A Bartholin's duct cyst is a non-infectious occlusion of the distal Bartholin's duct, with resultant retention of secretions. They are thought to be relatively common, although the exact incidence and prevalence remains unknown.
Diagnosis is made on clinical exam. The classic appearance is a medially protruding cystic structure at the inferior aspect of the labia majora, in the 5 or 7 o'clock position, crossed by the labium minus.
Bartholin cysts are most commonly seen in women of reproductive age. In post-menopausal women with a vulval mass, malignancy should be considered.
A Bartholin's gland abscess may result from polymicrobial infection of the cyst fluid or, less commonly, from primary infection of the gland or duct.
Treatment of a cyst can be conservative or surgical and depends on size, symptoms, presence of infection, and whether the cyst is recurrent.
Broad-spectrum antibiotics are recommended for the treatment of Bartholin's gland abscesses. Incision and drainage may be required.
A Bartholin's duct cyst is a non-infectious occlusion of the distal Bartholin's duct, with resultant retention of secretions. The paired Bartholin's ducts are located at the posterior vestibule and provide a conduit for secretions from the Bartholin's glands. A Bartholin's duct cyst may be asymptomatic if the cyst is small. It typically presents as a medially protruding mass at the inferior aspect of the labia majora, in the posterior introitus, and is crossed by the labium minus. Duct cysts and gland cysts are indistinguishable, and the terms are used interchangeably. A Bartholin's duct abscess may be primary (from bartholinitis) or secondary (from infection of Bartholin's cyst).
History and exam
Key diagnostic factors
- vulval/perineal mass
- vulval pressure or fullness
- pain during sitting or walking
Other diagnostic factors
- vulval erythema and induration
- spontaneous rupture
- woman of reproductive age
- previous Bartholin's cyst/abscess
- sexual activity
- direct trauma or surgery
Investigations to consider
- microscopy and culture of abscess material
- biopsy of vulval lesion
asymptomatic Bartholin's cyst
symptomatic Bartholin's cyst
- Mucous cyst of the vestibule
- Vulval haematoma
- Vulval fibroma
- Balloon catheter insertion for Bartholin’s cyst or abscess
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