Bartolin Cyst-Abscess

Bartholin cyst is a relatively painless swelling. If the fluid within the cyst becomes infected, a collection of pus (abscess) may develop surrounded by inflamed tissue.

Bartholin cyst or abscess is common. Treatment for a Bartholin cyst depends on the size of the cyst, how painful it is, and whether the cyst is infected.

Sometimes home treatment may be sufficient. In other cases, surgical drainage of the Bartholin cyst is required. If an infection occurs, antibiotics may be useful in treating an infected Bartholin cyst.

symptoms

If you have a small, uninfected Bartholin cyst, it may go unnoticed. If the cyst grows, a lump or mass may be felt near the vaginal opening. Although the cyst is usually painless, it may be tender.

A complete infection of the Bartholin cyst may occur within a few days. If the cyst becomes infected, the following may be observed:

• A tender, painful lump near the vaginal opening

• Discomfort when walking or sitting

• pain during intercourse

• Fire

A Bartholin cyst or abscess typically occurs on only one side of the vaginal opening.

When to See a Doctor

If there is a painful lump near the entrance to the vagina that does not heal after two or three days of personal care, a doctor should be called. 

Also, the vaginal opening  If a new lump is noticed nearby and the person is over 40 years old, a doctor should be called immediately. Although rare, this type of swelling may be a sign of a more serious problem such as cancer.

reasons

Experts have observed that the cause of Bartholin cyst is fluid accumulation. When the opening of the gland (duct) becomes blocked, fluid can accumulate, possibly due to infection or injury.

Bartholin's cyst may become infected and form an abscess. A number of bacteria can cause infection, including Escherichia coli (E. coli) and bacteria that cause sexually transmitted infections such as gonorrhea and chlamydia.

Complications

A Bartholin cyst or abscess may recur and require repeat treatment.

Prevention

There is no way to prevent a Bartholin cyst. However, safer sexual practices (especially using condoms) and good hygiene habits can help prevent infection of the cyst and abscess formation.

Diagnosis

To diagnose Bartholin cyst, a doctor may:

• Ask questions about your medical history

• Perform a pelvic exam

• Take a sample of secretions from your vagina or cervix to test for a sexually transmitted infection

• If you are post-menopausal or over 40, recommend a mass test (biopsy) to check for cancerous cells

If cancer worries you, your doctor may refer you to a gynecologist who specializes in cancers of the female reproductive system.

Treatment

Generally, Bartholin's cyst does not require treatment; especially if the cyst causes no signs or symptoms. Treatment if necessary depends on the size of the cyst, your level of discomfort, and whether it is infected, which could result in an abscess.

Treatment options your doctor may recommend include:

• Sitz Baths: Soaking in a tub (sitz bath) filled with a few inches of warm water several times a day for three or four days may help a small, infected cyst rupture and drain on its own.

• Surgical Drainage: Surgery may be needed to drain an infected or very large cyst. Drainage of the cyst can be done using local anesthesia or sedation.

  For the procedure, the doctor makes a small incision in the cyst, allows it to drain, and then inserts a small rubber tube (catheter) into the incision. The catheter remains in place for up to six weeks to keep the incision open and allow complete drainage.

• Antibiotics: If the cyst is infected or if tests reveal that you have a sexually transmitted infection, the doctor may start antibiotic treatment. However, if the abscess is drained properly, antibiotics may not be needed.

• Marsupialization: If cysts recur or are bothersome, a marsupialization (mahr-soo-pee-ul-ih-ZAY-shun) procedure may help. The doctor stitches both sides of the drainage incision to create a permanent opening less than 1/4 inch (about 6 millimeters) wide. An implanted catheter may be placed to promote drainage and help prevent recurrence for several days after the procedure.

In rare cases, for persistent cysts that cannot be effectively treated with the above procedures, the doctor may recommend surgery to remove the Bartholin gland. Surgical removal is usually done in a hospital under general anesthesia. Surgical removal of the gland carries a greater risk of bleeding or complications after the procedure.

Self-Care

Soaking in warm water several times a day may be sufficient to relieve an infected Bartholin's cyst or abscess.

Soaking in warm water is especially important after a surgical procedure to treat an infected cyst or abscess. Sitz baths help keep the area clean, relieve discomfort, and ensure effective drainage of the cyst. Painkillers may also be helpful.

What Can Be Done?

To prepare for an appointment:

• Writing down all symptoms, including those that seem unrelated to the condition.

• Making a list of medications, vitamins, or supplements taken along with their dosages

• Taking a notepad to write down information during the visit.

• Preparing questions to ask the doctor 

Some basic questions to ask for a Bartholin cyst are:

• What causes the symptoms? 

• What kind of tests will be done?

• What are the chances of the cyst disappearing on its own?

• How long should one wait before having sexual intercourse after treatment?

• What self-care measures can help relieve symptoms?

• Will the cyst appear again?

Some possible questions the doctor may ask include:

• How long have you had symptoms?

• How severe are the symptoms?

• Is pain felt during sexual intercourse?

• Is there pain during normal daily activities?