Bartholin Cyst: Symptoms, Treatment, and Recovery Concerns

Bartholin's gland cyst

Hello Doctor, on June 13th, I discovered a pus-filled bump on the upper inner side of my right labia majora, which felt like it had already burst and was very painful.
When I visited the hospital, the doctor scheduled surgery for June 14th to excise the abscess (he mentioned it was not in the Bartholin gland area).
After a 7-day hospital stay, I was discharged and prescribed oral antibiotics.
On June 29th, I returned to the clinic to have my stitches removed, and I continued to have regular follow-up appointments in July.
I reported to the doctor that the wound was still very painful, and he reassured me that it was healing well.

However, on July 17th, while caring for the wound and applying medication as usual, I noticed that one of the stitches had not been completely removed.
I then went to the emergency department of that hospital for treatment and decided to consult another gynecologist.
During the examination, the doctor noted that the wound was still very painful and suspected that it had not healed properly and was still inflamed.
Upon further examination, he found a swollen area on the inner right side of the vaginal opening that was painful to the touch.
This swollen area was also within the range of the surgical incision.
Based on the appearance after the initial suturing, it seemed to be a small protrusion of tissue between the sutures.

The doctor was hesitant to determine whether the swelling on the inner vaginal side was a normal post-suture structure or if it was due to inflammation from other wounds.
He mentioned the possibility of a Bartholin gland cyst but could not confirm it.
The current management plan is to continue oral antibiotics to see if the swelling resolves (I have been on antibiotics for 14 days now).
The tissue has not enlarged, but it has not decreased either, and other wounds continue to be painful.

My concern and confusion are that it has been over a month since the surgery, and the wound has still not healed and remains painful, which is very troubling for my daily activities.
Based on your clinical experience, do you think this could be a Bartholin gland cyst, or is it more likely that the prolonged inflammation from the surgical site is causing the swelling? Thank you, Doctor, for taking the time to respond.

Xiao Hui, 30~39 year old female. Ask Date: 2017/07/28

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I apologize for not being able to provide a diagnosis based on what you've described.
If you are still experiencing discomfort, I recommend visiting a hospital for a detailed examination by an obstetrician-gynecologist.
Wishing you good health.

Reply Date: 2017/07/28

More Info

Bartholin cysts are fluid-filled sacs that can develop near the vaginal opening, often resulting from blocked Bartholin glands, which are responsible for secreting fluid that helps lubricate the vagina. When these cysts become infected, they can turn into abscesses, leading to significant discomfort and pain, as you have experienced.

Based on your description, it seems that you initially had a painful abscess that required surgical intervention. The fact that you are still experiencing pain and have noted swelling at the surgical site more than a month post-operation raises several important considerations.

1. Post-Surgical Recovery: After any surgical procedure, particularly in sensitive areas like the vulva, it is not uncommon to experience pain and discomfort for an extended period. The healing process can vary significantly from person to person, and factors such as the extent of the surgery, individual pain tolerance, and overall health can influence recovery time. It is also possible that the surgical site may still be inflamed, which can contribute to ongoing pain.

2. Infection and Inflammation: The persistent pain and swelling you describe could indicate that there is still some degree of inflammation or possibly an infection at the surgical site. While you have been on antibiotics for 14 days, it is essential to monitor whether the swelling decreases or if it remains unchanged. If the area remains painful and swollen, it may warrant further evaluation to rule out any residual infection or complications from the surgery.

3. Bartholin Gland Involvement: Your concern about whether the swelling could be related to a Bartholin cyst is valid. If the cyst was not completely excised or if there is a new blockage of the gland, it could lead to the formation of another cyst or abscess. The fact that the swelling is located near the vaginal opening and is painful upon palpation suggests that it could be related to the Bartholin glands.

4. Next Steps: Given your ongoing symptoms, it is crucial to follow up with your healthcare provider. They may recommend imaging studies, such as an ultrasound, to assess the area more thoroughly and determine whether there is a new cyst or if the existing surgical site is healing properly. Additionally, if the antibiotics do not seem to be effective, your doctor might consider changing the antibiotic or exploring other treatment options.

5. Pain Management: In the meantime, managing your pain is essential. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may help alleviate some discomfort. However, always consult your doctor before taking any medication, especially if you are currently on other prescriptions.

In summary, while it is possible that the swelling and pain you are experiencing could be related to a Bartholin cyst, it is equally plausible that they are due to inflammation or complications from your recent surgery. Close communication with your healthcare provider is key to ensuring proper diagnosis and treatment. Your concerns are valid, and it is essential to advocate for your health and seek further evaluation if your symptoms persist.

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