An Overview of Bartholin's Cyst

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A Bartholin's cyst occurs when a woman's Bartholin's glands—the glands responsible for the lubrication of the vagina—get filled up with its fluid. The openings of the glands, which are located on either side of the vaginal entrance, sometimes get blocked and this makes the gland’s fluids back up into them. When that happens, a cyst develops.

The cyst is usually soft and painless and doesn’t cause any problems. However, it’s possible for it to get infected and cause a painful, pus-filled mass called an abscess. Also, the cyst sometimes grows to become very large and visible and starts to cause discomfort, interfering with sitting, walking, and other related activities.

Bartholin's cysts generally only occur on one side of the vaginal opening and it is also known as Bartholin's gland cyst and Bartholin’s duct cyst. 

About 2 percent of women develop a Bartholin's cyst at one point in their lives. It is most common between sexually active women between the ages of 20 and 30. The older you get, the less likely you are to develop cysts because the glands often start shrinking by the time you reach the age of 30.

Symptoms

In many cases, these cysts don’t cause any symptoms whatsoever, and you may just on your own discover a painless lump at the opening of your vagina or when undergoing a pelvic exam. If you experience unexplained discomfort while walking, sitting, or during sexual intercourse, it could also be a sign you have a Bartholin's cyst.

Symptoms that the cyst has become infected and/or become an abscess include:

  • Pus in/coming out from the cyst 
  • Pain and/or tenderness at the site of the cyst 
  • High body temperature 
  • Redness, swelling, and firmness of the cyst

Causes

Bartholin's cysts form when there’a blockage at the opening of the gland. This then causes the gland's fluid to accumulate there and a cyst is formed. Most times, it isn't known what causes the blockage/obstruction.

Although this rarely happens, a Bartholin's gland cyst can be caused by sexually transmitted diseases like gonorrhea and chlamydia. Vulvovaginal surgery is also another rare cause of a Bartholin's cyst.

The cyst may get infected by bacteria like E. coli and an abscess could form as a result of this infection.

Diagnosis

Your doctor will diagnose a Bartholin's cyst by a pelvic examination. Your doctor will also be able to tell from this pelvic exam whether the cyst has become infected or formed an abscess yet.

If you’re over the age of 40 and have undergone or are undergoing menopause, your doctor may order a biopsy of the cyst to rule out the chances of you having vulvar cancer. A biopsy involves removing the cyst or a small part of it and having it microscopically examined.

Treatment

If your Bartholin's cyst is asymptomatic—that is, you don't experience any symptoms at all—you may not have to do anything at all to treat it. However, you should make sure to report any changes in size or shape to your doctor.

At-Home Treatment

If your cyst is painful, tender, or causing you some discomfort, your doctor may recommend you take sitz baths, which simply involves you soaking the area in warm water. Your doctor may recommend you do this several times daily for a couple of days. The cyst may disappear after this treatment. Your doctor may also recommend that you get some painkillers to help with the pain and discomfort.

Step-by-Step Instructions for Taking a Sitz Bath

Surgical

If the cyst does not disappear after the at-home treatments, or your doctor feels like it's necessary because the cyst is infected or particularly large, you may have to undergo a minor surgery. 

The different surgical options available are:

  • Simple drainage: The cyst can simply be cut open and the fluids drained out of it. This, however, is regarded as ineffective and isn't commonly done because the cyst tends to come back.
  • Catheter insertion: In order to drain the cyst and prevent it from coming back, your doctor may insert a balloon-tipped catheter (also known as Word catheter) into it. How this works is that a cut is made in the cyst, and the fluid in it is drained out. Your doctor will then insert and inflate a balloon catheter into the emptied out cyst. The catheter will be left in place for a minimum of four weeks for a permanent opening to form. This way, there’ll always be a drainage passage there and future build-up of fluids will be prevented.
  • Marsupialization: This involves making a small cut in the cyst, draining it out, and then stitching the edges of the skin there onto the surface of your vulva to create a permanent drainage passage. This procedure generally requires the use of general anesthesia and is mostly only recommended for recurring cysts.
  • Surgical excision: If other methods of treating your Bartholin's cyst have failed and it continues to recur, your doctor may recommend that your Bartholin's gland is removed completely.

Medication

If your cyst is infected, your doctor may prescribe antibiotics to clear up the infection.

Other procedures

There are other less commonly used procedures that can be used to treat your Bartholin's cyst. One such procedure is needle aspiration, which involves using a needle and syringe to drain the cyst. Another such procedure involves using a carbon dioxide laser to open up the cyst which is then drained, and the cyst enclosure is vaporized/destroyed.

Lifestyle

If you had surgery to treat your Bartholin's cyst, it’s important that you keep the area clean and regularly soak it in warm water to promote healing—per your doctor's instructions.

While there’s no way to prevent a Bartholin's cyst from developing, practicing safe sex is medically believed to reduce your chances of developing one.

A Word From Verywell

Having a Bartholin's cyst is by no means life-threatening. Chances are that your cyst will resolve on its own or respond very well to minor surgical treatment. However, if you’re going to undergo surgery to treat it, it’s important that you discuss your options with your doctor in a comprehensive manner. Particularly, you should make sure that all the possible complications that could arise from the procedures are disclosed to you. Also, surgery or not, you should keep in mind that there’s always a possibility that your cyst will recur.

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