Patient education: Bartholin gland cyst (The Basics)

What is a Bartholin gland cyst? — This is a small sac of fluid that forms when the opening of a Bartholin gland is blocked. There are 2 Bartholin glands, 1 on each side, just below the opening of the vagina (figure 1).

The Bartholin glands make small amounts of fluid. The fluid helps keep the vulva (the area around the opening of the vagina) moist. If something blocks the opening of a Bartholin gland, fluid can build up and form a cyst. This usually happens in just 1 gland, not both at once.

What are the symptoms of a Bartholin gland cyst? — You might notice a lump in your vulva, but Bartholin gland cysts often do not cause any other symptoms. If they do, the main symptoms are pain or discomfort when you walk, sit, or have sex.

If a Bartholin gland cyst gets infected, it can form an abscess. An abscess is a pocket of pus. Symptoms of a Bartholin abscess include:

●Severe pain – It might be painful to walk. You also might not be able to sit or have sex.

●Swelling

●Redness

Should I see a doctor or nurse? — See your doctor or nurse if:

●You see or feel a lump in your vulva.

●It is painful to walk, sit, or have sex.

Will I need tests? — Your doctor or nurse might do a test called a "biopsy" to check for cancer, but this is only done in some situations. Cancer in a Bartholin gland is rare, but it can happen. For a biopsy, the doctor takes a small sample of tissue from the area. Then, they send the tissue to a lab. Another doctor looks at it under a microscope to check for cancer.

How is a Bartholin gland cyst treated? — Treatment depends on the size of the cyst, whether it is causing symptoms, and whether the cyst is infected (abscess). If you do not have symptoms, you might not need any treatment. Otherwise, treatments can include:

●Expectant management – This means trying to get the cyst to drain on its own. Your doctor or nurse might ask you to apply warm (not hot) compresses to the affected area or take sitz baths to help with this.

●Draining the cyst or abscess – Your doctor might cut a small hole in the cyst to let fluid or pus out. They can also place a tiny balloon in the hole to keep it from closing completely. The balloon is connected to a tiny tube called a "catheter" that helps fluid drain from the Bartholin gland. The doctor takes the balloon out in about 1 month. It leaves a small opening where fluid can drain. This procedure is often done in a doctor's office. But if you have a large or deep abscess, you might need treatment in the hospital.

A sample of the pus or fluid will be sent to a lab for testing. If it shows certain types of bacteria or infections, you might need antibiotics. Often, antibiotics are not needed. But you might get them in some cases, like if you have had an abscess before, have other symptoms (such as fever), or have a sexually transmitted infection.

●Surgery – Doctors can also do a small surgery if draining the cyst and putting in a balloon does not work well. They can make a new opening to help the gland drain fluid. Or they can remove the gland as well as the cyst or abscess. But surgery has a higher risk of side effects than other treatments, so doctors only do this if the other treatments did not work.

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