What are Bartholin’s glands?
Bartholin’s glands are located in a woman's genital area. The pea sized glands are found just behind and on either side of the inner vagina lips (labia minora). They are not normally noticeable because they rarely measure more than 1cm in diameter.
Bartholin’s glands secrete mucus-like fluid that acts as a lubricant during sexual intercourse. The fluid emerges from two tiny tubes next to the opening of the vagina. These are called Bartholin’s ducts.
What are Bartholin’s cysts?
If a Bartholin’s duct becomes blocked, it will fill with fluid, expand and develop into a cyst.
It is estimated that Bartholin’s cysts affect about 2% of women during their lifetime.
If the duct becomes infected, an abscess can form.
Several types of bacteria can cause an infection that blocks the ducts. These include sexually transmitted infections (such as gonorrhea or chlamydia), and bacteria found naturally in the environment.
Children do not develop Batholin’s cysts because the glands do not start functioning until puberty.
Older women who have started the menopause are unlikely to be affected by Bartholin’s cysts because the glands usually shrink at this stage in a woman's life.
What are the symptoms of Bartholin’s cysts?
A Bartholin’s cyst may remain small and painless and most women are unlikely to notice any symptoms.
If the cyst becomes large it may become uncomfortable and can cause pain to the external sex organs (vulva) during sexual intercourse or when walking or sitting down.
How are Bartholin’s cysts treated?
Mild cases of cysts or abscesses may be treated by warm compresses or baths together with pain killers, such as paracetemol or ibuprofen to alleviate symptoms. Antibiotics may be prescribed if an infection develops.
There are a number of surgical techniques to treat problematic cysts or abscesses. One of these is balloon catheter insertion. The technique - carried out under general or local anaesthetic - involves cutting into the abscess or cyst to drain the fluid before a catheter (a plastic tube with a balloon at the end) is inserted through the cut. The balloon is inflated with approximately 2-4 ml of saline solution.
The catheter remains in the duct until it heals, leaving a passage in place.
A few small studies have found that this technique is successful in between 83% and 97% of women. However, possible complications include:
- Pain from having the catheter left in
- Pain during sexual intercourse
- Swelling of the labia
- The abscess reoccurring
Alternative treatments are:
Marsupialisation: A procedure which involves draining the duct and reshaping it into a pouch to allow it to shrink to its original size.
Silver nitrate gland ablation: In which the duct is drained before a small solid stick of silver nitrate is inserted which causes the cyst cavity to form into a small, solid lump.
Carbon dioxide laser: In which a laser is used to create an opening in the skin of the vulva so that the cyst can be drained.
Alcohol sclerotherapy: A procedure in which the cyst is drained via a needle. The cavity is then filled with a 70% solution of alcohol that is left in the cyst cavity for five minutes before being drained out.
Gland excision: Removal of the Bartholin’s gland.