Everything you need to know about cysts

The Bartholin’s glands are located on each side of the vaginal opening. These glands secrete fluid that helps lubricate the vagina. Sometimes the openings of these glands become obstructed, causing fluid to back up into the gland. The result is relatively painless swelling called a Bartholin’s cyst.

It does happen though that sometimes the fluid within the cyst becomes infected, you may develop a collection of pus surrounded by inflamed tissue (abscess).

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

Sometimes home treatment is all you need. In other cases, surgical drainage of the Bartholin’s cyst is necessary. If an infection occurs, antibiotics may be helpful to treat the infected Bartholin’s cyst. Visit your doctor urgently if you have a painful lump near the opening of your vagina that doesn’t improve after two or three days of self-care.

This may include for instance, soaking the area in warm water (sitz bath). If the pain is severe, make an appointment with your doctor right away. Also visit your doctor promptly if you find a new lump near your vaginal opening and you’re older than 40 years of age.

Although rare, such a lump may be a sign of a more serious problem, such as cancer.

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Symptoms

If you have a small, noninfected Bartholin’s cyst, you may not notice it. If the cyst grows, you might feel a lump or mass near your vaginal opening. Although a cyst is usually painless, it can be tender. A full-blown infection of a Bartholin’s cyst can occur in a matter of days. If the cyst becomes infected, you may experience the following symptoms:

• A tender, painful lump near the vaginal opening
• Discomfort while walking or sitting
• Pain during intercourse
• Fever.

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

Causes

Experts believe that the cause of a Bartholin’s cyst is a backup of fluid. Fluid may accumulate when the opening of the gland (duct) becomes obstructed, perhaps caused by infection or injury. A Bartholin’s cyst can become infected, forming an abscess. A number of bacteria may cause the infection, including Escherichia coli (E. coli) and bacteria that cause sexually transmitted infections such as gonorrhoea and chlamydia.

E. coli is typically found in the anal area and wiping from the back to the front may cause this infection to spread to the genitalia.

Risk factors for developing Bartholin’s Abscess

These factors may increase the risk of Bartholin’s abscess, the condition can also occur without any apparent cause.

• Infection: Bacterial infection is a common trigger for Bartholin’s abscess. Infections may occur due to various bacteria, including those normally present in the genital area.
• Sexually transmitted infections: Certain sexually transmitted infections, such as gonorrhoea and chlamydia, may increase the risk of developing Bartholin’s abscess.
• Trauma or injury: Any trauma or injury to the area around the Bartholin’s glands, including during childbirth or sexual activity, can increase the risk of developing an abscess.
• Blockage of ducts: Anything that blocks the ducts of the Bartholin’s glands can lead to the accumulation of fluid and subsequent infection. This blockage can be caused by a variety of factors, including thick mucus, debris, or other substances.
• Poor hygiene: Inadequate personal hygiene can contribute to the growth of bacteria in the genital area, increasing the likelihood of infection and abscess formation.
• Cyst formation: Pre-existing Bartholin’s cysts, which are fluid-filled sacs in the gland, may become infected and progress to an abscess.
• Immunosuppression: Individuals with weakened immune systems, either due to medical conditions (such as diabetes or HIV) or medications (such as corticosteroids), may be more susceptible to infections, including Bartholin’s abscess.
• Age: Bartholin’s abscess is more common in women of reproductive age, although it can occur at any age.

Complications

The main complication of Bartholin’s cyst or abscess is recurrence and again require treatment.

Prevention

There’s no way to prevent a Bartholin’s cyst. However, safer sex practices in particular, using condoms and good hygiene habits may help to prevent infection of a cyst and the formation of an abscess.

Treatment

Often a Bartholin’s cyst requires no treatment, especially if the cyst causes no signs or symptoms. When needed, treatment depends on the size of the cyst, your discomfort level and whether it’s infected, which can result in an abscess.

Treatment options your doctor may recommend include:

• Sitz baths: Soaking in a tub filled with a few inches of warm water (sitz bath) several timesa day for three or four days may help a small, infected cyst to rupture and drain on its own. You may add disinfectant to the water.
• Surgical drainage: You may need surgery to drain a cyst that’s infected or very large. Drainage of a cyst can be done using local anaesthesia or sedation. For the procedure, your doctor makes a small incision in the cyst, allows it to drain, and then places a small rubber tube (catheter) in the incision. The catheter stays in place for up to six weeks to allow complete drainage.
• Antibiotics: Your doctor may prescribe an antibiotic if your cyst is infected or if testing reveals that you have a sexually transmitted infection. But if the abscess is drained properly, you may not need antibiotics. Marsupialisation: If cysts recur, a marsupialisation procedure may help. Your doctor places stitches on each side of a drainage incision to create a permanent opening. An inserted catheter may be placed to promote drainage for a few days and to help prevent recurrence.

Home Care

Daily soaking in warm water, several times a day, may be adequate to resolve an infected Bartholin’s cyst or abscess. After a surgical procedure to treat the infected area, soaking in warm water is particularly important. Sitz baths help to keep the area clean, ease discomfort and promote effective drainage of the cyst. Pain relievers also may be helpful.

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