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Bartholin cyst

Definition


Disease: Bartholin cyst Bartholin cyst
Category: Gynecological diseases
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Disease Definition:

Located on each side of the vaginal opening are the Bartholin’s glands, which secrete fluid that helps lubricate the vagina. In some cases, fluid backs up into the gland due to the obstruction of the openings of these glands, which causes a relatively painless swelling called a Bartholin cyst. In other cases, when the fluid is infected, a small area of puss is created, surrounded by inflamed tissue (abscess).

Depending on the pain, the size of the cyst and whether it’s infected the treatment will be determined. In the case of an infection, antibiotics will be necessary to treat the Bartholin cyst. Although in some cases home treatment is the only thing needed, however, in other cases surgical drainage of the Bartholin cyst will be necessary.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

A cyst is usually painless, but it can be tender. In case this cyst grows, the woman may feel the presence of a lump or mass near her vaginal opening. However, if it remains small with no infection, it may go unnoticed.

A full-blown infection could occur in a matter of days if the cyst becomes infected. Some of the signs and symptoms are:

  • Fever
  • Discomfort while walking or sitting
  • A tender or painful lump near the vaginal opening.
  • Pain during intercourse.


Normally, a cyst or abscess only occurs on one side of the vaginal opening.

Causes:

When the opening of the gland (duct) becomes obstructed, perhaps by the growth of a flap of skin, fluid may accumulate. So, the cause of a Bartholin cyst is believed to be a backup of fluid.

A number of bacteria could cause a cyst to become infected, forming an abscess. Some of those bacteria are:

  • Escherichia coli (E. coli), which is a common bacterium.
  • Bacteria that cause sexually transmitted diseases, including Chlamydia and gonorrhea.

Complications

Complications:

Even though a Bartholin cyst could recur, however, when treated properly, the swelling, pain and infection will go away, even in the case of recurrent cysts or abscesses.

Treatments:

The size of the cyst, the amount of discomfort it causes and whether it’s infected, resulting in an abscess is what treatment of a Bartholin cyst will depend on. Some of the options that a patient may be recommended include:

Surgical drainage:
Usually, an infected or a very large cyst requires drainage by a doctor. If it makes the patient more comfortable, she and her doctor could decide on general sedation during the drainage of the cyst, however, in most cases, it is done in the doctor’s office under local anesthesia. During this procedure, a small incision is made in the cyst to allow it to drain, and then a small rubber tube (catheter) is inserted in the incision. To prevent the opening from closing up and to drain the fluid completely, the catheter will stay in place for four to six weeks, after which it is removed and the incision is healed completely.

Sitz baths:
A small and uncomplicated cyst can rupture and drain on its own if the woman sits in a tub filled with a few inches of warm water several times a day for three or four days.

Antibiotics:
A woman may be prescribed antibiotics if her cyst is infected or if testing reveals a sexually transmitted disease, in order to ensure that the bacteria causing the infection are destroyed. However, she may not need antibiotics if the abscess is drained properly.

Marsupialization:
This technique could be performed when cysts recur because it helps in preventing recurrences. It is quite similar to the surgical drainage procedure, the only difference is that a few stitches are placed on either side of the incision in order to create a permanent opening, about 5 millimeters long (less than one quarter of an inch). A catheter may be inserted to promote draining for a few days, preventing its recurrence. This procedure may be done in an operating room in a hospital under general anesthesia depending on the complexity of the cyst. However, it is generally done in the doctor’s office. The doctor would want to drain the abscess first and get rid of the infection, then perform the marsupialization, because this procedure isn’t recommended while an active infection is present.

A woman may be recommended removal of the Bartholin’s gland in case she has persistent recurrences and none of the procedures mentioned above is successful, but this is rarely necessary. This surgical removal of the Bartholin’s gland is done under general anesthesia in a hospital.

An experimental treatment is using laser therapy in treating Bartholin cyst.

Prognosis:

Not availabe

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