Bartholin Cyst: Symptoms, Causes and Treatment

Bartholin cysts are a common condition that many women experience, yet they often remain misunderstood. To effectively manage this condition, it’s essential to understand the causes of the Bartholin cyst. These cysts develop when the Bartholin’s glands, which are responsible for lubricating the vagina, become blocked. While they can be painless, in some cases, they may cause discomfort or even become infected, resulting in an abscess. Let’s understand this condition.

What is a Bartholin Cyst?

A Bartholin cyst is a firm, noncancerous lump that forms when the ducts of the Bartholin’s glands become obstructed. These glands are located on either side of the vaginal opening and produce a fluid that helps reduce friction during sexual activity. When the ducts are blocked, the fluid accumulates, leading to the formation of a cyst.

Causes of Bartholin Cyst

A Bartholin’s cyst develops when the duct of the Bartholin’s gland becomes obstructed, disrupting the normal flow of lubricating fluid. Several factors can contribute to this blockage:

• The exact cause of blockage is often unclear but may result from chronic irritation or injury.
• STIs like gonorrhoea and chlamydia can cause blockage and cyst formation.
• Bacterial infections such as E. coli, Streptococcus pneumoniae, and Haemophilus influenzae can also lead to cysts.
• Physical trauma, including episiotomy or childbirth, increases the risk of Bartholin’s cyst.
• Previous vaginal or vulval surgeries may contribute to cyst development.

Symptoms of Bartholin Cyst

The symptoms of a Bartholin’s cyst can range from being asymptomatic to causing significant discomfort. Here are the main signs to look out for:

• Small cysts are often painless and found during routine exams.
• Larger cysts may cause swelling, redness, and pain during activities like walking or sitting.
• Infection can lead to fever, chills, and pus drainage.
• Large cysts may also cause uneven labia majora.

Risk Factors for a Bartholin Cyst

While any woman can develop a Bartholin’s cyst, some factors can increase the risk:

• Women in their 20s and 30s are more likely to develop Bartholin’s cysts.
• Sexual activity, especially with STI exposure, increases the risk.
• A history of Bartholin’s cysts or abscesses raises the likelihood of recurrence.
• Trauma from childbirth or surgery is a risk factor.

Complications of Bartholin Cyst

Complications of a Bartholin cyst can significantly impact a woman’s quality of life and health if the cyst becomes infected or treatment is not properly managed. Some of the potential complications include:

• Infection and abscess can cause pain, swelling, and fever.
• Post-surgery risks include bleeding, pain during sex, and infections.
• Surgical drainage may lead to scarring and bleeding.
• Cysts may recur after treatment.
• In rare cases, vulvar cancer in women over 40 may require a biopsy.

Diagnosis of Bartholin Cyst

Diagnosing a Bartholin cyst involves a combination of clinical evaluation, laboratory tests, and sometimes additional procedures to rule out other conditions. The diagnostic process typically includes:

• A pelvic exam to locate the cyst or abscess.
• Testing discharge for STIs and bacterial infections.
• Biopsy for women over 40 to rule out vulvar cancer.
• Culturing abscess fluid to identify the cause.
• Reviewing medical history, including past Bartholin’s cysts or abscesses.

Treatment for Bartholin Cyst

Treatment for a Bartholin cyst depends on the severity of symptoms and whether the cyst is infected. Various methods are available to manage and treat the condition, including:

• Surgical drainage with a catheter for up to 6 weeks.
• Marsupialization to prevent recurrence by stitching the cyst walls to the skin.
• Balloon-tipped catheter to maintain cyst opening for drainage.
• Antibiotics for treating infections.
• Pain management for postoperative comfort.
• Postoperative care with sitz baths, movement, and hydration for recovery.
• Regular follow-up appointments to monitor healing and prevent recurrence.

Prevention of Bartholin Cyst

While it may not be possible to prevent the development of a Bartholin cyst completely, there are certain measures you can take to reduce your risk:

• Practice safer sex: Use condoms to prevent STIs like gonorrhoea and chlamydia, which can contribute to Bartholin cysts.
• Maintain good hygiene: Keep the genital area clean and dry, but avoid harsh soaps or douching to prevent irritation.
• Wear breathable underwear: Opt for cotton underwear to reduce moisture buildup and bacterial growth.
• Regular check-ups: Attend gynaecological appointments to monitor reproductive health and address issues early.

When to See a Doctor

If you have a painful lump near the vaginal opening that doesn’t improve with self-care measures like warm sitz baths after a few days, it’s important to see a doctor. Seek immediate medical attention if you experience severe pain or discomfort while sitting or walking or if a fever develops, as these could indicate an infected cyst or abscess requiring professional treatment. Women over 40 who notice a new lump should consult a doctor promptly to rule out conditions like vulvar cancer. Early diagnosis and treatment are essential for preventing complications and ensuring proper recovery.

Conclusion

A Bartholin cyst is typically painless but can become serious if infected or forms an abscess. Early detection and prompt medical evaluation are key to effective treatment, including sitz baths, pain relief, or surgical procedures like incision and drainage. Understanding symptoms, causes, and treatment options helps manage and prevent complications. Practising safer sex, maintaining good hygiene, and regular gynaecological check-ups can reduce the risk of cysts and their recurrence.

Frequently Asked Questions (FAQs)

References

• https://www.ncbi.nlm.nih.gov/books/NBK532271/
• https://pmc.ncbi.nlm.nih.gov/articles/PMC4483306/
• https://www.msjonline.org/index.php/ijrms/article/view/12897
• https://www.aafp.org/pubs/afp/issues/2019/0615/p760.html