Bartholin's cyst - Symptoms, causes and treatment

Bartholin's cyst is a fluid-filled lump due to blockage of the Bartholin's gland. Bartholin's cysts are generally small and painless. However, if the fluid inside a Bartholin's cyst becomes infected, then an abscess or pus buildup occurs

Bartholin's glands are located on both sides of the vaginal lips. These glands are so small that they are not easily detected by the hands or eyes. Bartholin's glands function to secrete a fluid that acts as a lubricant during sexual intercourse.

Causes of Bartholin's Cyst

Bartholin's cyst is caused by a blockage in the duct of the Bartholin's gland. When the duct is blocked, the fluid will be trapped in the duct or back into the gland. Over time, this will cause the duct or gland to swell and form a cyst.

The exact cause of the blockage of the Bartholin's gland duct is not yet known. However, certain conditions, such as cuts, injuries, repetitive irritation, and surgery, in the vagina can increase the risk of a blocked Bartholin's gland.

In some cases, Bartholin's cysts are also associated with sexually transmitted infections, namely gonorrhea and chlamydia. In addition, Escherichia coli infection is also often associated with the appearance of Bartholin's cysts.

Bartholin's cyst can occur in all age groups. However, this condition is more common in women aged 20-30 years who are sexually active. These cysts are rare in postmenopausal women, because the Bartholin's glands have shrunk.

Bartholin's Cyst Symptoms

Bartholin's cyst rarely causes symptoms. New symptoms will appear if the size of the cyst is large enough. However, in general, blockages in the Bartholin's glands can cause symptoms such as:

• Small lumps that don't hurt, and generally occur only on one of the lips of the vagina
• Redness and swelling on the sides of the vaginal lips
• Discomfort when walking, sitting, or having sex

If the cyst becomes infected and develops into an abscess, several other symptoms will appear, namely:

• The lump is painful and tender
• Vagina looks swollen
• Push on the lump
• Fever

When to see a doctor

Do an examination to the doctor if a lump appears around the vagina. The examination aims to determine the cause of the lump and detect as early as possible if there is a more serious condition.

Immediately see a doctor if a lump appears when you are over 40 years old. Although quite rare, this condition can signal a disease or other, more serious condition, such as cancer.

Please note that Bartholin's cysts can recur. Check with the doctor if the symptoms of the cyst reappear even though it has been declared cured.

Diagnosing Bartholin's Cyst

The doctor will ask questions about the patient's symptoms and medical history. After that, the doctor will perform a physical examination, especially in the pelvis and vagina, to see the cyst directly. Generally, the cyst only occurs on one side of the vagina, while the other side remains normal in size.

If needed, the doctor will also perform the following supporting examinations:

• Vaginal swab, to detect sexually transmitted infections, by taking and examining fluid samples from a cyst or cervix (cervix)
• Biopsies, to detect abnormal cells, including cancer cells, by taking a sample of Bartholin's gland tissue

Bartholin's Cyst Treatment

Treatment of Bartholin's cyst is adjusted according to the size of the cyst and the symptoms that appear. Small cysts that don't cause symptoms usually don't require treatment and go away on their own.

On the other hand, a cyst requires further treatment if it causes symptoms or becomes infected and develops into an abscess. Here are some treatment methods that can be done:

1. Soak in warm water or sitz bath

In the early stages, the doctor will advise the patient to sit and soak in warm water at hip level or sitz bath, for 3-4 days. This method can help relieve pain and discomfort in the intimate organs, and sometimes can treat small cysts.

Sitz bath can be done independently at home.

2. Drugs

Pain relievers, such as paracetamol, can be taken to relieve pain. In addition, the doctor can also give antibiotics to relieve the infection that causes abscesses in the cyst.

Antibiotics can also be used if the infection spreads to the skin or tissues around the abscess or when the sufferer has a sexually transmitted infection.

3. Incision and drainage surgery

Incision and drainage surgery needs to be done if the cyst size is large enough, especially if there is an infection. The operation is done by making a small incision (incision) on the cyst so that the pus fluid inside can be released.

4. Catheter insertion

Installation of the tube with a balloon catheter is done to drain the pus. In this procedure, a small incision is made to insert a catheter into the cyst. After that, the balloon is inflated to keep the catheter from coming loose and can last for 2–6 weeks.

5. Marsupialization of the cyst

This procedure is done by making an incision in the cyst to drain the pus. After that, the doctor will sew the end of the incision into the surrounding skin to keep the cyst open permanently.

Marsupialization of the cyst can be combined with catheter insertion.

6. Bartholin's gland removal

This procedure is performed if other procedures are not successful. The operation is performed by removing the entire Bartholin's gland.

During the healing process, it is important to always keep the cyst area clean according to the doctor's advice. Should avoid sexual activity during the healing process. Also, wear a bandage while the catheter is in place, as the pus will continue to drain as the infection clears.

Bartholin's Cyst Complications

Complications that may be caused by a Bartholin's cyst are recurrence of the cyst or infection. If left untreated, the infection can enter the bloodstream and spread throughout the body, causing sepsis. Even so, this condition is rare.

Bartholin's Cyst Prevention

Given the exact cause is not known, Bartholin's cyst is difficult to prevent. However, there are several ways that can be done to reduce the risk of abscess or infection in the cyst, namely:

• Keep intimate organs clean, and make it a habit to clean intimate organs from front to back.
• Avoid wearing underwear and pants that are too tight or of rough material.
• Use a condom when having sex to prevent sexually transmitted infections.