Bartholin's Gland Cyst
A Private Matter
Near the opening of the vagina, on each of the labia (vaginal lips) there are two small glands, normally invisible, that are called Bartholin's glands. These glands produce a fluid that keeps the vaginal lips lubricated, however, if skin grows over the opening of one of the glands the fluid backs up, causing a cyst. The swelling or cyst can grow in size from that of a penny to larger than an orange. However, they seldom grow beyond the size of a golf ball. These cysts are tender and most of the time they aren't infected.
Bartholin's gland cysts and abscesses are usually found in women of reproductive age. Normally they don't cause a great deal of pain; they grow slowly, and often go away on their own. But, if the cyst becomes infected, it takes on the characteristics of a boil and it becomes very painful, increasing in size over a short period of a few days. Walking and sexual intercourse may become very uncomfortable or painful. When the cyst becomes infected, professional treatment is recommended.
What Is A Bartholin's Gland Cyst?
In most cases, the cause of Bartholin's gland cysts is unknown. The cyst occurs if the duct of the gland becomes blocked for any reason. Infection, injury, or chronic inflammations are possible causes. Rarely is cancer a concern however, it is a possibility in women over the age of 40. Abscesses may be the result of sexually transmitted bacteria, like those that cause Chlamydia or gonococcal infections, or they may be the result of bacteria that normally occurs in the vagina. Biopsies have revealed over 60 types of bacteria found in the Bartholin's gland abscesses.
An abscessed Bartholin's gland has the following symptoms: pain that happens when walking, sitting, with physical or sexual activity; fever and chills; increased swelling in the vulva area over a two-to four-day period; and drainage from the cyst that occurs normally four to five days after the swelling starts.
Diagnosing and Treating the Cyst
Diagnosis is made through a gynecological pelvic exam. If the cyst appears to be infected, then a culture is taken to identify the type of bacteria that is causing the infection. Treatment depends upon the size of the cyst, whether it is infected and painful, and the age of the woman. If the cyst is not infected treatment may include watchful waiting to see if it develops into anything more than a swelling; soaking the genital area in a few inches of warm water (called a sitz bath); using warm towel compresses in the area of the cysts; and taking non-prescription pain killers to relieve discomfort. These methods allow the cyst to come to a head and drain with relatively little pain and discomfort.
Treatment for Abscessed Bartholin's Gland Cysts
Alternatively, if the gland is infected, the treatment changes to include (along with a sitz bath), treatment with antibiotics and prescription pain medication (if necessary). The doctor may perform an incision and drainage procedure where he cuts into the cyst and drains the fluid. This is usually not very successful and the cyst often returns. A Word catheter (a small tube) may be inserted into the cyst and left there for several weeks so the fluid can drain. This also prevents recurrence of the cyst.
Another procedure that can be done is called marsupialization. A small cut is made in the cyst to drain the fluid then stitches are placed at the edge of the cyst to allow a small opening to form. Other types of treatment include window operation; the use of a carbon dioxide laser to open the cyst and heat the cyst wall tissue so that the cyst cannot form a sac and recur; or the removal of the entire Bartholin's gland cyst if it continues to recur and does not respond to other treatment