Bartholin’s Cyst


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Also known as the Bartholin’s duct cyst, a Bartholin’s cyst is a small fluid-filled sac that can develop inside the opening of a woman’s vagina, in the Bartholin’s glands; they can be found just behind and either side of the inner lips at the entrance of the vagina. Normally you wouldn’t notice the glands, primarily due to their small size. These glands function to produce lubricating fluid during sex, and this fluid travels down through tubes (or ducts) towards the vagina. If the ducts are blocked, fluid will clog up and will then form a cyst. Various types of bacteria can block the Bartholin’s duct, some sexually transmitted (the bacteria’s associated with chlamydia, gonorrhoea) but others to do with the environment (bacteria including Escherichia coli, Streptococcus pneumonia)

Problems

Ordinarily, these lumps are painless and too miniscule to cause a problem. The cyst can only cause problems if the cyst becomes infected; where pus (or an abscess) forms in the Bartholin’s gland. As the Bartholin’s glands do not begin to produce lubricating fluid until adolescence, the Bartholin’s gland rarely affects children. However, the condition can occur among young women, particularly if they are sexually active.

Diagnosis of Bartholin’s cysts

Your GP can diagnose whether or not you have a Bartholin’s cyst, but it is recommended that you make an appointment with your GP should you have a cyst which is causing considerable discomfort. This can mean discomfort in walking, or other exercise, and also discomfort having sexual intercourse. Very rarely, the cyst can become cancerous, so it is vital you make an appointment with your GP if you suspect you have developed a cyst on the Bartholin’s duct.    

Treatment for Bartholin’s cysts

GP’s may advise you to take pain relief, such as ibuprofen or paracetemol should the cyst be an agitation. If the cyst becomes an abscess, antibiotics can be given to you to clear up the infection. Incision is not considered a beneficial method as cysts often recur as a result. Instead, surgeons recommend a balloon catheter insertion. The balloon catheter, a tube with an inflatable balloon at one end, drains away all the fluid and creates a passage to drain away in fluid that collects in future. The balloon catheter remains in the cyst, while a stich will be made to partly close the cut, which helps to heal the wound while ensuring the drainage continues. The procedure can be performed under local or general anaesthetic. 

Alternatives

Alternative options include marsupialisation, which is a similar operation, except that the catheter is not needed; the edges of the skin are instead sewn up in a manner which prevents more fluid building up.

Silver nitrate gland ablation is also an option, where a stick of silver nitrate is placed in the cyst after the cut is made. This prevents bleeding after the cut, and gets rid of the abscess. A risk with this method is that the skin around the vulva could be burnt by the silver nitrate. Another alternative would be needle aspiration, where a needle is used to drain the cyst. If the problem is persistent however, the Bartholin’s gland may need to be completely excised.


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