Bartholin's cyst

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at April 5, 2016
StartBartholin's cyst

A Bartholin's cyst is the name used to refer to an enlarged Bartholin's gland. These glands are located on either side of the vaginal opening, and their purpose is to secrete fluid that helps lubricate the vagina. A blockage of the gland opening can cause fluid to back up and swell the gland to abnormal size. This condition is also known as Bartholinitis.

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Definition & Facts

Although not defined as an infection, an enlarged Bartholin's gland can be the result of an infection of the vulva or vaginal opening. Normally, fluid is secreted through the small ducts that connect the glands to the vulva. If there is an infection that causes tissue swelling near the duct openings, the fluid secreted from the glands may collect and cause swelling.

If an infection occurs in the vaginal area and the glands become swollen, the condition is known as a Bartholin's abscess. The cyst that forms can range from pea-sized to more than an inch in diameter. It is a common occurrence in women who are in their childbearing years, but rarely occurs in younger females or women over 50 years of age. Approximately two percent of women will experience enlarged, swollen Bartholin's glands at some point in their lives.

Symptoms & Complaints

Women may not know of the existence of a Bartholin' s cyst unless the condition becomes painful. Quite often, the cyst forms and swells without any pain symptoms. If, on the other hand, an infection in the vaginal area has already occurred, a simple examination of the area will likely bring the existence of the swollen gland to the woman's attention.

The cyst itself may be slightly reddish or brown in color. Because the location of surface veins vary from one individual to another, the swollen area may also look slightly bluish in tone. In most cases, an abscess will form only on the right or left gland. Rarely are both glands subjected to swelling. If the cyst grows to a large size, walking or running may become slightly painful. Sexual intercourse can also produce pain because of the additional pressure being put on the adjacent tissues.

Causes

There is no definitive cause for this type of cyst. It can form because certain bacteria such as E. coli begin to grow in the vaginal area. The bacteria responsible for chlamydia and gonorrhea can also cause the fluid ducts to swell. Sometimes, the swollen tissues surrounding the Bartholin's gland ducts cause the ducts to compress, and the blocked fluid flow increases the chances of glandular inflammation.

However, medical experts agree that no single cause of cyst formation has ever been determined. If examined by a medical professional, the cyst is rarely determined to be a direct effect of vaginal area infection. It is known, however, that the secretions of the Bartholin's glands can become solidified, due perhaps to a change in diet or the amount of liquid being taken in by the affected individual.

When a collection of mucus forms, the gland continues to produce a small amount of lubricating fluid. The enlargement of the gland triggers a response from the body, namely increased blood flow to the affected area. The mucus itself rarely becomes infected with bacteria.

Diagnosis & Tests

A physician will want to closely examine the affected area to make certain that the swelling is not being caused by any sort of tumor or malignant growth. Epidermoid cysts, lipomas, and Skene's duct cysts present similar symptoms, so a thorough examination is recommended to determine which condition is affecting the individual.

In rare cases, the doctor will perform a biopsy so that the tissue can be examined in more detail. The doctor will also ask the patient about recent medical history, may perform a pelvic examination, and will likely run additional tests if the patient is over 40 years of age or is postmenopausal.

In some instances, the examination will reveal a small cut or tissue tear that has become infected. In these cases, the swelling is not due to an enlarged or inflamed gland. If a blocked Bartholin's duct is recognized as the source of the inflammation or swelling of the gland, the doctor will recommend a certain treatment based on the size of the cyst.

Treatment & Therapy

During the examination by the physician, a determination will be made as to whether the cyst is causing any sort of infection. If the cyst formation and tissue swelling is not showing symptoms of bacterial infection, the patient may require no special treatment. Quite often, these types of cysts go away over time.

If the abscess remains for a lengthy period of time, a catheter may be used to drain off the fluid that has collected. A special device called a Word catheter is often used to drain off fluid from a Bartholin's cyst. The catheter has a balloon on one end, and after it is inserted, the balloon is inflated. The catheter remains in place for a predetermined amount of time, usually about one month.

If a diagnosis of infection has been made, antibiotic drugs may be the only treatment needed to correct the problem. Marsupialization is another form of treatment used to drain this type of cyst. The surgery involves the creation of a new opening in the gland, with the created duct held open by stitches.

In very rare cases, a Bartholin's gland may swell and show cyst-like symptoms repeatedly over several years. If this occurs, the physician may decide to remove the gland and duct canal completely.

Prevention & Prophylaxis

No prevention advice exists for this type of cyst. Because the Bartholin's gland performs a specialized duty and is not comprised of tissues that frequently become infected, the only prophylaxis measures are the general ones regarding a healthy lifestyle. However, Bartholinitis can become a more serious condition if the enlarged, inflamed gland becomes infected with bacteria. Practicing safe sex and condom use by the male is important to ensure that infection in the gland duct does not occur. If the duct becomes infected, the bacteria can easily spread to the gland itself.