Cysts can develop anywhere in the body. Unfortunately ladies, they can also occur in the vagina. On either side of the vaginal opening in the 5 o’clock and 7 o’clock positions lay our Bartholin glands.
Bartholin glands are pea-size glands responsible for providing vaginal lubricant. If these glands become plugged, a cyst can develop made up of secretions that can no longer escape. Small cysts are usually painless, do not cause symptoms and typically do not need any intervention.
However, larger cysts can be problematic, as they can become infected and swell to sizes as large as a golf ball. These infected Bartholin's cysts can turn into Bartholin's abscesses.
Bartholin's abscesses are painful, interfere with sitting, walking and having sex. A fever may even develop.
Doctors are not sure why Bartholin's cysts or abscesses occur but American Family Physician said that 2 percent of women of reproductive age develop them, more typically on one side. They are more common in white and black women then Hispanic women.
In postmenopausal women, Bartholin's cysts should be further evaluated for malignancy as the Bartholin glands usually shrink during menopause.
Treatment for Bartholin Cysts/Abscesses
Treatment depends on the symptoms a women has. Bartholin's cysts that are small and are not painful do not need treatment and can just be monitored by a gynecologist during yearly exams.
If a small Bartholin's cyst develops an infection, then sitz baths are usually recommended to be done several times a day for three to four days, noted the Mayoclinic.com. Fill a tub with a couple of inches of very warm water and soak for 10-15 minutes at a time.
A larger abscess or infected cyst needs surgical intervention. The doctor may perform this as a sterile procedure in the office. The area will be made numb with anesthetic and an incision will be made to drain the contents of the abscess.
A special catheter called a Word catheter is inserted to keeps the cyst space open. After the catheter is inserted through the incision, a small balloon at the tip of the catheter is inflated to keep it from falling out.
The catheter is left in place for four to six weeks, wrote American Family Physician. NHS said that a few small studies showed “that 83–97% of women healed well and their cysts or abscesses did not reoccur.”
If the cyst or abscess is too deep or keeps reoccurring then another procedure called marsupialization may be performed. This may be done under general anesthesia in a surgi-center. With marsupialization, the cyst area is opened and drained but sewn back with a larger opening so that secretions cannot accumulate.
Daily sitz baths will be needed after both an incision with Word catheter placement or a marsupialization procedure to keep the area clean and promote drainage of the cyst. American Family Physician stated that, “approximately 5 to 15 percent of Bartholin duct cysts recur after marsupialization.”
The final method to treat Bartholin cysts/abscess is to remove the Bartholin gland entirely. This is done in a hospital or a surgi-center setting. Excision of the Bartholin gland is performed in those cases where previous methods have not been able to control recurrent infections.
Cultures of the fluid removed from any of the three treatments for Bartholin's cysts may be sent off to determine if antibiotics are needed. In older women, cells may be sent and checked for adenocarcinoma.
If you find yourself suffering from Bartholin's cysts that become infected or develop abscesses, discuss the risks of all of the above procedures thoroughly with your doctor.
We don't know yet how to prevent Bartholin's cysts. However, careful monitoring of pain or soreness during sitting or intercourse and swelling that is felt at the opening of the vagina should be promptly examined by your doctor.
Sources:
Management of Bartholin's Duct Cyst and Gland Abscess. American Family Physician. 2003 Jul 1;68(1):135-140. Retrieved Sept. 25, 2013.
http://www.aafp.org/afp/2003/0701/p135.html
Various Treatment Options Available for Large Bartholin Cyst. Mayoclinic.org. Retrieved Sept. 25, 2013.
http://www.mayoclinic.org/medical-edge-newspaper-2010/dec-10a.html
Bartholin’s cyst or abscess. Medline.plus. Retrieved Sept. 25, 2013.
http://www.nlm.nih.gov/medlineplus/ency/article/001489.htm
Bartholin's cyst. Maycoclinc.org. Retrieved Sept. 25, 2013.
http://www.mayoclinic.com/health/bartholin-cyst/DS00667/METHOD=print
Bartholin’s cyst. National Health Service. Retrieved Sept. 25, 2013.
http://www.nhs.uk/Conditions/Bartholins-cyst/Pages/Introduction.aspx
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles
Edited by Jody Smith