Topic Overview
What are the Bartholin glands?
The Bartholin
glands are in a woman's genital area. They are two pea-sized organs under the
skin. They are on either side of the folds of skin (labia) that surround the
vagina
and
urethra
. Normally, you cannot feel or see the
Bartholin glands.
The Bartholin glands make a small amount of
fluid that moistens the outer genital area, or
vulva
. This fluid comes out of two tiny tubes next to
the opening of the vagina. These tubes are called Bartholin ducts.
What are Bartholin gland cysts?
If a Bartholin
duct gets blocked, fluid builds up in the gland. The blocked gland is called a
Bartholin gland cyst
. (Sometimes it is called a Bartholin duct cyst.) These cysts
can range in size from a pea to a large marble. They usually grow slowly. If
the Bartholin gland or duct gets infected, it is called a Bartholin gland
abscess
.
Bartholin gland cysts are often
small and painless. Some go away without treatment. But if you have symptoms,
you might want treatment. If the cyst is infected, you will need treatment.
What are the symptoms of a Bartholin gland cyst or abscess?
If a Bartholin gland cyst is not infected, you will
likely feel a painless lump in the vulva area. You may have some redness or
swelling. The size of a cyst can be about
0.25 in (0.6 cm) to
1 in (2.5 cm). You may find
the cyst on your own, or your doctor may notice it during a physical exam.
If a cyst gets infected, it will probably hurt a lot. An infected
cyst forms an
abscess
. A gland is probably infected if you are in
extreme pain and have trouble even walking or sitting. This abscess can get
bigger over 2 to 4 days.
What causes a Bartholin gland cyst?
A Bartholin
gland duct can get blocked by infection, swelling, or thick mucus.
1
When a duct gets blocked, fluid builds up and creates a cyst.
The cyst can get bigger after sex because the glands make more fluid during
sex.
1
Can you prevent Bartholin gland cysts?
You cannot
prevent Bartholin gland cysts.
Infected Bartholin cysts are sometimes caused by
sexually transmitted diseases (STDs)
. You can lower
your risk of infection by using a condom when you have sex.
How are they treated?
In some cases, you may not
need to treat a Bartholin gland cyst. Some cysts go away without treatment. But
if you have symptoms, you might want treatment. If the cyst is infected and
painful, you will need treatment. Your gynecologist or family doctor can treat
a Bartholin gland cyst.
If the cyst is infected, it may break open and start
to heal on its own after 3 to 4 days. Call your doctor if you have a lot of
pain or a fever.
At home, you can take a nonprescription pain
medicine such as ibuprofen (Advil, Motrin) to relieve pain. To help healing,
soak the area in a shallow, warm bath, or
sitz bath
. Do not have sex while a Bartholin cyst is
healing.
If a Bartholin gland abscess comes back several times,
your doctor may surgically remove the gland and duct.
Frequently Asked Questions
|
Learning about Bartholin gland cyst:
|
|
|
Being diagnosed:
|
|
|
Getting treatment:
|
|
|
Ongoing concerns:
|
|
Symptoms
A small
Bartholin gland cyst
most often has no symptoms. But a
large cyst or infection can cause symptoms.
Bartholin gland cyst that is not infected
Symptoms
may include:
- A painless lump in the
vulva
area. It is possible, though unlikely, for both
glands to develop cysts at the same time.
- Redness or swelling in
the vulva area. A Bartholin gland cyst can swell from about
0.25 in (0.6 cm) to
1 in (2.5 cm).
- Discomfort when walking, sitting, or having sex.
You may find a Bartholin cyst on your own, or your doctor
may notice it during a physical exam.
Infected Bartholin gland cyst (abscess)
Symptoms
may include:
- Increasing pain that limits activities or
occurs with walking, sitting, physical activity, or sex.
- Fever and
chills.
- Swelling in the vulva area over a 2- to 4-day
period.
- Drainage from the cyst. Drainage may occur 4 to 5 days
after the swelling starts.
To prevent complications, an
abscess
that opens (ruptures) on its own should be
checked by a doctor.
Exams and Tests
Unless a
Bartholin gland cyst
is causing symptoms, you may not
know you have one. You or your doctor are most likely to notice one if it is
big enough to be uncomfortable, creates a lump you can see or feel under the
skin, or is infected.
If you are older than 40, your doctor may
more carefully examine a lump to make sure that it is not cancerous. Although
cancer is rare, a woman's risk increases with age.
A Bartholin
gland abscess is diagnosed based on signs of infection, such as fever or
swelling, and pain in the
Bartholin gland area
. Your doctor may
culture
some of the fluid drained from the abscess.
Culture results show what type of bacteria are causing the infection. Knowing
this helps your doctor choose an antibiotic for you. More than 60 different
types of bacteria have been found in Bartholin gland abscesses, including
gonorrhea
and
chlamydia
.
Treatment Overview
Most
Bartholin gland cysts
don't need treatment, or they go
away on their own. But if you have a cyst that is causing bothersome symptoms
or that may be infected, see your doctor for treatment. Your treatment options
will depend on how severe your symptoms are.
Treatment for a Bartholin gland cyst that is not infected
When a Bartholin gland cyst appears, but there are no
symptoms or mild symptoms, treatment includes:
-
Watchful waiting
. Symptoms are watched without using medical treatment. Some
Bartholin cysts never get worse.
- Soaking the genital area in a
warm, shallow bath (
sitz bath
). This can reduce discomfort
and helps the genital area to heal.
-
Nonprescription pain medicine, such as ibuprofen (Motrin, Advil) or acetaminophen (Tylenol)
to relieve discomfort.
A Bartholin gland cyst can be present for months or years
without causing any symptoms.
If sexual intercourse causes
symptoms, talk to your doctor.
Treatment for a ruptured Bartholin abscess
An
infected Bartholin gland cyst (
abscess
) that has burst open (ruptured)
sometimes will heal on its own. In this case, your doctor may suggest sitz
baths, nonprescription pain relievers, and watchful waiting. You may not need
to take antibiotics after the cyst has ruptured.
Treatment for a Bartholin gland cyst that causes symptoms
A Bartholin cyst that is large, painful, or infected will be
drained. If you have an abscess, you may take antibiotics after the procedure.
Simply draining a cyst and letting it heal shut will likely
allow it to fill up again. To keep the cyst from closing and filling up again,
it is usually held open for a few weeks with:
- A Word catheter, which is a small drainage
tube with a small balloon on one end. The balloon is inflated inside the cyst
to keep the tube in place. After the gland has healed and the tube and balloon
are removed, the opening remains. This is the most common way to treat a large
or infected Bartholin gland cyst.
- A small piece of gauze which
keeps the cyst from closing.
- Stitches, which prevent the cyst wall
from reforming a closed sac. Bartholin gland cysts only come back in about 5 to
10 out of 100 women after this procedure.
2
Less commonly, the cyst wall is damaged with a
carbon dioxide laser
or silver nitrate to prevent it
from growing back.
Bartholin cyst treatment can be done with a
local anesthetic
in the doctor's office. But a painful
cyst is more likely to be surgically treated using
general anesthesia
.
For severe Bartholin
cysts and abscesses that do not get better with repeated treatment, the entire
Bartholin gland and duct can be removed. This is a surgery, also known as
excision. Because excision is an involved procedure
that can lead to blood loss and complications, it is done in a surgery center.
Excision is only used when other treatments have repeatedly failed.
What to think about
To reduce the risk of
infection after treatment, do not have sexual intercourse until the area is
completely healed. This can take several weeks, depending on the treatment
method that was used.
Excision is sometimes recommended for
postmenopausal
women who have Bartholin gland cysts or
abscesses. This is because of general concerns about the risk of cancer in the
pelvic area, which increases with age. But simply draining a Bartholin cyst and
testing the cyst tissue for cancer is also a reasonable first-time treatment
for older women.
Treatment during pregnancy
If you are pregnant
and have a Bartholin gland cyst, your treatment will depend on how severe your
symptoms are and whether you have an infection.
- When possible, draining a cyst is delayed
until after your baby is born. This is because the genital area has increased
blood flow during pregnancy, so bleeding is more likely. A large cyst, though,
may need to be drained to prevent problems during delivery.
- Because
having an infection can cause you to go into labor before your due date, an
abscess is drained and treated with antibiotics. Antibiotics and local
anesthesia are considered safe during pregnancy.
Home Treatment
Watchful waiting
and home treatment may be all that you need for a
Bartholin gland cyst
that has:
- No symptoms.
- Mild
symptoms.
- Opened and drained on its own. (See your doctor to make
sure that other treatment is not needed.)
You can help relieve Bartholin gland cyst discomfort by
taking warm
sitz baths
and
nonprescription pain medicine.
Call your
doctor if your symptoms become worse or do not improve as expected. If you have
signs of infection, such as fever, chills, pain, redness, or sudden swelling,
see your doctor for treatment.
Other Places To Get Help
Organization
|
American Academy of Family
Physicians
|
| P.O. Box 11210 |
| Shawnee Mission, KS 66207-1210 |
| Web Address: |
www.familydoctor.org |
| |
|
The American Academy of Family Physicians produces a
variety of health-related educational materials. Its Web site offers a health
library and bulletin board, news, and comments sections.
|
|
References
Citations
-
Eilber KS, Raz S (2003). Benign cystic lesions of the
vagina: A literature review. Journal of Urology, 170(3):
717–722.
-
Eckert LO, Lentz GM (2007). Infections of Bartholin's
glands section of Infections of the lower genital tract. In VL Katz et al.,
eds., Comprehensive Gynecology, 5th ed., pp. 571–573.
Philadelphia: Mosby Elsevier.
Other Works Consulted
-
Mazdisnian F (2007). Bartholin's duct cyst and abscess
section of Benign disorder of the vulva and vagina. In AH DeCherney et al.,
eds., Current Diagnosis and Treatment in Obstetrics and Gynecology, 10th ed., pp. 618–619. New York: McGraw-Hill.
Credits
|
Author
|
Sandy Jocoy, RN |
|
Editor
|
Kathleen M. Ariss, MS |
|
Associate Editor
|
Pat Truman, MATC |
|
Primary Medical Reviewer
|
Joy Melnikow, MD, MPH - Family Medicine |
|
Specialist Medical Reviewer
|
Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology |
|
Last Updated
|
February 4, 2009 |
