Why is it important to treat Bartholin cyst?

Bartholin glands that are present just behind the labia, like other glands, release fluid through a duct. The purpose of the fluid is to lubricate the vagina. If the ducts get blocked, the fluid backs up and forms a collection of fluid, developing a cyst. These cysts are called Bartholin cysts, and they are tiny fluid-filled lumps that appear on the surface of the vaginal wall.

Bartholin cysts are quite common in women of reproductive age, and it is very rare to occur after menopause.

Asymptomatic Bartholin’s cyst usually does not require any specific treatment. But if the cysts are larger and recurrent, then it requires timely treatment, or else it can increase the risk of bacterial infection like Escherichia coli (E.coli) and other sexually transmitted infections such as gonorrhoea and chlamydia. The infected cyst, without treatment, may develop an abscess too.

Diagnosis and Treatment of Bartholin Cyst

Diagnosis of Bartholin cyst

Gynaecologists may suggest a few diagnostic tests after evaluating your medical history to define the best treatment for Bartholin Cyst:

• Pelvic exam - Doctors suggest this test to evaluate the reproductive organ (vagina, cervix, uterus) for any abnormalities. They are usually recommended when you experience unusual vaginal discharge and pelvic pain.

• Needle biopsy – It is mainly performed to obtain a sample of cells and to check for cancerous cells. Postmenopausal women are more vulnerable to cancerous Bartholin cyst.

Treatment of Bartholin cysts

The treatment method usually depends on the size of the cyst, how painful the cyst is, and whether the cyst is infected or not. Bartholin cysts treatment is broadly categorized into two ways:

Non-surgical treatment

• Sitz bath - In a sitz bath, the vaginal area is soaked in a few inches of warm water. This helps in managing the pain and also makes the cyst soft. Doctors usually suggest adding an antibiotic solution to warm water for better and quick relief. Doctors usually suggested a sitz bath to be done 3-4 times a week for better results.

• Medicines - Doctors recommend a few antibiotics and painkillers to manage pain and fever. Antibiotics include ceftriaxone, ciprofloxacin, doxycycline, and azithromycin. The medicines work when the size of the cysts are very small.

Surgical treatment

Surgical intervention is recommended when the Bartholin cyst causes some serious complications.

• Bartholin gland removal - Gynecologists suggest Bartholin gland surgical removal treatment when they suspect cancer or the cyst is recurring and is quite painful. In this surgical procedure, the entire Bartholin gland might be recommended to be removed. Although, it is very rare and depends on the severity of the condition. Surgical removal of the gland carries a risk of bleeding or complication after the procedure.

• Surgical drainage - Surgical drainage is performed to drain the cyst through an incision. For this procedure, doctors use local/general anesthesia to numb the site and then make a minor incision to drain the pus. After that small drainage tube (rubber tube) is placed to support fuller drainage for the next few weeks. After the drainage is completed, the tube is removed.

Marsupialization - This surgical procedure is performed for recurring and extremely painful Bartholin cysts. It is performed under local/spinal anesthesia. Surgeons drain the cyst through an incision, and after drainage, the incision becomes slightly enlarged and gives the appearance of a kangaroo pouch on the vaginal lips, which allows any further fluid to drain out.

When to consult a doctor for Bartholin cyst treatment?

Consult your Gynecologist and seek emergency help if you experience any of the following symptoms -

• Painful lump near the opening of the vagina that doesn’t improve after two or three days of self-care.

• Pain in the skin surrounding the vagina when you walk, sit or involve in any sexual activity.

• Constant high body temperature

• Severe vaginal pain disrupts your daily physical activities.

Any delay in the treatment can worsen the condition and can lead to infection and even cancer.

What to expect after Bartholin cyst surgery?

The surgical procedure of Bartholin cyst treatment is done under anesthesia and does not require much time. Post-surgery, you can expect the following changes -

• Pain and discomfort in your vulva for the next few days.

• Discomfort when sitting for long periods of time.

• A burning sensation if your urine comes in contact with the wound.

• Get tired easily and need painkillers for a week or two.

Complete recovery may take around 2 to 4 weeks.