage of the cyst. A surgical incision and drainage is usually done if a large abscess forms. You may be given antibiotics after the drainage to help prevent a secondary infection. Sometimes a small catheter (a flexible tube) is placed in the cyst to help it drain and keep it from sealing up again. This can be done in the doctor's office.
To help prevent cyst recurrence, your doctor may recommend a surgical procedure called marsupialization. With this procedure, the cyst is drained and its outer edges are sewn to the skin to form an opening that will allow continuous drainage and prevent recurrences. This surgery is usually done in an operating room. In some cases, a catheter is placed in the cyst at the same time. If the procedure doesn't prevent recurrences, the doctor may suggest removing the Bartholin's gland.


Complications
Recurrences of a Bartholin's cyst are common. Rarely, the lubricating action of the gland is lost and vaginal dryness or painful sex may occur after treatment.

Pregnancy-specific information
If necessary, a Bartholin's cyst or abscess can be treated during pregnancy. If the cyst isn't painful, large or infected, however, treatment may be postponed until after delivery.

Senior-specific information
Bartholin's cysts are rare after age 40.

Prevention
Bartholin's cysts are very common. Since the bacteria that produce gonorrhea can cause a Bartholin's abscess, avoid sex until it's determined what bacteria caused the cyst. Good genital hygiene may also help prevent infection.