Bartholin's cyst (drainage treatment)

Bartholin's cyst is an abscess that forms in the outlet duct of the Bartholin's gland due to an obstruction caused by the accumulation of the fluid that helps to lubricate the vagina.

The Bartholin's glands are located on both sides of the vaginal opening and their main function is to produce a fluid to lubricate the vagina. In the event that an accumulation of this fluid occurs in the outlet duct, an obstruction is generated that ends up creating a lump or abscess, called a Bartholin's cyst.

What are the symptoms caused by a Bartholin's abscess?

The most common symptoms usually differ depending on whether the cyst is infected or if there is no case of infection:
If there is an infection in the abscess, the symptoms that usually appear are:

• Intense pain in the area.
• Acute inflammation in the Bartholin's glands.
• Fever or general malaise.
• Redness and a sensation of heat in the vaginal area.
• Appearance of pus.

In the event that the cyst is small or there is no sign of infection, these are usually the most common symptoms:

• Pain and discomfort when walking, sitting or during sexual intercourse.
• Sensation of pressure in the area.
• Appearance of a rounded lump on one side of the vulva.

If the patient identifies any of these symptoms, she attends a consultation with a specialist in Gynaecology where a clinical diagnosis is primarily performed, that is:

1. The specialist performs a physical examination of the patient through a tactile and visual pelvic exam.
2. They also ask a series of questions to obtain a clinical context of the patient's case: when the symptoms began, what types of symptoms she has, if she has previously suffered from problems with the Bartholin's glands (the cyst can be recurrent), etc…
3. The specialist performs an observation of the lump, its size and thickness, and whether there is an infection in the area.

Diagnostic tests are generally not required to complete the diagnosis of the cyst, although there are some exceptional cases, such as: the specialist may request a biopsy if the patient is over 40 years old to rule out Bartholin's gland cancer; or on the other hand, if the patient's cyst presents pus, the specialist may request a culture of the pus to analyse which bacteria has caused it.

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When the cyst is small and there is no sign of symptoms, there is a possibility that it may disappear on its own within a matter of days or weeks.

It is necessary to perform surgery on a Bartholin's cyst when:

1. It is a large cyst that is incapacitating in daily life due to the pain.
2. There is a serious infection problem.
3. There is continuous recurrence and, after treatment, it reappears.
4. It produces acute and chronic pain in the patient.
5. There is a suspicion of a tumour.
6. Non-surgical medical treatment has not worked or solved the problem, and surgery is the only remaining option.

Can it be treated and cured with medication alone?

In mild cases of the abscess (for example, small and asymptomatic cysts), an initial attempt can be made to treat it with anti-inflammatories, analgesics, or antibiotics (in cases of infection).

Home treatments such as sitz baths can also be used, that is, immersing the area in warm water to relieve discomfort.

Even so, medication and home care alone are not sufficient to treat the cyst, so it is ultimately necessary to resort to surgical treatment to drain or remove it.

There are different types of surgical techniques for treating the cyst. Among them, the most commonly used are the following:

• Abscess drainage: surgical technique in which the cyst is opened and the obstructed fluid is drained.
• Marsupialisation: this is minor surgery in which the cyst is opened to empty it and the edges are then sutured, so that it remains as a permanent opening, allowing the gland to continue draining.
• Excision: surgery known as a Bartholinectomy, in which the cyst or the gland is completely removed.

In those cases where the patient presents a Bartholin's cyst episode for the first time, or the abscess is very painful and requires urgent treatment, specialists will always opt first for the least aggressive technique: simple drainage.

Step by step of a simple drainage of a Bartholin's cyst

The simple drainage procedure of the cyst is performed under local anaesthesia and does not require prior preoperative tests:

1. It is a simple procedure performed in a private consultation; booking of operating room is not necessary.
2. As it is performed under local anaesthesia, it is not necessary to fast.
3. Once lying on the stretcher, the area is carefully cleaned and local anaesthesia is applied.
4. A small incision is made over the cyst or abscess and gentle pressure is applied so that the accumulated fluid or pus begins to come out.
5. Once the abscess has been successfully drained, the interior is cleaned through irrigation with saline solution.
6. Finally, a temporary gauze is usually placed in the opening, or it is also left open to allow further drainage. In this procedure, the incision is not usually sutured.

It is an outpatient surgery: the patient is discharged on the same day as the drainage, after recovering from the anaesthesia in the hospital recovery room.

The length of surgery usually lasts approximately between 10 and 20 minutes.

Post-operative care at home after drainage is quite simple:

• Hygiene of the area: wash the area gently and keep it dry and clean.
• Sitz baths are recommended: it is recommended to soak the area for 10-15 minutes in warm water to help the incision remain open and draining, as well as helping to improve inflammation.
• Sanitary pads: it is advisable to use sanitary pads during the first few days as the wound will continue to drain fluid during the following days.
• Medication: the specialist generally prescribes analgesics or anti-inflammatories for the patient to help with post-operative pain. In those cases where there are signs of infection, antibiotics are prescribed.
• Avoid sexual intercourse during the first few days after drainage, until the wound has completely healed.

The complete recovery time after drainage takes between 1-2 weeks, but the patient notices a significant improvement within the 24h - 48h following the procedure.

If you need treatment for a Bartholin's cyst following a recommendation from gynaecology specialists, you can request your medical voucher for Bartholin's abscess drainage immediately by filling out our contact form, calling at +34 91 141 33 56 or by clicking on the following button:

Do you have a Bartholin's cyst and need treatment?

Request appointment now with one of our specialists and solve the discomfort caused by the cyst.

Request appointment