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Tuesday, May 21, 2019

Bartholin's cyst: Causes, Diagnosis and Treatment

bartholin's cyst/abscess




WHAT IS 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. If the fluid within the cyst becomes infected, you may develop a collection of 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, how painful the cyst is 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.

What are Symptoms of Bartholin's cyst

If you have a small, noninfected Bartholin's cyst, you may not notice it. If the cyst grows, you might feel a lump or mass near your vaginal opening. Although a cyst is usually painless, it can be tender.

A full-blown infection of a Bartholin's cyst can occur in a matter of days. If the cyst becomes infected, you may experience:
  1. A tender, painful lump near the vaginal opening
  2. Discomfort while walking or sitting
  3. Pain during intercourse
  4. Fever
A Bartholin's 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(Batholin's cyst) near the opening of your vagina that doesn't improve after two or three days of self-care — for instance, soaking the area in warm water (sitz bath). If the pain is severe, make an appointment with your doctor right away.




Also call your doctor promptly if you find a new lump near your vaginal opening and you're older than 40. Although rare, such a lump may be a sign of a more serious problem, such as cancer.

What are Causes of bartholin's cyst

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 caused by infection or injury.

A Bartholin's cyst can become infected, forming an abscess. A number of bacteria may cause the infection, including Escherichia coli (E. coli) and bacteria that cause sexually transmitted infections such as gonorrhea and chlamydia.

Complications of the bartholin's cyst

A Bartholin's cyst or abscess may recur and again require treatment.

Possible Prevention of bartholin's cyst

There's no way to prevent a Bartholin's cyst. However, safer sex practices — in particular, using condoms — and good hygiene habits may help to prevent infection of a cyst and the formation of an abscess.




Diagnosis of bartholin's cyst

To diagnose a Bartholin's cyst, your doctor may:
  1. Ask questions about your medical history
  2. Perform a pelvic exam
  3. Take a sample of secretions from your vagina or cervix to test for a sexually transmitted infection
  4. 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. 

Treatment Bartholin's cyst

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:
  1. 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.
  2. 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.
  3. 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 incision open and allow complete drainage.
  4. 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 (bartholi's cyst) abscess is drained properly, you may not need antibiotics.
  5. Marsupialization. If cysts recur or bother you, a marsupialization (mahr-soo-pee-ul-ih-ZAY-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-millimeter) long. An inserted catheter may be placed to promote drainage for a few days after the procedure and help prevent recurrence.










Questions to ask your doctor about bartholoin's cyst and Glands.

  1. I have a bump on one of my vaginal lips. Could it be a Bartholin’s gland cyst?
  2. Do I need any tests, such as tests for sexually transmitted infections?
  3. How serious is the cyst? Is it infected?
  4. What are my treatment options? What treatment do you recommend for me?
  5. Is it safe for me to have sex?

REFERENCE

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  2. Chen KT. Disorders of Bartholin's gland. http://www.uptodate.com/home. Accessed Jan. 11, 2015.
  3. Bope ET, et al. Conn's Current Therapy. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed Jan. 11, 2015.
  4. Mayeaux EJ, et al. Vulvar procedures: Biopsy, Bartholin abscess treatment, and condyloma treatment. Obstetrics and Gynecology Clinics of North America. 2013;40:759.
  5. Laughlin-Tommaso S (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 15, 2015.
  6. AskMayoExpert. Bartholin cyst. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
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  9. Scott PM. Draining a cyst or abscess in a Bartholin's gland with a Word catheter. JAAPA 2003; 16:51.
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  11. Haider Z, Condous G, Kirk E, et al. The simple outpatient management of Bartholin's abscess using the Word catheter: a preliminary study. Aust N Z J Obstet Gynaecol 2007; 47:137.
  12. Reif P, Ulrich D, Bjelic-Radisic V, et al. Management of Bartholin's cyst and abscess using the Word catheter: implementation, recurrence rates and costs. Eur J Obstet Gynecol Reprod Biol 2015; 190:81.