Bartholin’s Cyst Treatment & Surgery in Ankara
What is a Bartholin’s Gland? The Bartholin’s glands are two small organs located at the 4 o’clock and 8 o’clock positions on both sides of the vaginal opening. They are not visible from the outside and usually cannot be felt by hand because their size rarely exceeds 1 cm. They open just in front of the hymen via a thin duct.
These glands begin to produce secretions with puberty. The function of these glands, which start working during sexual intercourse, is to facilitate the entry of the penis into the vagina by secreting fluid (lubrication) and thus prevent pain during sexual intercourse. This secretion increases with sexual arousal.
Bartholin’s Cyst and Abscess
The opening of the Bartholin’s gland can become blocked for any reason. The cause of this blockage is usually bacterial infections. The mouth of the Bartholin’s gland can be blocked due to infection by other bacteria caused by a decrease in the resistance of vaginal flora bacteria, intestinal bacteria contaminating the vaginal entrance due to improper toilet hygiene, or sexually transmitted diseases (STDs).
If the fluid secreted from the Bartholin’s gland cannot flow into the area at the vaginal entrance, the secreted fluids accumulate inside the gland. This condition is called a Bartholin’s Cyst. If the fluid inside the cyst becomes infected, a Bartholin’s Abscess occurs.
Symptoms of Bartholin’s Cyst and Abscess
Very small Bartholin’s cysts may not cause any symptoms. However, if a cyst or abscess has formed, the following are common:
A painless lump (cyst) or a painful swelling (abscess) on one side of the outer lips (labia), rarely bilateral.
If an abscess has formed: Redness, increased heat, tenderness, and severe pain.
Sometimes the pain increases so much that the patient cannot sit or walk.
As swelling and pain increase, difficulty in sexual intercourse (Dyspareunia) occurs.
Due to the abscess, a throbbing sensation is sometimes felt at the vaginal entrance.
Causes: How do Cysts and Abscesses Form?
When there is a blockage in the secretion ducts of the Bartholin’s gland, a cyst forms with the accumulation of fluid inside. If the fluid inside the cyst turns into pus, it becomes a Bartholin’s Abscess. The exact factors causing blockage of the Bartholin’s secretion ducts are not always known. Previous surgical procedures are known as a risk factor, but almost all patients have no history of operation.
In culture samples taken from Bartholin’s abscesses, Gonorrhea is one of the most frequently encountered microorganisms. Another common microorganism is Chlamydia. In addition to these, E. Coli bacteria transmitted from the intestines due to poor toilet hygiene are also frequently detected microorganisms.
Since Gonorrhea and Chlamydia are frequently encountered in cultures, it is thought that Bartholin’s cyst formation is due to sexually transmitted diseases. However, this is certainly not the only cause. Often, not a single bacterium is responsible, but many different bacteria are found together (Polymicrobial).
Treatment of Bartholin’s Cyst
Bartholin’s cyst treatment varies according to the situation. If the cyst is small and does not cause any complaints, it may not require treatment. However, a biopsy must be performed on women in menopause to rule out cancer. If the cyst is small and asymptomatic, sitz baths (warm water baths), applying warm compresses to the swollen area, and taking painkillers may be sufficient.
If the Bartholin’s cyst has turned into an abscess, symptoms will increase. You must consult a doctor immediately. Primarily, if the abscess is not mature enough to intervene, the infection can be treated with antibiotic therapy.
Surgical Treatments for Bartholin’s Abscess
1. Abscess Drainage: First, the abscess surface is cleaned with an antiseptic, and a local anesthetic is injected. Then a small incision is made on the inner surface of the vagina. The infected material inside the abscess is completely drained. General anesthesia can also be preferred upon request.
2. Word Catheter Application: After an incision is made in the Bartholin’s abscess or cyst and the contents are thoroughly emptied, a Word Catheter is placed inside the Bartholin’s gland. This catheter, which resembles a small urinary catheter with a balloon, is inflated with about 3 cc of saline. The remaining part is placed inside the vagina. It is kept there for about 4 weeks. While the catheter is there, it will create a new opening (duct) for the gland. After one month, the catheter is deflated and removed painlessly and easily. This procedure prevents the hole from closing up again too quickly.
3. Marsupialization: After the cyst or abscess content is emptied, the capsule of the Bartholin’s gland is sutured to the skin with four stitches to create a permanent open pouch. This procedure is called Marsupialization. It can be done with local anesthesia or general anesthesia. Hygiene rules should be followed after the procedure, and dressings should be applied. To prevent infection, sexual intercourse, sea, and pools should be avoided until healed. Standing showers are allowed.
4. Excision of Bartholin’s Gland: If cysts and abscesses recur constantly despite drainage or marsupialization, or if there is a rare risk of cancer (especially in older women), the Bartholin’s gland can be completely removed. Since there will be no natural lubrication during sexual intercourse after this procedure, lubricating gels are recommended to the patient.
Frequently Asked Questions
Can Bartholin’s Cyst Recur? The recurrence rate of the abscess after Bartholin’s cyst surgical procedures is around 20%. While the recurrence rate after simple needle aspiration was found to be 38% in a study, recurrence after Marsupialization is seen more rarely.
How Common is it? Bartholin’s cysts are the most common cystic formations in the female external genital organs. Approximately 2 out of every 100 women will have a Bartholin’s cyst or abscess at some point in their lives. Bartholin’s abscess is seen approximately three times more often than a simple cyst. It occurs most frequently in sexually active women between the ages of 20-29.
How to Prevent Bartholin’s Cyst? Although the exact cause of Bartholin’s gland infections is not fully known, it is important to take precautions for known causes.
Safe Sex: Since microorganisms like Gonorrhea and Chlamydia have been grown in cultures, using a condom in every intercourse reduces the risk of STDs and thus the risk of Bartholin’s abscess.
Hygiene: Since E. Coli microorganisms found in the intestines can cause infection by coming to the vaginal entrance, genital organ hygiene (wiping front to back) must be observed.
Regular Check-ups: Every woman should have a gynecological examination once a year.
Early Treatment: If there is any suspicion of a small cyst in the Bartholin’s gland, a doctor’s examination is important before it turns into a painful abscess.