Bartholin cyst or abscess

 

Alternative Names

Abscess - Bartholin; Infected Bartholin gland

Definition

Bartholin abscess is the buildup of pus that forms a lump (swelling) in one of the Bartholin glands. These glands are found on each side of the vaginal opening.

Causes

A Bartholin abscess forms when a small opening (duct) from the gland gets blocked. Fluid in the gland builds up and may become infected. Fluid may build up over many years before an abscess occurs.

Often the abscess appears quickly over several days. The area will become very hot and swollen. Activity that puts pressure on the vulva, and walking and sitting, may cause severe pain.

Symptoms

  • A tender lump on either side of the vaginal opening
  • Fever
  • Pain with sexual intercourse

Exams and Tests

The health care provider will do a pelvic exam. The Bartholin gland will be enlarged and tender. A biopsy may be recommended in older women to look for a tumor, although this is very rare.

Any vaginal discharge or fluid drainage will be sent to a lab for testing.

Treatment

SELF-CARE STEPS

Soaking in warm water four times a day for several days can ease the discomfort. It can also help the abscess open and drain on its own. However, the opening is often very small and closes quickly. Therefore, the abscess often returns.

DRAINAGE OF THE ABSCESS

A small surgical cut can completely drain the abscess. This relieves symptoms and provides the fastest recovery.

  • The procedure can be done under local anesthesia in a doctor's office.
  • A catheter (tube) may be inserted and left in place for 4 - 6 weeks to continue to allow draining while the area heals.
  • You should begin soaking in warm water 1 - 2 days afterward. You cannot have sexual intercourse until the catheter is removed.

Antibiotics may be prescribed if there is pus or other signs of infection.

MARSUPIALIZATION

Women can also be treated with a minor surgical procedure called marsupialization.

  • The procedure involves creating a small, permanent opening to help the gland drain.
  • The procedure can sometimes be done in the clinic with medicine to numb the area. In other cases it may need to be done in the hospital with general anesthesia so that you are asleep and pain-free.
  • You should begin soaking in warm water 1 - 2 days afterward. You cannot have sexual intercourse for 4 weeks after surgery.
  • You can use oral pain medicines after the procedure. Your doctor may prescribe narcotic pain medicines if you need them.

Your health care provider may recommend that the glands be completely removed if abscesses keep coming back.

Outlook (Prognosis)

The chance of a full recovery is excellent. The abscesses return in about 1 in 10 cases.

It is important to treat any vaginal infection that is diagnosed at the same time as the abscess.

When to Contact a Medical Professional

Call your health care provider if:

  • You notice a painful, swollen lump on the labia near the vagina opening and it does not improve with 2 - 3 days of home treatment.
  • Pain is severe and interferes with your normal activity.
  • You have one of these cysts and develop a fever higher than 100.4 degrees Fahrenheit.

References

Holtzman LC, Hitti E, Harrow J. Incision and drainage. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Saunders Elsevier; 2013:chap 37.

Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 23.

Review Date: 6/11/2014
Reviewed By: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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