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Bartholin's gland
2-3 out of 100 women have a Bartholin's gland cyst or abscess during their lifetime.
The glands are symmetrically distributed on both sides of the vagina and play a key role in maintaining humidity during the sexual intercourse. However, sometimes problems can occur, such as cysts or abscesses that require monitoring and treatment.
Find out how the problem with Bartholin's gland manifests itself, what can be the cause and what treatments we perform in the Gyn-Fertility Clinic Milenković so that you can quickly and effectively overcome this unpleasant condition.
Bartholin's gland is a paired organ located at the entrance to the vagina, i.e.in the lower part of the labia minora. These glands are located symmetrically on each side, we can imagine them as points on a clock, at the positions of 4 and 8 hours. Bartholin's gland is relatively small, usually about 5 mm in size, and cannot be felt under the skin. Its role is to secrete secretions through a duct that is approximately 2-2.5 cm long.
The name Bartholin's gland comes from the Danish anatomist Caspar Bartholin, who described it back in 1675. These glands are also known as vestibular glands.
Also, the Bartholin's gland secretes a secretion during sexual intercourse.
Inflammation (bartholinitis) occurs when the duct of the Bartholin's gland becomes blocked or infected. Then there may occur swelling, redness and pain in the area of the Bartholin's gland.
Inflammation of the Bartholin's glands can be caused by bacterial infections, such as E. coli or Staphylococcus, or other factors that lead to the blockage of the gland ducts.
When the duct of the Bartholin's gland becomes blocked, a cyst may be form. It is important to note that a Bartholin's gland cyst originates from the duct of this gland and not from the gland itself.
In more severe cases, the infection can lead to the formation of an abscess, which is a collection of pus bounded by a capsule.
Symptoms of cyst and abscess of Bartholin’s gland
In most cases, the patient herself notices a swelling or a cystic change at the entrance into the vagina, which is most often on one side.
The size is from 1 to 6-7 cm.
In the beginning, it is not painful and is only an aesthetic nuisance, but the cyst can become painful over the time.
When infection and abscess occur, the change is always painful, sometimes so much so that the patient cannot stand or walk.
Pain is present during sexual intercourse, especially if infection and abscess have developed.
The cause of the formation of a Bartholin's cyst is not completely clear. The cyst occurs more often in sexually active women. Factors and conditions associated with cyst formation are:
- tissue injury, which most often occurs during sexual intercourses;
- clogging of the canal with thick mucous content;
- tissue swelling as a result of infection of the surrounding tissue;
- inadequate hygiene.
The cause of an infection, and/or an abscess of the Bartholin's gland, is as follows:
- secondary infection with already existing Bartholin’s gland cysts;
- primary infection of the Bartholin's gland, most often caused by chlamydia or bacteria from the vaginal flora Escherichia coli and Staphylococcus aureus.
Treatment of a cyst/abscess of the Bartholin's gland in the Gyn.Fertility Clinic Milenković
Find out what preparation for the procedure looks like in our clinic, what methods are used and what recovery looks like:
Prior to intervention-surgical treatment of Bartholin's gland
- No special preparation is required.
- The patient is advised to take two 500 mg Paracetamol tablets one hour before the surgical treatment of the cyst and abscess of the Bartholin’s gland.
- Considering that urgent treatment is often needed due to severe pain, the patient receives an appointment on the same day. It is necessary to call the number of the Gyn. Fertility Clinic Milenković 069 50 22222.
Preparation for removal of a complete gland with a cyst under general anesthesia
- The patient fills out a detailed questionnaire about her health.
- It is necessary to perform blood tests (leukocytes, erythrocytes, hemoglobin, platelets) and blood type.
- An anesthesiologist's examination is performed before the operation.
Word catheter intervention
The procedure is performed on the gynecological table and begins with disinfection of the operative field with an aseptic solution based on iodine or chlorine.
- The intervention is most often performed under local anesthesia using the Word catheter method or the application of material containing silver based preparations.
- A local anesthetic is injected into the most bulging part of the Bartholin's gland cyst. Then a small incision is made so that the contents of the cyst or abscess drain out.
- The next step is taking a microbiological swab and washing the inside of the cyst. In certain cases, a biopsy is taken for histopathological analysis.
- The intervention is completed by inserting a Word catheter or materials containing silver preparations. The goal is to "destroy" the layer of cells that secrete the secretion and then form a new layer of cells with the mechanical pressure of the Word catheter or by the chemical action of the silver preparation. At the same time, the contents of the cyst/abscess are drained through the catheter, while the synthetic material absorbs the liquid contents.
- The Word catheter is removed after 4 weeks, and the material with silver preparations is removed after a few days.
- In certain situations, in addition to the operative treatment, antibiotics are also taken.
- The intervention lasts for about 15 minutes and the patient stays in the clinic for one hour after the intervention.
Operative procedure of marsupialization
This procedure is performed after disinfection of the operative field and injection of local anesthesia.
- Then a small incision is made on the cyst/abscess and the same procedure is repeated as with the application of the Word catheter, only that instead of inserting the catheter, an opening is left on the cyst where the contents will drain, and the wound will heal spontaneously.
- The intervention lasts for about 15 minutes and the patient stays in the clinic for one hour after the intervention.
Cyst aspiration
After disinfection and administration of local anesthesia, the contents of the cyst/abscess are extracted with a simple needle sting with a syringe. With incision the procedure is the same, only that instead of a needle sting, a minimal incision is made with a scalpel so that the contents leak out.
Operative treatment for gland removal
It is performed under general anesthesia and the patient stays in the clinic/hospital for a day.
- The patient remains in the clinic for one hour after the application of the Word catheter, the application of the material with silver and marsupialization, and one day after the removal of the entire gland.
- Analgesics are recommended against pain.
- The control examination is, depending on the method, from 3-4 days to 30 days after the application of the Word catheter.
- It is not recommended to take a bath or swim for 3-4 weeks after the surgical treatment.
- As for sexual intercourses, abstinence from a few days to 4 weeks is advised, depending on the method used.
- Showering is allowed on the same day.
- The patient can return to normal activities on the same day if the intervention was performed under local anesthesia, or 2-3 days after if the operation of the removal of the Bartholin's gland was performed under general anesthesia.
- In case of pain, high fever or other complications, call 069 50 22222.
Expert advice: frequently asked questions
Answered by: Milan Milenković, MD, PhD
What are the complications of the Bartholin’s gland cyst/abscess?
Complications are rare, but if a Bartholin's gland cyst/abscess is not treated, severe infection, sepsis and rectovaginal fistula (a passage created between the vagina and the end of the colon) can occur.
Who is at risk for Bartholin's gland cancer?
The risk for Bartholin's gland cancer is low and is more common in menopausal women. Bartholin's gland carcinoma belongs to vulvar cancers and occurs in about 5% of all vulvar cancers or less than 1% of all gynecological cancers. If the clinical examination suspects a malignant change, a biopsy or removal of the gland is performed.
How can I distinguish whether if it is a cyst or an abscess of the Bartholin's gland?
Gland cyst is not painful, it is soft and mobile. Bartholin's gland abscess has a hard consistency, is always painful and sensitive to pressure. Pus is always present if there is a spontaneous leakage of contents from the abscess.
Can the cyst come back after the procedure?
Gland cyst or abscess sometimes returns after surgical treatment, which is a common scenario faced by female patients. In about 3-40% of cases, the problem recurs, especially after applying methods such as needle aspiration and incision.
However, there is a therapeutic option that stands out as a better choice in reducing the chance of recurring problems – the application of Word Catheter.
It turns out that methods such as the application of material with silver preparations and marsupialization, although effective, have a similar recurrence rate of a cyst or abscess of 3-12%. In contrast, the application of the Word catheter stands out with a significantly lower recurrence rate. This technique has the advantage of preserving the gland and preventing the problem from recurring, thus providing the patient with long-term relief.
When is the complete gland removal performed?
This operation also carries the risk of bleeding during and after the procedure. Therefore, its application is considered only in extreme cases, especially if there is a suspicion of malignant changes.
Which method of operative treatment of cyst/abscess of Bartholin's gland has the best results?
The placement of Word catheter, material with silver preparations and marsupialization has approximately the same results and a recurrence rate of cyst or abscess of 3-12%.
After marsupialization, there is secretion from the opening for up to several weeks, which can be uncomfortable for patients, which is why the Word catheter is most often placed.
How often does a Bartholin's gland cyst/abscess recur after the Word Catheter placement?
Gland cyst/abscess recurs in 3-12% after Word catheter placement.
What is the cost of surgical treatment of cyst and abscess of Bartholin's gland?
For the price of interventions, see the price list which is updated regularly.
When can I shower after a surgical treatment of a Bartholin's gland cyst/abscess?
You will be able to shower the same day after surgical treatment of a Bartholin's gland cyst/abscess. It is not recommended to apply shampoo or soap directly to the surgical site.
When can I train after surgical treatment of Bartholin's gland cyst/ abscess?
You can train the day after the surgical treatment of the cyst/abscess of the Bartholin's gland when you feel able to train.
Can spontaneous leakage of the contents of a cyst or abscess of Bartholin's gland occur?
Sometimes, there is a spontaneous leakage of contents from a cyst or abscess of the Bartholin's gland, and then most often no additional therapy or surgical intervention is required. The patient feels relief and the cessation of pain. In the case of spontaneous leakage, that is, the "rupture" of a cyst or abscess of the Bartholin's gland, there is a high risk that the cyst or abscess will form again.
Does Bartholin's gland treatment affect vaginal lubrication?
No. Even in the case of a complete removal of Bartholin's gland the vaginal lubrication does not decrease given that Skene's gland discharge secretions during intimate intercourse.
