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Bartholin Gland Cyst

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Learn more about Bartholin Gland

What are the Bartholin glands?

The Bartholin glands are two small organs under the skin in a woman's genital area. They are on either side of the folds of skin (labia) that surround the vagina and urethra . Most of the time, you can't feel or see these glands. The Bartholin glands make a small amount of fluid that moistens the outer genital area, or vulva . This fluid comes out of two tiny tubes next to the opening of the vagina. These tubes are called Bartholin ducts.
What are Bartholin gland cysts?

If a Bartholin duct gets blocked, fluid builds up in the gland. The blocked gland is called a Bartholin gland cyst . (Sometimes it's called a Bartholin duct cyst.) These cysts can range in size from a pea to a large marble. They usually grow slowly. If the Bartholin gland or duct gets infected, it's called a Bartholin gland abscess . Bartholin gland cysts are often small and painless. Some go away without treatment. But if you have symptoms, you might want treatment. If the cyst is infected, you will need treatment.
What causes a Bartholin gland cyst?

Things like an infection, thick mucus, or swelling can block a Bartholin gland duct and cause a cyst. The cyst can get bigger after sex, because the glands make more fluid during sex. Infected Bartholin cysts are sometimes caused by sexually transmitted infections (STIs) . You can lower your risk of STIs by using a condom when you have sex.
What are the symptoms?

You may not have any symptoms if the Bartholin gland cyst is small. But a large cyst or an infected cyst (abscess) can cause symptoms. Symptoms of a cyst that is not infected include:

A painless lump in the vulva area. Redness or swelling in the vulva area. Discomfort when you walk, sit, or have sex.

Symptoms of an infected cyst include:

Pain that gets worse and makes it hard to walk, sit, or move around. Fever and chills. Swelling in the vulva area.

Drainage from the cyst.

How are Bartholin gland cysts diagnosed?

You may find a Bartholin gland cyst on your own, or your doctor may notice it during a physical examination. Unless it is causing symptoms, you may not know you have one. An abscess is diagnosed based on signs of infection, such as fever or swelling, and pain in the vulva area. In some cases, especially if you are older, your doctor may remove the cyst to make sure that it isn't cancer or another problem.
How are they treated?

Some Bartholin gland cysts go away without treatment. You can take a non-prescription pain medicine such as ibuprofen (Advil or Motrin, for example) to relieve pain. To help healing, soak the area in a shallow, warm bath, or a sitz bath . Don't have sex while a Bartholin cyst is healing. If the cyst is infected, it may break open and start to heal on its own after 3 to 4 days. But if the cyst is painful, your doctor may drain it. You may also need to take antibiotics to treat the infection. To keep the cyst from closing and filling up again, your doctor may put a small drainage tube with a small balloon at one end inside the cyst. The balloon is inflated inside the cyst to keep the cyst open. After the gland has healed, the tube and balloon are removed. Sometimes a carbon dioxide laser or silver nitrate is used to prevent a cyst from growing back. For severe cysts that keep coming back, you may have surgery to remove the Bartholin gland and duct. There is a procedure called marsupialization in which a pouch is created by making a cut over the cyst and stitching the sides together. This allows the cyst to drain.

Frequently Asked Questions

Last Revised: January 31, 2013 Author: Healthwise Staff Medical Review: Sarah Marshall, MD - Family Medicine & Femi Olatunbosun, MB, FRCSC Obstetrics and Gynecology

Source : http://www.healthlinkbc.ca/kb/content/special/tw2685.html

Apa kelenjar Bartholin?

Kelenjar Bartholin adalah dua organ kecil di bawah kulit di daerah kelamin wanita. Berada di kedua sisi lipatan kulit (labia) yang mengelilingi vagina dan uretra. Sebagian besar waktu, Anda tidak bisa merasakan atau melihat kelenjar ini. Kelenjar Bartholin membuat sejumlah kecil cairan yang membasahi daerah kelamin luar, atau vulva. Cairan ini keluar dari dua tabung kecil di samping pembukaan vagina. Tabung ini disebut Bartholin saluran.

Apa kista kelenjar Bartholin?

Jika saluran Bartholin diblokir, cairan menumpuk dalam kelenjar. Kelenjar diblokir disebut kelenjar Bartholin kista. (Kadang-kadang itu disebut kista saluran Bartholin) Kista ini terdapat berbagai ukuran dari kacang ke marmer besar. Biasanya tumbuh perlahan-lahan. Jika kelenjar Bartholin atau saluran terinfeksi, itu disebut kelenjar Bartholin abses. Kista kelenjar Bartholin sering kecil dan tanpa rasa sakit. Beberapa hilang tanpa pengobatan. Tapi jika Anda memiliki gejala, Anda mungkin ingin pengobatan. Jika kista terinfeksi, Anda akan membutuhkan pengobatan. Apa yang menyebabkan kista kelenjar Bartholin? Hal-hal seperti infeksi, lendir tebal, atau pembengkakan dapat memblokir saluran kelenjar Bartholin dan menyebabkan kista. Kista bisa mendapatkan lebih besar setelah berhubungan seks, karena kelenjar membuat lebih banyak cairan saat berhubungan seks. Terinfeksi Bartholin kista kadang-kadang disebabkan oleh infeksi menular seksual (IMS). Anda dapat menurunkan risiko IMS dengan menggunakan kondom ketika Anda berhubungan seks. Apa saja gejalanya? Anda mungkin tidak memiliki gejala apapun jika kista kelenjar Bartholin kecil. Tapi kista besar atau kista yang terinfeksi (abses) dapat menyebabkan gejala. Gejala kista yang tidak terinfeksi meliputi: Sebuah benjolan tidak nyeri di daerah vulva. Kemerahan atau pembengkakan di daerah vulva. Ketidaknyamanan ketika Anda berjalan, duduk, atau berhubungan seks. Gejala kista terinfeksi meliputi:

 Nyeri yang semakin buruk dan membuatnya sulit untuk berjalan, duduk, atau bergerak. Demam dan menggigil. Pembengkakan di daerah vulva. Drainase dari kista. Bagaimana Kista Bartholin kelenjar didiagnosa? Anda mungkin menemukan kista kelenjar Bartholin pada Anda sendiri, atau dokter Anda mungkin melihat itu selama pemeriksaan fisik. Kecuali jika tidak ada gejala, sulit untuk dideteksi Abses didiagnosa berdasarkan tanda-tanda infeksi, seperti demam atau bengkak, dan nyeri di daerah vulva. Dalam beberapa kasus, terutama jika Anda lebih tua, dokter Anda dapat membuang kista untuk memastikan bahwa itu bukan kanker atau masalah lain. Bagaimana Tindakan yang dilakukan? Beberapa kista kelenjar Bartholin bisa hilang tanpa diobati. Dapat diberikan obat penghilang rasa nyeri non-resep seperti ibuprofen (Advil atau Motrin, misalnya) untuk menghilangkan rasa sakit. Untuk membantu penyembuhan, rendam daerah dalam dangkal, mandi air hangat, atau mandi sitz. Jangan berhubungan seks sementara kista Bartholin adalah penyembuhan. Jika kista terinfeksi, itu bisa pecah terbuka dan mulai sembuh sendiri setelah 3 sampai 4 hari. Tetapi jika kista menyakitkan, dokter mungkin mengalirkan itu. Dan juga mungkin perlu minum antibiotik untuk mengobati infeksi. Untuk menjaga kista dari menutup dan mengisi lagi, dokter Anda dapat menempatkan sebuah tabung drainase kecil dengan balon kecil di salah satu ujung di dalam kista. Balon mengembang di dalam kista untuk menjaga kista terbuka. Setelah kelenjar telah sembuh, tabung dan balon dihapus. Terkadang dioksida laser atau perak nitrat karbon digunakan untuk mencegah kista tumbuh kembali. Untuk kista parah yang terus datang kembali, Anda mungkin harus pembedahan untuk mengangkat kelenjar Bartholin dan saluran. Ada prosedur yang disebut marsupialisasi di mana kantong dibuat dengan cara membuat potongan di atas kista dan jahitan sisi bersama-sama. Hal ini memungkinkan kista untuk mengeringkan.

Patient Care Health Information For Medical Professionals Research Educatio

Bartholin's cyst Definition

By Mayo Clinic staff

Bartholin's cyst

The Bartholin's (BAHR-toe-linz) glands are located on each side of the vaginal opening. These glands secrete fluid that helps lubricate the vagina. Sometimes the openings of these glands become obstructed, causing fluid to back up into the gland. The result is relatively painless swelling called a Bartholin's cyst. At times, the fluid within the cyst may become infected, resulting in pus surrounded by inflamed tissue (abscess). A Bartholin's cyst or abscess is common. Treatment of a Bartholin's cyst depends on the size of the cyst, the pain and whether the cyst is infected. Sometimes home treatment is all you need. In other cases, surgical drainage of the Bartholin's cyst is necessary. If an infection occurs, antibiotics may be helpful to treat the infected Bartholin's cyst.

Symptoms

By Mayo Clinic staff If the cyst remains small and no infection occurs, you may not notice it. If it grows, you might feel the presence of a lump or mass near your vaginal opening. Although a cyst is usually painless, it can be tender. If the cyst becomes infected a full-blown infection can occur in a matter of days you may experience these signs and symptoms:

A tender or painful lump near the vaginal opening Discomfort while walking or sitting Pain during intercourse Fever

A cyst or abscess typically occurs on only one side of the vaginal opening. When to see a doctor Call your doctor if you have a painful lump near the opening of your vagina that doesn't improve after two or three days of self-care treatment for instance, soaking the area in warm water (sitz bath). If the pain is severe, make an appointment with your doctor right away. If you find a new lump near your vaginal opening and you're older than 40, call your doctor promptly. Although rare, such a lump may be a sign of a more serious problem, such as cancer.

Causes
By Mayo Clinic staff Experts believe that the cause of a Bartholin's cyst is a backup of fluid. Fluid may accumulate when the opening of the gland (duct) becomes obstructed, perhaps by the growth of a flap of skin or because of infection. A cyst can become infected, forming an abscess. A number of bacteria may cause the infection, including common bacteria, such as Escherichia coli (E. coli), as well as bacteria that cause sexually transmitted infections such as gonorrhea and chlamydia.

Complications
By Mayo Clinic staff Bartholin cysts are likely to persist. Abscesses may recur and again require treatment.

Preparing for your appointment

By Mayo Clinic staff Your first appointment will likely be with either your primary care provider or a doctor who specializes in conditions that affect women (gynecologist). Because appointments can be brief, and there's often a lot to cover, it's a good idea to be prepared. What you can do

Write down your symptoms, including any that seem unrelated to your condition. Make a list of any medications as well as vitamins or other supplements that you take. Take a notebook or notepad with you to write down information during your visit. Prepare questions to ask your doctor, listing the most important first in case time runs out.

For a Bartholin's cyst, some basic questions to ask include:

What's likely causing my symptoms? What kind of tests might I need? Will the cyst go away on its own, or will I need treatment? How long should I wait after treatment before having sex? What self-care measures might help relieve my symptoms? Will the cyst come back again? Do you have any printed material or brochures I can take home with me? What websites do you recommend?

Don't hesitate to ask questions during your appointment if you don't understand something. What to expect from your doctor Some potential questions your doctor might ask include:

How long have you been experiencing symptoms? How severe are your symptoms? Do you experience pain during sex? Do you experience pain during normal daily activities? Does anything improve your symptoms?

Does anything make your symptoms worse?

Tests and diagnosis

By Mayo Clinic staff To diagnose a Bartholin's cyst, your doctor may:

Ask questions about your medical history Perform a pelvic exam Take a sample of secretions from your vagina or cervix to test for a sexually transmitted infection Recommend a test of the mass (biopsy) to check for cancerous cells if you're postmenopausal or over 40

If cancer is a concern, your doctor may refer you to a gynecologist who specializes in cancers of the female reproductive system

Treatments and drugs

By Mayo Clinic staff Often a Bartholin's cyst requires no treatment especially if the cyst causes no signs or symptoms. When needed, treatment depends on the size of the cyst, your discomfort level and whether it's infected, which can result in an abscess. Treatment options your doctor may recommend include:

Sitz baths. Soaking in a tub filled with a few inches of warm water (sitz bath) several times a day for three or four days may help a small, infected cyst to rupture and drain on its own. Surgical drainage. You may need surgery to drain a cyst that's infected or very large. Drainage of a cyst can be done using local anesthesia or sedation. For the procedure, your doctor makes a small incision in the cyst, allows it to drain and then places a small rubber tube (catheter) in the incision. The catheter stays in place for up to six weeks to keep the opening from closing and to allow complete drainage. Antibiotics. Your doctor may prescribe an antibiotic if your cyst is infected or if testing reveals that you have a sexually transmitted infection. But if the abscess is drained properly, you may not need antibiotics. Marsupialization. If cysts recur or bother you, a marsupialization (mahr-soo-pee-uhl-ihZAY-shun) procedure may help. Your doctor places stitches on each side of a drainage

incision to create a permanent opening less than 1/4-inch (about 6 millimeters) long. An inserted catheter promotes draining for a few days after the procedure and helps prevent recurrence. Depending on how complex your cyst is, you may need to have the procedure done in a hospital operating room under general anesthesia. If you have an active infection, your doctor will likely drain the abscess first, treat the infection with a course of antibiotics and then perform the marsupialization. Rarely for persistent cysts that aren't effectively treated by the above procedures, your doctor may recommend surgery to remove the Bartholin's gland. Surgical removal is usually done in a hospital under general anesthesia.

Lifestyle and home remedies

By Mayo Clinic staff Daily soaking in warm water, several times a day, may be adequate to resolve an infected Bartholin's cyst or abscess. After surgical procedures to treat an infected cyst or abscess, soaking in warm water is particularly important. Sitz baths help to keep the area clean, ease discomfort and promote effective drainage of the cyst. Pain relievers also may be helpful. If you have a catheter in place, after your doctor's approval, you may resume your normal activities, including sex, depending on your level of comfort.

Prevention
By Mayo Clinic staff There's no way to prevent a Bartholin's cyst. However, practicing safe sex in particular, using a condom and maintaining good hygiene habits may help to prevent infection of a cyst and the formation of an abscess.
Source: www.mayoclinic.com/health/bartholin-cyst/DS00667

References 1. Wechter ME, et al. Management of Bartholin duct cysts and abscesses: A systematic review. Obstetrical and Gynecological Survey. 2009;64:395. 2. Chen KT. Disorders of Bartholin's gland. http://www.uptodate.com/index. Accessed March 6, 2012. 3. Patil S, et al. Bartholin's cysts and abscesses. Journal of Obstetrics and Gynaecology. 2007;27:241. 4. Pundir J, et al. A review of the management of diseases of the Bartholin's gland. Journal of Obstetrics and Gynaecology. 2008;28:161.

5. McPhee SJ, et al. Current Medical Diagnosis & Treatment 2012. 51st ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=8880. Accessed March 6, 2012.

Resources
for Bartholin's cyst Mayo Clinic Store Book: Mayo Clinic Family Health Book, 4th Edition Newsletter: Mayo Clinic Health Letter Last Revised: April 24, 2012

Defenisi : kelenjar Bartholin yang terletak di setiap sisi lubang vagina. Kelenjar mensekresi cairan yang membantu melumasi vagina. Terkadang saluran kelenjar ini menjadi terhambat, menyebabkan cairan untuk kembali ke kelenjar. Hasilnya adalah pembengkakan relatif tanpa rasa sakit disebut kista Bartholin. Pada saat ini, cairan dalam kista dapat terinfeksi, sehingga nanah yang dikelilingi oleh jaringan yang meradang (abses). Kista Bartholin atau abses umum. Pengobatan kista Bartholin tergantung pada ukuran kista, rasa sakit dan apakah kista terinfeksi. Kadang-kadang perawatan di rumah adalah semua yang Anda butuhkan. Dalam kasus lain, drainase bedah kista Bartholin diperlukan. Jika infeksi terjadi, antibiotik mungkin dapat membantu untuk mengobati kista Bartholin yang terinfeksi. Gejala Jika kista masih kecil dan tidak ada infeksi terjadi, Anda mungkin tidak menyadarinya. Jika tumbuh, Anda mungkin merasakan adanya benjolan atau massa di dekat lubang vagina Anda. Meskipun kista biasanya tidak nyeri, bisa menjadi lembut. Jika kista menjadi terinfeksi - infeksi full-blown dapat terjadi dalam hitungan hari Anda mungkin mengalami tanda-tanda dan gejala: Sebuah tender atau menyakitkan benjolan di dekat lubang vagina Ketidaknyamanan saat berjalan atau duduk

 Nyeri saat berhubungan intim Demam Sebuah kista atau abses biasanya terjadi hanya pada satu sisi dari lubang vagina. Konsultasi ke Dokter: Hubungi dokter Anda jika Anda memiliki benjolan yang sakit dekat pembukaan vagina yang tidak membaik setelah dua atau tiga hari pengobatan perawatan diri misalnya, merendam daerah dalam air hangat (sitz bath). Jika sakit semakin parah, segera konsultasi ke dokter. Jika Anda menemukan benjolan baru di dekat lubang vagina pada usia lebih dari 40 tahun, segera ke dokter. Meskipun jarang, benjolan tersebut mungkin merupakan tanda masalah yang lebih serius, seperti kanker. Penyebab Para ahli percaya bahwa penyebab kista Bartholin adalah cadangan cairan. Cairan bisa menumpuk ketika pembukaan kelenjar (duktus) menjadi terhambat, mungkin dengan pertumbuhan flap kulit atau karena infeksi. Kista dapat terinfeksi, membentuk abses. Sejumlah bakteri dapat menyebabkan infeksi, termasuk bakteri yang umum, seperti Escherichia coli (E. coli), serta bakteri yang menyebabkan infeksi menular seksual seperti gonore dan klamidia. Komplikasi Bartholin kista cenderung bertahan. Abses bisa kambuh lagi dan memerlukan pengobatan. Mempersiapkan untuk janji pertemuan Anda Pertemuan pertama Anda kemungkinan besar akan baik dengan penyedia perawatan primer atau dokter yang mengkhususkan diri dalam kondisi yang mempengaruhi perempuan (ginekolog). Karena janji dapat singkat, dan sering ada banyak untuk menutupi, itu ide yang baik untuk dipersiapkan. Apa yang dapat Anda lakukan Tuliskan gejala Anda, termasuk yang tampaknya tidak berhubungan dengan kondisi Anda. Buatlah daftar dari setiap obat serta vitamin atau suplemen lain yang Anda ambil. Ambil notebook atau notepad dengan Anda untuk menuliskan informasi selama kunjungan Anda.

 Siapkan pertanyaan untuk meminta dokter Anda, daftar yang paling penting pertama dalam kasus waktu berjalan keluar. Untuk kista Bartholin, beberapa pertanyaan dasar untuk meminta meliputi: Apa yang mungkin menyebabkan gejala saya? Apa jenis tes mungkin saya butuhkan? Apakah kista pergi sendiri, atau akan saya memerlukan pengobatan? Berapa lama saya harus menunggu setelah pengobatan sebelum bercinta? Apa langkah-langkah perawatan diri dapat membantu meringankan gejala saya? Apakah kista kembali lagi? Apakah Anda memiliki bahan cetak atau brosur bisa saya bawa pulang dengan saya? Website apa yang anda rekomendasikan? Jangan ragu untuk bertanya selama janji Anda jika Anda tidak memahami sesuatu. Apa yang diharapkan dari dokter Anda Beberapa pertanyaan potensial dokter Anda mungkin bertanya meliputi: Berapa lama Anda telah mengalami gejala? Seberapa parah adalah gejala Anda? Apakah Anda mengalami nyeri saat berhubungan seks? Apakah Anda mengalami rasa sakit selama kegiatan normal sehari-hari? Apakah sesuatu memperbaiki gejala Anda? Apakah sesuatu membuat gejala lebih buruk? Tes dan diagnosis Untuk mendiagnosis kista Bartholin, dokter Anda dapat: Ajukan pertanyaan tentang riwayat kesehatan Anda Lakukan pemeriksaan panggul Ambil sampel cairan dari vagina atau leher rahim untuk menguji untuk infeksi menular seksual

 Merekomendasikan uji massa (biopsi) untuk memeriksa sel-sel kanker jika Anda pascamenopause atau lebih dari 40 Jika kanker adalah kekhawatiran, dokter Anda dapat merujuk Anda ke dokter kandungan yang mengkhususkan diri dalam kanker sistem reproduksi wanita Perawatan dan obat-obatan Seringkali kista Bartholin tidak memerlukan pengobatan - terutama jika kista tidak menyebabkan tanda-tanda atau gejala. Jika diperlukan, pengobatan tergantung pada ukuran kista, tingkat ketidaknyamanan Anda dan apakah itu terinfeksi, yang dapat mengakibatkan abses. Pilihan pengobatan dokter anda dapat merekomendasikan meliputi: Sitz mandi. Berendam dalam bak diisi dengan beberapa inci air hangat (sitz bath) beberapa kali sehari selama tiga atau empat hari dapat membantu kecil, kista terinfeksi pecah dan tiriskan sendiri. Bedah drainase. Anda mungkin memerlukan pembedahan untuk mengeringkan kista yang terinfeksi atau sangat besar. Drainase kista dapat dilakukan dengan menggunakan anestesi lokal atau sedasi. Untuk prosedur, dokter membuat sayatan kecil di kista, memungkinkan untuk menguras dan kemudian menempatkan tabung karet kecil (kateter) dalam sayatan. Kateter tetap di tempat selama enam minggu untuk menjaga pembukaan dari penutupan dan memungkinkan drainase lengkap. Antibiotik. Dokter mungkin meresepkan antibiotik jika kista Anda terinfeksi atau jika pengujian menunjukkan bahwa Anda memiliki infeksi menular seksual. Tetapi jika abses dikeringkan dengan benar, Anda tidak mungkin perlu antibiotik. marsupialisasi. Jika kista kambuh atau mengganggu Anda, sebuah marsupialisasi (mahar-soo-pee-Uhl-ih-ZAY-shun) prosedur dapat membantu. Tempat dokter jahitan pada setiap sisi insisi drainase untuk membuat celah permanen kurang dari 1/4-inch (sekitar 6 milimeter) panjang. Sebuah kateter dimasukkan mempromosikan pengeringan selama beberapa hari setelah prosedur dan membantu mencegah kekambuhan. Tergantung pada seberapa kompleks kista Anda, Anda mungkin harus memiliki prosedur dilakukan di ruang operasi rumah sakit dengan anestesi umum. Jika Anda memiliki infeksi aktif, dokter mungkin akan menguras abses pertama, mengobati infeksi dengan antibiotik dan kemudian melakukan marsupialisasi tersebut. Jarang untuk kista persisten yang tidak efektif diobati dengan prosedur di atas, dokter anda dapat merekomendasikan operasi untuk mengangkat kelenjar Bartholin. Operasi pengangkatan biasanya dilakukan di rumah sakit dengan anestesi umum. Gaya Hidup dan rumah obat Dengan Mayo Clinic staff

Harian berendam dalam air hangat, beberapa kali sehari, mungkin cukup untuk mengatasi kista Bartholin yang terinfeksi atau abses. Setelah prosedur bedah untuk mengobati kista atau abses terinfeksi, berendam di air hangat sangat penting. Sitz mandi membantu untuk menjaga daerah bersih, meringankan ketidaknyamanan dan mempromosikan drainase yang efektif dari kista. Penghilang rasa sakit juga dapat membantu. Jika Anda memiliki kateter di tempat, setelah persetujuan dokter Anda, Anda dapat melanjutkan kegiatan normal Anda, termasuk jenis kelamin, tergantung pada tingkat kenyamanan Anda. Pencegahan Tidak ada cara untuk mencegah kista Bartholin. Namun, mempraktekkan seks aman - khususnya, menggunakan kondom - dan mempertahankan kebiasaan kebersihan yang baik dapat membantu mencegah infeksi kista dan pembentukan abses.

Mayo Clinic support Give today to find cures for tomorrow Web sites American Academy of Family Physicians http://www.familydoctor.org

Bartholin's Cyst
Medical Author: R Daniel Braun, MD Coauthor: Melissa Howell Kennedy, MD Medical Editor: Anthony Anker, MD, FAAEM Medical Editor: Francisco Talavera, PharmD, PhD Medical Editor: Lee P Shulman, MD
Bartholin's Cyst Overview

The Bartholin's glands are located at the entrance to a woman's vagina, one on each side. They are small and cannot be seen or felt when they are normal. Their function is to secrete fluid onto the mucosal (inner) surface of the labia-the liplike skin surrounding the vagina. Problems with the Bartholin's glands include cysts, which are relatively painless enlargements of the gland, and abscesses, which are infections of the gland. Typically only 1 of the 2 glands is affected.

Bartholin's Cyst Causes

A Bartholin's cyst develops when the duct exiting the Bartholin's gland becomes blocked. The fluid produced by the gland then accumulates, causing the gland to swell and form a cyst. An abscess occurs when a cyst becomes infected. Bartholin's abscesses can be caused by any of a number of bacteria. These include bacterial organisms that cause sexually transmitted diseases such as chlamydia and gonorrhea as well as bacteria normally found in the intestinal tract, such as Escherichia coli. It is common for these abscesses to involve more than one type of organism.
Bartholin's Cyst Symptoms A Bartholin's cyst causes swelling of the labia on one side, near the entrance to the vagina. A cyst is usually not very painful, and significant pain suggests that an abscess has developed. However, large cysts may be painful simply by virtue of their size.

A Bartholin's abscess causes significant pain in addition to the swelling. The swollen area is extremely tender and the skin reddened. Walking and sitting may be quite painful. Women with Bartholin's abscesses do not usually have fever. Vaginal discharge may be present, especially if the infection is caused by a sexually transmitted organism.

When to Seek Medical Care See a doctor if any genital lump or mass continues to enlarge or does not improve within a few days of home treatment.

If a lump or mass is painful, this suggests that an abscess has developed. It needs to be drained. If other symptoms develop, including vaginal discharge, fever, or vomiting, call the doctor. With Bartholin's cysts and abscesses, the primary reason to seek emergency care is acute pain. Women who are experiencing severe pain or who cannot sit or walk comfortably should see a doctor as soon as possible. Although symptoms such as high fever and abdominal pain usually are not caused by Bartholin's abscesses, seek emergency care if these symptoms do develop.

Exams and Tests

In general, the diagnosis of Bartholin's cyst or abscess is made by physical examination. In many cases, no additional testing is needed. Sometimes cultures are taken to determine the type of bacteria causing the infection and to check for sexually transmitted infections such as gonorrhea and chlamydia. These cultures simply involve taking a swab either from the material drained from the abscess or from another area such as the cervix. Results of these tests are not available until about 48 hours later, so they do

not change the immediate treatment. However, they may indicate a need for additional treatment with antibiotics.
Bartholin's Cyst Treatment Patient Comments Read 36 Comments Share Your Story Self-Care at Home

Home treatment of Bartholin's cysts and abscesses involves sitz baths, which promote drainage. Special sitz bath basins are available, but the simplest method is to sit in the bathtub in a few inches of warm water. The water should not be so hot as to burn the skin but should be fairly warm. These soaks should be done for 10-15 minutes at a time, 3-4 times daily. This treatment is frequently all that is needed for Bartholin's cysts. Abscesses often require drainage by a doctor.
Medical Treatment

For a small Bartholin's cyst that is not too painful, treatment consists of sitz baths with follow-up if the cyst enlarges or becomes painful. Especially with recurrent cysts treatment with antibiotics and sitz baths to cool off the infection is sometimes done. If this clears up the infection, a surgical procedure called a marsupialization can be done later

Surgery

For Bartholin's abscesses and cysts that are symptomatic (large or painful), the treatment is drainage. An abscess is an infection within an enclosed space, and antibiotics do not adequately enter into the enclosed space. Therefore, treatment of an abscess almost always requires that the infection be drained.
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Drainage of a Bartholin's abscess can be done in the doctor's office or a hospital's Emergency Department. Local anesthetic is injected over the abscess, and then an incision is made on the inner surface of the entrance to the vagina. After the infected material is drained, the abscess cavity is packed either with gauze or a small catheter. This holds the cavity open and promotes further drainage. Gauze packing is removed after 24-48 hours. If a small catheter is used, it may be left in place for several weeks to minimize the chance of recurrence. Drainage of an abscess can be uncomfortable, because local anesthetics do not always work well in inflamed tissue. Depending on the preferences of both the woman and the doctor, as well as other factors including the size of the abscess, IV medications may be given for sedation and additional pain relief during the procedure. After drainage of an abscess, antibiotic treatment is usually not necessary. However, if there is a concern of a sexually transmitted infection, or if there is evidence of urinary or vaginal infection, an

antibiotic may be prescribed. In some cases, this will be done a couple of days after the initial treatment, after the results of any cultures are received.

Once a recurrent cyst has been cooled off, a procedure called a marsupialization can be carried out. This is usually done in an outpatient surgical setting. An incision is made into the skin over the cyst and then carried down through the cyst wall. This drains the fluid from the cyst and then the lining of the cyst wall is sutured to the overlying skin in such a way as to create a permanent drain site. This usually prevents recurrence of the cyst.
Next Steps Follow-up Women who have had a Bartholin's cyst or abscess drained should follow up in 24-48 hours for recheck and possible removal of packing material. In the meantime, sitz baths should be taken to continue drainage.

Contact the doctor if the packing falls out prematurely. Depending on the timing, the size of the abscess, and whether symptoms are continuing, it may or may not need to be replaced. Women may be given pain medication. Take this as prescribed. If antibiotics were prescribed, they should be taken until gone. Women should be rechecked if they experience new symptoms including increasing swelling, pain, vaginal discharge, or fever.

Prevention If a Bartholin's cyst develops, prompt treatment with sitz baths may prevent the development of an abscess.

Safe sex practices can decrease the spread of sexually transmitted diseases and therefore prevent the formation of abscesses caused by these organisms.

Outlook

The majority of women feel much better within 24 hours of drainage. Some have problems with recurrent cysts or abscesses. If that becomes the case, there is a procedure called marsupialization, which can be performed to destroy the cyst and prevent future episodes. A gynecologist most often performs this procedure.

Authors and Editors

Author: R Daniel Braun, MD, Professor of Clinical Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Indiana University School of Medicine. Coauthor(s): Melissa Howell Kennedy, MD, Former Consulting Staff, Department of Emergency Medicine, West Shore Medical Center. Editors: Anthony Anker, MD, FAAEM, Attending Physician, Emergency Department, Mary Washington Hospital, Fredericksburg, VA; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; Lee P Shulman, MD, Professor of Obstetrics and Gynecology, Head, Section of Reproductive Genetics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Last Editorial Review: 8/25/2005 Source: http://www.emedicinehealth.com/bartholin_gland_cyst-health/article_em.htm