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Bartholin’s duct cysts and abscesses are common vaginal lesions that can cause a lot of discomfort to a woman. Although usually not serious, they should be followed closely and treated by your gynecologist.
Bartholin’s glands are small glands on either side of the vagina. These glands drain lubricating fluid through small 2-centimeter ducts into the vagina. Blockage of the Bartholin’s ducts can occur, leading to the development of a Bartholin’s duct cyst. If the cyst becomes infected, it is called a Bartholin’s gland abscess. Most women describe a “bulge” in the vaginal area that is often extremely tender when infected. With infected abscesses women often have trouble sitting or walking.
Anyone at any age can be affected by a Bartholin’s duct cyst. There is no certain ethnic group that is more likely to be affected. The greatest risk factor for developing cysts is prior history of cysts. They can be caused by trauma, infection, or other material that blocks the Bartholin’s duct. In the past, it was thought that Bartholin’s duct abscesses were caused by gonorrhea, but it is now thought that bacteria normally found in the vagina can be responsible.
Diagnosis of a Bartholin’s duct cyst is made on clinical exam by your physician. Women often notice swelling in the vaginal area. Often there is also tenderness with infection (abscess). Women often complain of dyspareunia (painful intercourse) with Bartholin’s duct cysts. Pain is often more severe if an abscess has formed and is often made worse by sitting or walking. On examination your physician will notice swelling and redness of the labia minora, the area just next to the vagina.
If you are under 40 years old and have a small Bartholin’s duct cyst, your physician may advise you to just leave it alone. Warm sitz baths may relieve mild tenderness. Some women display no symptoms from a small Bartholin’s cyst, and do best if the cysts are left intact. If you are over 40 years old, your physician may suggest removing the cyst or taking a biopsy of the cyst wall. Cancer of the Bartholin’s gland is rare, but about 10% of patients have a history of a prior cyst or abscess in this area.
If your Bartholin’s duct cyst is large or has an abscess, your physician may recommend placement of a word catheter. This is a minor procedure that your physician will often perform in his or her office. The physician will make a small incision over the swollen gland and insert a small rubber tube into the cyst. This tube will drain fluid from the cyst/abscess. The tube will stay in place from one to two weeks, or until it falls out on its own. The goal of the word catheter placement is to create a new tract from which the lubricating fluid can drain.
Alternatively, your physician may suggest marsupialization of your Bartholin’s cyst. This also is a procedure that can be done in the phsician’s office or may be done on an outpatient basis in the operating room. During a marsupialization procedure, your physician will make a small incision in the cyst wall, and by suturing will surgically create a new tract for drainage of fluid.
Finally, your physician may suggest surgically removing your Bartholin’s gland. This is often suggested for patients over 40 who have symptomatic cysts or abscesses. This procedure is done on an outpatient basis in the operating room.
At this time no specific actions have been proven to prevent Bartholin’s duct cysts and abscesses. If you notice a bulge or discomfort in the vaginal area, it certainly is prudent to consult your gynecologist for further evaluation and treatment.
Thomas G. Stovall, M.D.
Dr. Stovall is a Clinical Professor of Obstetrics and Gynecology at the University of Tennessee Health Science Center in Memphis, Tennessee.
Date Published: 2004-03-04
*The recommendations and information provided by this Web site are for educational purposes only. This Web site does not contain comprehensive coverage of the topics addressed, and is not a substitute for direct consultation with your health care provider. Always consult a health care provider regarding your specific condition. Trademarks referred to are the property of their respective owners.
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