Am Fam Physician. 1998;57(7):1619-1620
See related article on Bartholin gland cysts.
The Bartholin gland is a tiny organ on each of the labia (vaginal lips), near the opening of the vagina. If the vagina were the face of a clock, these glands would be found at about 4 and 8 o'clock. Normally they are invisible. They put out a small amount of fluid to lubricate the vaginal lips. If a flap of skin grows over the opening to one of the glands, the fluid backs up. It causes a round swelling called a Bartholin gland cyst (say this: sis-st). The cyst can grow from the size of a penny to larger than an orange, although most don't get bigger than a golf ball. They can be tender.
Are Bartholin gland cysts caused by an infection?
Most of the time, Bartholin gland cysts are not infected and can't be spread to others. In some cases, however, they can be caused by an infection, or they may get infected after they get bigger. Your doctor may want to culture the cyst fluid to see if an antibiotic is needed. Most infected cysts contain the normal bacteria that are found on our skin. Some infected cysts, called Bartholin gland abscesses (say this: ab-sess-es), are caused by sexually transmitted germs.
How do I know if I have a Bartholin gland cyst?
You may notice a round, painless or slightly tender bulge within one of the vaginal lips, near the opening of the vagina. The cyst may stay the same size or may slowly grow larger. Cysts that get infected are usually very tender. In extreme cases, walking may be painful. Your doctor will look at the area to see if you have a Bartholin gland cyst and to find out if it's infected.
How are Bartholin gland cysts treated?
The treatment depends on the size of the cyst, how painful it is, if it's infected and your age. In some cases, a small cyst can just be watched over time to see if it grows. In other cases, the doctor can perform a minor procedure in the office. In this procedure, the doctor puts a small tube, called a “Word catheter,” into the cyst. The catheter has to stay in place for two to four weeks. This causes a normal gland opening to form. Then the catheter is easily taken out in the doctor's office. If you have this catheter put in, you can go on with your normal activity, although sexual relations would be uncomfortable while the catheter is in place.
Another treatment option that can also be performed in the doctor's office or the emergency department of a hospital is done by making a small cut into the cyst to drain out the fluid. Stitches are then placed at the edge of the cyst to allow a small opening to form. This procedure is called a “marsupialization.” (Say this: mar-soup-eel-eye-za-shun.) You may have a light discharge for a few weeks. Panty liners should be all you need to use to take care of it.
Less common procedures involve using a laser or removing the entire gland surgically. Both of these procedures are usually performed in an out-patient operating room, as same-day surgery. If you have one of these procedures, you should tell your doctor right away if you have increasing pain, redness, pus formation or other symptoms after the procedure.
Will the cyst come back after it's been treated?
Bartholin gland cysts hardly ever come back after treatment. Sometimes a cyst will come back years later. It can be treated again.
How can I prevent Bartholin gland cysts?
These cysts seem to be more of a case of “bad luck” than anything else. It's very hard to keep them from happening. If you get a Bartholin gland cyst, tell your doctor right away so you can get early and effective treatment.