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Bartholin Cyst: Causes, Symptoms & Treatment

A Bartholin cyst is a benign fluid-filled sac that forms near the vaginal opening when the duct of the Bartholin gland becomes blocked. It can cause swelling and discomfort.

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Things worth knowing about "Bartholin Cyst"

A Bartholin cyst is a benign fluid-filled sac that forms near the vaginal opening when the duct of the Bartholin gland becomes blocked. It can cause swelling and discomfort.

What Is a Bartholin Cyst?

A Bartholin cyst is a benign, fluid-filled swelling that develops at the Bartholin gland, located on either side of the vaginal opening. These glands normally produce a small amount of fluid that helps lubricate the vagina. When the duct of one of these glands becomes blocked, fluid builds up and forms a cyst. Bartholin cysts are among the most common gynecological conditions and predominantly affect women of reproductive age.

Causes

A Bartholin cyst forms when the opening of the gland duct becomes obstructed. Common causes include:

Inflammation or infection in the genital area
Thickening or scarring of the duct (e.g., following injury or surgery)
Bacterial infections caused by organisms such as Escherichia coli, Staphylococcus aureus, or sexually transmitted pathogens like Neisseria gonorrhoeae or Chlamydia trachomatis
Congenital narrowing of the duct

If bacteria infect the cyst, it can develop into a Bartholin abscess, which is characterized by intense pain, redness, and swelling.

Symptoms

Small Bartholin cysts are often asymptomatic and discovered incidentally during a gynecological examination. Larger cysts or abscesses may cause the following symptoms:

A soft, noticeable lump on one side of the vaginal opening
Pressure or pain when sitting, walking, or during sexual intercourse
Redness and swelling of the labia majora
In the case of an abscess: severe pain, warmth, fever, and purulent discharge

Diagnosis

Diagnosis is typically made through a gynecological physical examination. The clinician palpates the swelling to assess its size, location, and consistency. Additional diagnostic steps may include:

Swab culture: to identify bacterial or sexually transmitted infections
Ultrasound: to evaluate cyst size and exclude other causes
Biopsy (in rare cases, especially in postmenopausal women): to rule out malignancy

Treatment

Treatment depends on the size of the cyst, the presence of symptoms, and whether an abscess has formed.

Watchful Waiting for Small, Asymptomatic Cysts

Small cysts without symptoms can often be monitored without immediate intervention. Warm sitz baths several times a day may promote spontaneous drainage and provide relief.

Marsupialization

Marsupialization is the most common surgical treatment. The cyst is surgically opened, and the edges of the cyst wall are sutured to the surrounding skin to create a permanent drainage channel. This outpatient procedure is performed under local or general anesthesia.

Word Catheter Placement

An alternative approach involves inserting a small inflatable rubber catheter (known as a Word catheter) into the cyst cavity. The catheter remains in place for several weeks, allowing the fluid to drain while a new epithelialized tract forms.

Antibiotics

When a bacterial infection or abscess is confirmed, antibiotic therapy is prescribed. The choice of antibiotic is guided by culture and sensitivity results.

Surgical Excision

In rare cases, particularly for recurrent cysts or abscesses, complete surgical removal of the Bartholin gland may be recommended.

When to See a Doctor

Women should seek medical advice if:

A painful swelling appears near the vaginal opening
The cyst grows rapidly or is accompanied by fever
Symptoms interfere with daily activities
The cyst does not resolve with self-care measures

References

Omole F, Simmons BJ, Hacker Y. Management of Bartholin's duct cyst and gland abscess. American Family Physician. 2003;68(1):135-140.
Bhide A, Nama V, Patel S, Kalu E. Microbiology of cysts/abscesses of Bartholin's gland. Journal of Obstetrics and Gynaecology. 2010;30(7):717-719.
Lee MY, Dalpiaz A, Schwamb R, et al. Clinical pathology of Bartholin's glands: a review of the literature. Current Urology. 2015;8(1):22-25.

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