Bartholin Cyst Treatment
Treatment for a cyst or abscess affecting the Bartholin gland near the vaginal opening
What is bartholin cyst treatment?
The Bartholin glands sit one on each side, just inside and behind the opening of the vagina, and each releases a small amount of fluid through a narrow duct to keep the area moist. You are not normally aware of them at all.
A cyst forms when that duct blocks. The gland keeps producing fluid with nowhere to send it, so a smooth swelling builds on one side of the opening. A small one causes nothing and is often found by chance. A larger one is felt when you sit, walk, cycle or have sex, and can reach the size of a lime.
If bacteria reach the trapped fluid the cyst becomes an abscess, and the change is fast. Over a day or two the swelling becomes hot, red, tense and severely painful, and walking and sitting become difficult. A blocked duct is a mechanical event in a normal structure, so it is not in itself a sign of an infection passed between partners, though swabs are sometimes taken when there is an abscess.
What you might notice
- A painful lump near the vaginal opening
- Pain during intercourse
How it is diagnosed
This is a diagnosis made by looking and feeling, and it takes a couple of minutes. Your doctor examines the vulva and then feels the swelling between finger and thumb to judge its size, whether it is soft and fluid-filled or tense, and whether the overlying skin is hot and inflamed. The position is what identifies it: low down, to one side of the vaginal opening, with normal tissue in front of it.
They are also separating it from the other things that swell in the same area, including a boil in the skin, a cyst arising from a different gland, and a collection tracking from elsewhere. Where there is an abscess, swabs may be taken, partly to guide antibiotics and partly to test for infections that are passed between partners, since treating a partner as well changes the outcome when one is found.
Age changes the threshold for caution. In a woman over forty a lump in this position that is firm, irregular or refuses to settle is examined more carefully and sampled where there is any doubt, because a rare cancer of this gland can behave like a cyst that will not go away.
Recovery
A small painless cyst asks nothing of you. Warm baths several times a day, sitting in a few inches of warm water, often soften a blocked duct enough for it to open on its own within a few days, and it is worth trying first.
Where a swelling is drained, the relief of pain is immediate and almost startling. The wound is usually left open so it keeps draining instead of sealing over the problem, and that means discharge and a pad for one to two weeks. The amount of fluid can look alarming and is expected. Most people are back at work in two or three days, keep the area clean and dry, and wait until it has healed, at around two weeks, before having sex.
Where a small drainage device is left in place to keep the channel open, it stays for several weeks and you can work, walk and manage normally with it in. Recurrence is the thing to plan around: a share of cysts come back after simple drainage, and the treatments that deliberately keep a channel open are the ones that come back least often.
If it is left untreated
A cyst that is small, soft and painless can be left alone and watched. Many settle without anybody doing anything, and there is no need to treat one that you only notice when you go looking for it.
An untreated abscess usually bursts on its own after several days. That relieves the pain and is an unpredictable, messy and painful way to reach the same point, and the opening it makes seals quickly, so it tends to re-form. Infection spreading into the surrounding tissue is uncommon and needs antibiotics and sometimes admission; fever, spreading redness or feeling generally unwell are the signs of it, and they need same-day care. Diabetes and a weakened immune system both lower the threshold for taking that seriously.
A cyst that keeps coming back a third or fourth time is a reason to discuss a treatment that keeps the duct open permanently instead of draining it again. And a lump in this area that does not settle, or that feels firm and irregular, is worth insisting on having examined properly, particularly after forty.
Questions about bartholin cyst treatment
Is this a sexually transmitted infection?
Not in itself. A Bartholin cyst forms because a narrow duct has blocked and fluid has backed up behind it, which is a mechanical event in a perfectly normal gland, and it happens to women whatever their sexual history. Where the cyst becomes infected and forms an abscess, the bacteria involved are usually the ordinary ones that live on skin and in the bowel. Occasionally an organism that is passed between partners is found, so your doctor may take swabs when there is an abscess and may suggest a full check for other infections. Finding one changes the antibiotics and means your partner needs treating too, so the swabs are worth having.
Will it come back after it is drained?
It can. Simply draining a cyst or abscess relieves the pain immediately, and the opening that was made tends to seal over within days, so a proportion of women find the swelling returns weeks or months later. That is the reason surgeons prefer techniques that deliberately keep a channel open while the tissue heals around it, whether by leaving a small drainage device in place for several weeks or by stitching the edges of the opening back so it stays patent. Those have a much lower recurrence rate. If yours has returned two or three times, that is the conversation to have at the next appointment instead of having it drained again.
Can I treat it at home with warm baths?
For a small cyst or an early abscess, yes, and it is the right first step. Sitting in a few inches of warm water for ten to fifteen minutes, three or four times a day, softens the tissue and often lets a blocked duct open on its own, and a course of a few days is a fair trial. Take simple pain relief alongside it. What you should not do is try to squeeze or lance it yourself, because you will not reach the cavity, you will drive infection deeper, and the pain is considerable. Go in the same day if the swelling becomes hot and tense, if walking or sitting is difficult, or if you develop a fever.
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InpatientManagement of non-cancerous growths in the uterus, based on symptoms, size, location and reproductive plans
Day CareTalk to a care coordinator about bartholin cyst treatment
Leave a number and a care coordinator calls you back with what the treatment involves and which hospital it would be at. They book a consult only if you want one