Bartholin's Cysts

There are two small glands located on either side of the opening to the vagina call Bartholin’s glands. It is done of many glands and mechanisms that keep the vagina lubricated. They produce a gelatinous lubricating fluid. Sometimes the small duct between the glands and the vagina becomes obstructed, and the lubricating gluid collects inside the Bartholin’s gland, making the Barholin’s gland and duct expand into a cystic structure that causes a bulge out toward the vulva or vagina. This is called a Bartholin’s cyst.

If a cyst is not infected, there may be no symptoms, or simply a sensation of pressure when sitting or standing for a prolonged time, or during sexual activity.

Sometimes this cyst becomes infected and pus collects within the duct. This is called a Bartholin’s abscess.

If it becomes infected, if is typically excruciatingly painful, to the point that sitting is difficult and work is usually not possible, sex is painful or impossible and a fever may occur.

Sometimes a Bartholin’s abscess will resolve with antibiotics and hot soaks, either by gradually disappearing or by bursting and draining. More commonly, Barthlin’s abscesses require surgical drainage, and antibiotics simply delay that process.

The challenge with Bartholin’s cysts and abscesses is to keep the opening between the skin and the gland open long enough to allow the cyst or abscess to resolve and heal before the skin incision heals over. Thus it is uncommon for a physician to simply drain the cyst. More commonly it is incised and drained and a tiny drain placed through the skin incision to allow the drainage to continue and the skin incision to stay open for several more days. Alternatively, the cyst or abscess is marsupialized. The means that the edges of the cyst are sutured to the skin edge at the incision to keep the skin incision open several more days.

In patients who have Bartholin’s cysts or abscesses and who are more than 50 years old, cancer of the Bartholin’s gland must be ruled out. If a Bartholin’s cyst or abscess occurs in someone more than 50, it is usually removed surgically rather than incised and drained, or marsupialized. At the very least, it needs to be biopsied.