Bartholin’s cysts

Bartholin's cysts, also called Bartholin's duct cysts, are common, small mucous-filled cysts that are found on either side of the vaginal opening.

This chapter is set out as follows:

• Bartholin's glands are round, very small, non-palpable, and located deep in the posterolateral vaginal orifice. Obstruction of the Bartholin duct causes the gland to enlarge with mucous, resulting in a cyst. The cause of obstruction is usually unknown

• Cysts develop in about 2% of women, usually in the third decade. With ageing, cysts are less likely to develop

• A complication of a cyst is Bartholin’s abscess. The cause of these is generally unknown, although occasionally they may be caused by bacteria normally occurring in the vagina that infect the cyst, or by a sexually transmitted infection, such as chlamydia or gonorrhoea

• Most cysts are asymptomatic, unilateral, less than 1 cm in diameter, and palpable near the vaginal orifice. Lesions can distend the affected labia majora, causing vulvar asymmetry

• Large cysts can be irritating, interfering with sexual intercourse and walking

• If a cyst becomes infected and an abscess develops, the cyst becomes painful, swollen, and fever may develop

• Asymptomatic cysts do not require treatment. Troublesome cysts require surgical management 

• Abscesses - some respond to antibiotics, others require incision and drainage