Vaginal Infection

Updated 18 May 2015

Bartholin's cyst

This is a condition that arises from infection of the Bartholin's glands in the vagina.

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The Bartholin's glands are situated on each side of the vaginal opening, and lubricate the vulva. A cyst - a swollen, fluid-filled lump, 1-3cm large - may form in the gland or the duct draining it if it becomes blocked, due to infection, injury, or some unknown cause. This normally does not cause pain, and often disappears without treatment.

However, if infection occurs due to bacteria such as E. coli, bacteria normally occurring in the vagina, or those that cause sexually transmitted diseases, a painful pus-filled abscess may develop.

A cyst can be treated at home with "sitz baths", but s urgical drainage and antibiotics are needed to treat an infected abscess.

Rarely, cysts recur; and very rarely, usually only in older women, may indicate a tumour.

Alternative names

Bartholin's abscess, infected Bartholin's gland, or Bartholinitis.

Symptoms

If the cyst remains small and uninfected, you may not feel any symptoms. Symptoms of a more noticeable cyst may include:

  • a painless lump on one side of the vaginal opening, and
  • redness, swelling and tenderness.

If the cyst becomes infected, after a few days you may experience:

  • pain during activities such as walking, sitting, or sexual intercourse,
  • fever,
  • chills,
  • increased swelling, and
  • fluid draining from the cyst.

Diagnosis

Your doctor will ask about your symptoms and will usually perform a pelvic exam. If the cyst seems infected, your doctor may take a swab of your cervix or collect fluid from the cyst for analysis. If you are older than 40, your doctor may do a biopsy of the cyst to check for cancerous cells.

Treat ment

Sometimes, a cyst can be treated at home with "sitz baths" - submerging the area in shallow, warm water - a few times a day for three or four days. This can give relief and help a small cyst to rupture and drain.

If infection occurs, surgical drainage of the cyst under local anaesthetic may be necessary. A cut in the cyst allows it to drain. A small rubber tube (catheter) is inserted, and stays in place for four to six weeks to keep the incision from closing, allowing complete drainage.

Further treatment may include:

  • Continued sitz baths,
  • Antibiotics,
  • Pain medication,
  • Marsupialisation, in which a permanent incision is made to help the gland drain in cases of recurring cysts, and
  • Complete removal of the gland, in the case of chronic cysts or cancer.

Prognosis

Treatment is quick and effective, and Bartholin's cysts only rarely reoccur.

If an abscess requires surgery, healing may take days or weeks, depending on the size of the abscess and the type of procedure performed.

It is important to treat any underlying infection.

Complications

In older women, a swelling may mean indicate a tumour, but this is rare. Chronic cysts are also uncommon.

When to call your doctor

If a lump on one side of the vulva persists for more than a few days, you should see your doctor. If you are over 40, any lump should receive immediate attention.

See your doctor immediately if you also feel feverish.

How can it be prevented?

It is not usually possible to avoid a Bartholin's cyst, but safe sex practices, good personal hygiene and sitz baths may prevent it becoming infected.

Information supplied by the National Institutes of Health.

 

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