Female Genital Lump and Bump 1: Bartholin's Gland Cyst/Abscess 

What are Bartholin's gland and its function?

There are two Bartholin's gland located on each side of the vaginal opening. These glands secrete fluid that helps lubricate the vagina maintain the moisture of the vulva and during sexual activity. The glands is connected to about 2-cm long duct into an opening immediately outside the hymenal ring at about the 4 and 8 o'clock position. Normal Bartholin's gland are not palpable. Bartholin's cyst are more common in women of reproductive age between the ages of 20's and 30's. The older you get, the less likely you will develop Bartholin's gland cysts as the glands will typically shrink and produce less mucus 

How does Bartholin's cyst and abscess formed?

Sometimes the ducts of these glands become obstructed causing fluid to build-up into the gland causing a relatively painless swelling called Bartholin's cyst. Once the cyst become infected, an abscess may occur. This can happened due to injury or irritation of the vulva skin for example from shaving, bacteria infection (E. Coli, Staph and Strept) and sexually transmitted infections (STIs) like Chlamydia and Gonorrhoea

What are the symptoms of Bartholin's abscess?

Bartholin abscess cause tender swelling with pressure sensation on the vaginal area. The pain are usually worse during sitting and walking, sexual activity and insertion of tampon or menstrual cup.  Sometimes it can also cause vaginal discharge, painful urination, fever, chills and pus discharge from the swelling if spontaneous rupture occurs

How is Bartholin's cyst diagnosed?

Diagnosis can be confirmed based on physical examination. Your doctor may decide to do additional testing to include swab culture and sensitivity from the fluid or STD screening

What are the treatment for a Bartholin cyst or abscess?

Treatment for Bartholin's cyst depends on the symptoms. If the cyst is small, painless and doesn't appear infected, it may not need any treatment. However if the swelling persists or grows or becoming painful after two or 3 days of home care like sitz bath, then you may be developing an abscess. If this happened, please seek advise from your doctor for treatments. You should not squeeze, pop or insert  sharp objects like needle to force it to open. Sometimes the cyst may spontaneously drain on its own after several days

Treatment options may include:

1. Sitz bath 

2. Pain relief with anti-inflammatory effect to help with the pain and swelling

3. Antibiotic to treat for infection

4. Surgical drainage with or without cathether - this can be done using needle or a small cut to allow the fluid to be drained. However, it's likely that the cyst will recur after this treatment. A cathether can be inserted into the cyst after drainage and left in place for about 4- 6 weeks so that a permanent opening can form

5. Marsupialization is a surgical procedure after the cyst has been cut and drained. The edges of the cyst wall are stitched together to create a permanent drainage passage and is indicated for patient with recurrent cyst

6. Removal of the Bartholin's gland is a surgical procedure where the Bartholin's gland are excised completely after all other treatment methods has fail. The surgery need to be performed in operating theathre due to risk of pain, bleeding and other complication. Downtime can be up to several weeks and avoidance of sexual activity to allow wound to fully healed

How do I prevent Bartholin's gland to happen in the first place or if I have been treated for Bartholin's cyst or abscess how can I prevent it from recurring again?

There is no way to prevent Bartholin's cyst to recur again except to maintain good perineal hygiene and sitz bath when the swelling arises. There are also no food or dietary restriction to prevent it from recurring again. Recurrence of Bartholin's abscess indicate the need to consider surgical intervention, so talk to your doctor for more information

Refer to the link given for further information on keeping your vagina healthy

https://kliniktemasya.com/facts-about-your-vagina-and-how-you-can-keep-it-healthy/

If you have any concerns or questions regarding Bartholin's gland cyst and abscess, do contact our clinic  to book your appointment with our experienced female physician today