Bartholin's duct cyst

A Bartholin's duct cyst, also known as a Bartholin gland cyst, is a small fluid-filled sac that forms just inside the opening of the vagina. This type of cyst can occur when the tiny glands located on each side of the vaginal opening become blocked or obstructed.

Causes and Symptoms

• A Bartholin's duct cyst can be caused by a blockage in the small ducts that connect the Bartholin glands to the vagina.
• The symptoms of a Bartholin's duct cyst may include:
  • A painless lump near the opening of the vagina
  • Redness, tenderness, and swelling around the affected area
  • Discomfort or pain during sex or urination (in some cases)
• Most Bartholin cysts do not cause any symptoms and are often discovered incidentally.

Types and Characteristics

• A Bartholin's duct cyst can range in size from a pea to a large marble.
• These cysts usually grow slowly over time.
• They may become infected, leading to the formation of an abscess (a collection of pus).

Treatment Options

• Treatment for a Bartholin's duct cyst depends on the patient's symptoms and the severity of the condition.
• Asymptomatic cysts may not require treatment, but symptomatic cysts or those that have become infected may need medical attention.

References:

[1] A small fluid-filled sac just inside the opening of the vagina. [2] A painless lump near the opening of the vagina. [3] A Bartholin's duct cyst can range in size from a pea to a large marble. [8] Treatment for a Bartholin's duct cyst depends on the patient's symptoms and the severity of the condition. [9]

Common Signs and Symptoms of Bartholin's Duct Cyst

A Bartholin's duct cyst, also known as a Bartholin's gland cyst, is a fluid-filled sac that develops in one of the Bartholin's glands located on either side of the vaginal opening. The symptoms of this condition can vary from person to person, but here are some common signs and symptoms:

• Pain and discomfort: Pain during sex, walking, sitting, or when inserting a tampon or wiping after using the restroom [1].
• Swelling and tenderness: Swelling and tenderness in the affected area [2].
• Fever: Fever can occur if the cyst becomes infected [3].
• Redness and heat: The affected area may become red, swollen, and hot to the touch [4].
• Painless lump: In some cases, a Bartholin's duct cyst may not cause any symptoms at all, but when it does, it can be accompanied by a painless lump near the opening of the vagina [5].

Complications

If left untreated or if the cyst becomes infected, complications such as:

• Increased pain: Pain that gets worse and makes it difficult to walk, sit, or engage in sexual activity [6].
• Fever and chills: Fever and chills can occur due to infection [7].
• Rupturing and leakage: The cyst may rupture and leak fluid, leading to further complications [8].

It's essential to seek medical attention if you experience any of these symptoms or if you suspect that your Bartholin's duct cyst has become infected.

Diagnosing Bartholin's Duct Cyst

A diagnosis of Bartholin's duct cyst can be made through a combination of physical examination and medical history.

• A healthcare provider will typically perform a pelvic exam to check for any abnormalities in the vulva, including the Bartholin glands. [1]
• The classic appearance of a Bartholin gland cyst is a medially protruding cystic structure at the inferior aspect of the labia majora. [4]
• In some cases, a sample of secretions from the vagina or cervix may be taken to test for sexually transmitted infections (STIs), which can cause similar symptoms. [1]

Physical Examination

A physical exam is usually sufficient to diagnose a Bartholin gland cyst.

• The healthcare provider will look at the size of the cyst and check for signs of infection, such as redness or swelling. [3]
• If the cyst is large enough to be noticeable, it may be visible during the examination. [2]

Additional Tests

In some cases, additional tests may be necessary to rule out other conditions.

• A biopsy may be performed if there are concerns about cancer or if the diagnosis is unclear. [5]
• A small sample of cyst tissue will be removed and examined under a microscope to check for signs of Bartholin's gland cancer. [5]

References

[1] Context result 1 [2] Context result 2 [3] Context result 3 [4] Context result 4 [5] Context result 5

Treatment Options for Bartholin's Duct Cyst

The drug treatment for Bartholin's duct cyst typically involves medications to manage symptoms and prevent infection.

• Antibiotics: Antibiotics may be prescribed to treat or prevent infections in the Bartholin's duct. This is especially true if the cyst becomes infected and an abscess (a painful collection of pus) develops [3].
• Topical and local anesthetics: Medications used in the treatment of Bartholin abscesses include topical and local anesthetics to help manage pain and discomfort [1].

However, it's essential to note that antibiotics are only warranted when cellulitis is present, and excisional biopsy is reserved for ruling out adenocarcinoma in menopausal women [5]. In some cases, large cysts and abscesses may require drainage and sometimes excision, while abscesses also require antibiotics [7].

Warm Sitz Baths

In addition to medication, patients with Bartholin cyst or abscess are advised to take warm sitz baths 3 times per day for several days to help manage symptoms [8]. This can be a helpful adjunctive treatment in conjunction with medication.

It's always best to consult a healthcare professional for personalized advice on treating Bartholin's duct cyst.

The differential diagnosis for Bartholin's duct cysts includes several conditions that can present similarly to a cyst or abscess in the vulvar region.

• Bartholin gland abscess: This is a collection of pus in the Bartholin gland, which can be caused by an infection. It may show associated inflammatory features on imaging studies [1].
• Epidermal inclusion cyst: A type of skin cyst that can occur on the vulva.
• Skene's duct cyst: A small, fluid-filled sac that can develop near the opening of the Skene's glands (paraurethral glands).
• Hidradenoma papilliferum: A rare tumor that can occur in the apocrine sweat glands of the vulvar region.
• Bartholin gland benign tumors and carcinomas: Although rare, these can also be considered in the differential diagnosis [5].
• Other conditions: Such as epidermal inclusion cysts, hidradenoma papilliferum, and Bartholin's benign tumour, which should be considered among many other pathologies in the vulvovaginal area [9].

It is essential to consider these potential diagnoses when evaluating a patient with a suspected Bartholin's duct cyst. A thorough medical history, physical examination, and imaging studies can help differentiate between these conditions.

References: [1] Oct 1, 2024 - General imaging differential considerations include: Bartholin gland abscess: may show associated inflammatory features. [3] by F OMOLE · 2003 · Cited by 186 — The differential diagnosis includes cystic and solid lesions of the vulva... [5] by KT Chen — The most common Bartholin masses are cysts or abscesses; Bartholin gland benign tumors and carcinomas are rare. [7] by F Omole · 2003 · Cited by 186 — The differential diagnosis includes cystic and solid lesions of the vulva, such as epidermal inclusion cyst... [9] by BD de la Noval · 2019 · Cited by 7 — The differential diagnosis of a Bartholin's cystic mass should be considered among many other pathologies in the vulvovaginal area.