Bartholin's Cyst and Abscess

A Bartholin’s cyst is a fluid-filled sac within one of the Bartholin’s glands of the vagina

Aetiology

  • A build-up of mucus secretions can cause the duct of the gland to become blocked, from which a cyst can develop
  • The cyst itself can become infected, and if untreated, develop into an abscess
  • The infective organisms are usually aerobic, with Escherichia coli, MRSA and STIs being the most common
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Clinical presentation

Symptoms

  • Small Bartholin’s cysts are often asymptomatic
  • If cysts become large, they can cause vulvar pain (particularly when walking and sitting), and superficial dyspareunia 
  • Bartholin’s abscesses typically present with acute onset of pain, and/or difficulty passing urine

Signs

  • On examination, a unilateral labial mass will be observed, typically from the posterior aspect of the labia majora

Investigations

  • Often clinical diagnosis
  • Consider biopsy if women is over 40 to exclude vulval carcinoma

Management

  • If the cyst is small and asymptomatic, no treatment is required
  • Treatment is usually by:
    • Word catheter
    • Marsupialisation
  • Antibiotics not generally used but can be considered if patient is systemically unwell or immunocompromised