Bartholin's Cyst: Symptoms, Diagnosis, and Treatment Options

Q: Bartholin's Cyst: Symptoms, Diagnosis, and Treatment Options

Hello, Ms. <br>Kun： Your condition is likely a Bartholin's gland abscess, which is not uncommon among women of reproductive age. <br>The bacteria that typically cause this condition were previously often Neisseria gonorrhoeae, but current statistics show that most cases are cause

Bartholin's gland cyst

Hello, Doctor.
I discovered a lump in my genital area and after researching online, it seems like a Bartholin's gland cyst.
However, I read that 90% of cases are caused by gonorrhea.
I then visited a gynecologist who confirmed it was a Bartholin's gland cyst.
I was worried about gonorrhea, so I asked the doctor, who suggested I could undergo a bacterial culture.
The doctor prescribed medication and a suppository for me to use.
After finishing the medication, the lump hadn't disappeared, so I returned to see the doctor.
The doctor said it had reduced somewhat, about 2 cm, and suggested I continue taking the medication and monitor it.
However, the day after finishing the medication, my period started, and I felt like the lump had swollen again.
As soon as my period ended, I went back to see the doctor.
The doctor noted that there was some swelling and prescribed more medication and a suppository, suggesting surgery might be necessary.
The test results came back, and the doctor informed me there was no gonorrhea.
After taking the medication and suppository for two days (it was prescribed for four days), I woke up with pain and increased swelling.
I went to the clinic immediately to see the doctor and asked if there was anything to reduce the swelling.
The doctor suggested I schedule surgery for the following week.
I expressed that I was very uncomfortable, and a nearby nurse asked the doctor if they could use a needle.
The doctor then used a needle to drain pus and told me that it wasn't a Bartholin's gland cyst but an abscess, which explained the discomfort.
The doctor mentioned they had drained half of it, and when I said it was okay to continue, the doctor didn't respond.
The nurse told the doctor that I was okay with continuing, and the doctor then advised that it wasn't fully drained and still recommended scheduling surgery before leaving.
After getting dressed, I asked the doctor why it was pus.
The doctor explained it was due to bacteria and mentioned they had changed my medication because the abscess was more severe (I can't remember exactly because I was in a lot of pain at the time).
They switched my medication to three times a day after meals, instead of the original morning and evening doses with a suppository before bed.
Earlier, I was worried about gonorrhea, and the doctor had shown me the bacterial culture results, confirming there was no gonorrhea.
However, the doctor later said the abscess was due to bacteria.
I wonder if the bacterial culture can only detect gonorrhea or if it can identify other bacteria as well.
The doctor only mentioned there was no gonorrhea but indicated the abscess was due to bacteria, which makes me a bit anxious.
Is surgery really the only way to resolve this? Thank you, Doctor, for patiently reading this.
I appreciate your help in answering my questions, and I want to express my gratitude for your hard work!

Kun, 20~29 year old female. Ask Date: 2020/07/04

Dr. Huang Yiwen reply Obstetrics and Gynecology

Hello, Ms.
Kun: Your condition is likely a Bartholin's gland abscess, which is not uncommon among women of reproductive age.
The bacteria that typically cause this condition were previously often Neisseria gonorrhoeae, but current statistics show that most cases are caused by anaerobic bacteria or skin flora.
Since the bacterial culture did not grow Neisseria gonorrhoeae, you don't need to worry too much.
Bartholin's gland abscess can be treated with medication, but larger abscesses generally require incision and drainage or marsupialization for definitive treatment.
In your case, surgical intervention would be the better option.

Reply Date: 2020/07/04

More Info

Bartholin's cysts are fluid-filled sacs that develop in the Bartholin glands, which are located on either side of the vaginal opening. These glands are responsible for producing lubrication during sexual arousal. When the ducts of these glands become blocked, fluid can accumulate, leading to the formation of a cyst. While Bartholin's cysts are often asymptomatic, they can sometimes become infected, resulting in a painful condition known as a Bartholin's gland abscess.

Symptoms
The symptoms of a Bartholin's cyst can vary depending on whether it is infected or not. Common symptoms include:
- A noticeable lump or swelling near the vaginal opening.

- Discomfort or pain, especially during sexual intercourse or while sitting.

- If the cyst becomes infected, symptoms may include increased pain, redness, swelling, and possibly fever or chills.

Diagnosis
Diagnosis typically involves a physical examination by a healthcare provider. In your case, the doctor performed a bacterial culture to rule out sexually transmitted infections (STIs) like gonorrhea, which is a common concern. It's important to note that while gonorrhea can cause Bartholin's cysts, not all cysts are related to STIs. The culture can help identify the presence of bacteria and determine the appropriate treatment.

Treatment Options
Treatment for Bartholin's cysts depends on the severity of the symptoms and whether the cyst is infected. Here are some common approaches:
1. Observation: If the cyst is small and not causing discomfort, your doctor may recommend simply monitoring it.

2. Sitz Baths: Warm sitz baths can help alleviate discomfort and promote drainage if the cyst is not infected.

3. Medications: Antibiotics may be prescribed if there is an infection. Pain relief medications can also be recommended to manage discomfort.

4. Drainage: If the cyst becomes large or painful, your doctor may perform a procedure to drain the cyst. This can often be done in the office and may involve using a needle to aspirate the fluid or making a small incision.

5. Surgical Options: In cases where cysts recur or do not respond to other treatments, surgical intervention may be necessary. This could involve marsupialization, where the cyst is opened and the edges are stitched to the vaginal wall to create a permanent drainage opening.

Concerns About Infection
Your concern about the presence of bacteria and the development of an abscess is valid. An abscess occurs when bacteria infect the cyst, leading to the accumulation of pus. The fact that your doctor mentioned the presence of pus indicates that an infection is likely present, which would explain the increased pain and swelling you experienced.
While the bacterial culture primarily screens for gonorrhea, it can also indicate the presence of other bacteria. If the culture was negative for gonorrhea but the abscess is still present, it suggests that other bacteria may be involved.

Conclusion
In summary, Bartholin's cysts can be a source of discomfort and concern, especially when they become infected. It's essential to follow your doctor's recommendations regarding treatment and to keep an open line of communication about your symptoms. If the cyst continues to cause problems or if you have further concerns about the infection, discussing surgical options with your healthcare provider may be the best course of action. Always prioritize your health and seek immediate medical attention if you experience severe pain, fever, or other concerning symptoms.

Similar Q&A

Understanding Bartholin's Cyst: Symptoms, Treatments, and Complications

Hello Dr. Chang, I had my second child over five years ago, and shortly after, I experienced my first Bartholin's gland cyst, which was accompanied by blood and pus and caused severe pain. The second occurrence happened a year ago, and since then, I have had approximately ...

Dr. Zhang Kunmin reply Obstetrics and Gynecology
Hello, the lubrication secreted by the Bartholin's glands helps prevent vaginal dryness and facilitates sexual intercourse. It is recommended to consider a surgical procedure such as a marsupialization if antibiotic treatment has not improved the condition. Thank you! Wishin...

Understanding Bartholin's Cyst: Symptoms, Treatment, and Recovery Time

Hello, Doctor. I discovered a lump in my genital area on March 13. That evening, I visited a gynecologist who explained that it was a Bartholin's gland cyst. I was prescribed oral antibiotics and an ointment. On March 16, the cyst enlarged and became very painful, so I went ...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, it may not necessarily go away. Please continue to follow up with your original obstetrician-gynecologist. Wishing you good health.

Understanding Bartholin Cyst Treatment Options: Surgery or Alternatives?

Is surgery the only treatment method for a Bartholin's cyst? If it is just a small lump, are there alternative treatments available? If surgery has already been performed, what precautions should be taken? Thank you for your response.

Dr. Shi Chengyang reply Obstetrics and Gynecology
Larger cysts require surgical intervention, while smaller ones can be treated with oral antibiotics. Regular follow-up appointments are necessary after surgery.

Managing Bartholin Gland Cyst: When to Seek Further Medical Attention

Hello, during my appointment on Wednesday afternoon, the doctor diagnosed me with a Bartholin's gland cyst. The doctor used a needle to aspirate the pus and prescribed medication and ointment. However, after returning home, I still experience significant pain when cleaning o...

Dr. Lin Xinwang reply Obstetrics and Gynecology
Hello Coco: It is recommended to return for a follow-up appointment to perform a drainage procedure, specifically a fistulotomy, to ensure the abscess is completely drained.