Before we get to know about the Bartholin’s Cyst, we need to brush up some of the basics. When a woman is aroused, it is common that her vagina gets wet as it get readies for sexual intercourse. Irrespective of whether the act will happen on not, lubricating fluids are released into the vaginal tract. Who releases the fluids into the vagina? Bartholin Glands! Bartholin Glands reside between the vagina and the vulva (the external part of the vagina comprising of Clitoris, Labia Majora and Labia Minora).
Sometimes, in women, the fluids that are to be ejected by the Bartholin Glands get obstructed inside. This results in formation of cysts. If the cysts get infected, it turns into an abscess that has to be drained and treated with antibiotics. Typically, small Bartholin Cysts are painless and don’t cause much of a problem unless they get infected.
Symptoms of Bartholin’s Cysts
As long as the cysts are small, you won’t have any symptoms and you won’t even know that it/they exist unless they show up to your gynecologist during your regular check up. However, if the cyst gets infected, it can show following symptoms within days after infection:
- The lump becomes tender to touch and hurts
- You will feel uncomfortable to sit or walk
- Fever – caused due to infection
- Pain during intercourse
- Sensation of heat in the area
Typically, such cysts develop only on one side. Whenever you find any lumps near your vagina, irrespective of whether they cause pain or not, you will need to see your gynecologist and get his/her opinion and treatment, if required. Some cysts may turn out to be vulvar cancer.
Causes of Bartholin’s Cysts
Exact cause for the formation of Bartholin’s Cysts is not clear yet. Some medical experts are of the opinion that, if there is any infection in or around the vagina or in the body, the immune system that is fighting off the infection can result in blockage of the fluids that come from the Bartholin glands. In some women, the infection can reach the cysts and result in abscess. Some of the infections that result in abscess of Bartholin’s Cysts include:
- Neisseria Gonorrhoeae causes Gonorrhea – One of the very common sexually transmitted disease
- Chlamydia Trachomatis causes Chlamydia, another common sexually transmitted disease
- E Coli causes hemorrhagic colitis
- Streptococcus Pneumoniae causes pneumonia and middle ear infections
- Haemophilus Influenzae causes ear and respiratory infections
Who are at risk of developing Bartholin’s Cysts
- Women who are sexually active
- Women in the age group of 20 – 30 years
- Women who were previously diagnosed with Bartholin Cysts
- Women who had any injury in the area or who underwent surgery of vagina or vulva.
Diagnosis of Bartholin’s Cysts
In case when no symptoms are found, the cyst may be found by the gynecologist during regular pelvic exam or when checking your pelvis region for other problems.
Once the cyst is identified and if you are in the reproductive age, you will be asked to get screening done for some common STDs. If you have attained the menopause state, a piece of the cyst will be sent for biopsy to rule out vulvar cancer.
Treatment for Bartholin’s Cysts
Smaller cysts don’t really need any treatment. But, you must see your gynecologist at least once and take his/her opinion on the nature of the cyst.
In case of larger cysts that have developed abscess, they must be drained and treated. Draining of Bartholin’s Cysts’ abscess is the same as draining any other abscess in the body. Once drained, you will be put on some antibiotics to treat the infection.
In the case of very large cysts, the procedure to drain the cysts is a little different. It is called ‘Balloon Catheter Insertion’. In this procedure, local anesthesia is administered and a small tube will be inserted into the cyst (after draining it) and sutured. This is left in place for a period of 4 weeks to allow any puss to drain. You will be put on antibiotics during this period.
Other types of treatments for Bartholin’s Cysts include:
- Marsupialization – After the cyst is drained, the edges are sutured and the cut is left open for the puss to drain.
- CO2 Laser Treatment – The incision/cut is made using the laser to drain the puss/fluids
- Needle Aspiration – A needle will be used to drain the abscess. Later, the cyst will be filled with alcohol to avoid further infection and then the cyst will be drained again.
- Gland Excision – As the name suggests, this surgery involves removal of the Bartholin’s gland completely. This will be done only in cases where the cysts recur after treatment.
Of all the procedures to treat Bartholin’s Cysts, the safest and most preferred is treatment using CO2 laser due to the reduced recurrence rate and it is less invasive. Needle aspiration is one of the least preferred methods due to it’s high recurrence rate. The disadvantages in treatment of Bartholin’s cysts include hemorrhage, postoperative Dyspareunia (pain when having sex), the need for general anesthesia to perform the surgery.
Summary on Bartholin’s Cysts
Whether your body reports symptoms or if you find that there exists any lumps near your vagina, talk to your gynecologist immediately. Most of the times, it may be a normal cyst that can be treated with antibiotics or simple draining but in some, it may be the starting stage of cancer tumour in the body.
Bartholin’s cysts recur in many cases; completing the course of antibiotics and following your doctor’s advice in keeping up the hygiene of the vagina is important.