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Bartholin gland cyst and abscess

Last updated: November 4, 2020

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The Bartholin glands are located on both sides of the inner labia and primarily function to produce mucus that moisturizes the vaginal mucosa. The mucus is secreted into two ducts that appear in the posterior vaginal introitus. A Bartholin gland cyst is usually caused by blockage of the duct as a result of inflammation or trauma; a Bartholin gland abscess occurs when the obstructed duct becomes infected. The most common symptoms are swelling and, in the case that an abscess develops, pain and potentially fever. Both Bartholin gland cysts and abscess are clinical diagnoses. First-line treatment includes sitz baths, which may promote spontaneous rupture or resolution of the cyst after a few days. An abscess usually requires incision and must be drained surgically.

References:[1][2]

Epidemiological data refers to the US, unless otherwise specified.

  • Pathophysiology: blockage of the duct by inflammation or trauma accumulation of secretions from gland → cyst formation
  • Clinical features: often asymptomatic but can cause mild dyspareunia
  • Diagnostics
    • Pelvic exam: unilateral, palpable mass in the posterior vaginal introitus
    • Biopsy is indicated if any of the following apply: :
      • > 40 years of age
      • Progressive, solid, and painless mass found during pelvic exam
      • Not responsive to treatment
      • History of malignancy in the labia
  • Treatment:
    • Sitz baths to facilitate rupture of the cyst
    • Consider surgery for symptomatic cysts (see “Treatment” of Bartholin gland abscesses below)

A Bartholin gland cyst is generally a clinical diagnosis based on physical examination.

References:[1][2][3][4]

Bartholin gland abscess is usually a clinical diagnosis based on physical examination.

References:[1][2][3][4]

References:[4][5]

The differential diagnoses listed here are not exhaustive.

  1. Chen KT. Bartholin Gland Masses: Diagnosis and Management. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. http://www.uptodate.com/contents/bartholin-gland-masses-diagnosis-and-management.Last updated: December 11, 2015. Accessed: February 18, 2017.
  2. Karam A, Berek JS, Russo AL. Squamous Cell Carcinoma of the Vulva: Staging and Surgical Treatment. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/squamous-cell-carcinoma-of-the-vulva-staging-and-surgical-treatment.Last updated: September 6, 2016. Accessed: February 18, 2017.
  3. Bartholin Gland Cysts. http://www.merckmanuals.com/professional/gynecology-and-obstetrics/benign-gynecologic-lesions/bartholin-gland-cysts. Updated: July 1, 2014. Accessed: February 18, 2017.
  4. Omole F, Simmons BJ, Hacker Y. Management of Bartholin's duct cyst and gland abscess. Am Fam Physician. 2003; 68 (1): p.135-140.
  5. Quinn A. Bartholin Gland Diseases. Bartholin Gland Diseases. New York, NY: WebMD. http://emedicine.medscape.com/article/777112. Updated: September 8, 2016. Accessed: February 18, 2017.