Bartolino Cyst: History, Symptoms, Causes, Diagnosis, Treatment and Prognosis

They represent two percent of all gynecological visits per year.

Bartholin’s glands are a pair of vestibular glands that secrete vulvovaginal and pea-sized mucus that are located below the bulbo-spongeus muscle.

A Bartolino cyst is a sac filled with fluid that develops in one of Bartolino’s glands or ducts when the duct that drains the fluid from the gland becomes blocked and causes the duct and gland to swell.

Although empirical therapy with antibiotics is not indicated in the immunocompetent patient who presents abscess of the Bartholin’s gland without cellulitis, it is useful to know that a substantial proportion of patients with abscess of the Bartholin’s gland are positive culture, being Escherichia coli the pathogen more common.

Bartolino’s cyst

Bartholin’s cyst occurs when a Bartholin’s gland becomes blocked and the gland swells. Bartholin’s glands are located between the vagina and the vulva (the outer part of the female genitals) and produce a fluid that helps reduce friction during sex. They are usually not visible to the naked eye.

The sizes vary from that of a pea to that of an egg and are formed just inside each side of the lower part of the opening of the vagina.

An abscess may form if the cyst becomes infected. In this case, it often becomes red and painful when touched.

A Bartolino cyst is not an infection, although it may be caused by an infection, inflammation or physical blockage (mucus or other impediment) in Bartolino’s ducts (tubes that lead from the glands to the vulva).

If an infection occurs, the result is a Bartolino abscess. Cysts are not transmitted sexually. There is no known reason for its development and infection is rare. With an abscess, the cause is a bacterial infection, but it is usually not a sexually transmitted infection.

The treatment depends on the severity of the symptoms. If there are no symptoms, no treatment is needed. If a cyst is causing problems, drainage is recommended. The preferred method of drainage is the insertion of a Word catheter for four weeks.

The simple incision and drainage can allow the cyst to reform. A surgical procedure known as marsupialization can be used for cysts, but should not be used if they are infected. If the problem persists, the entire gland can be removed.

Elimination is sometimes recommended in people over 40 to ensure that cancer is not present. Antibiotics are usually not necessary.

Bartolino cysts only occur in women and most likely in those of childbearing age. About two percent of women have the problem at some time in their lives.

History of Bartolino’s cyst

Thomas Bartolino (1616-1680), Danish physician, mathematician and theologian, was the first person to describe these glands, hence his name. He was best known for his work in discovering the lymphatic system in humans.

Bartholin’s cysts can cause pain or discomfort, but they are not life-threatening. Not all Bartolino cysts require treatment.

Bartholin’s cysts are commonly small and do not present with presentable symptoms, which means that the diagnosis can be delayed until the medical examination.

Signs and symptoms

Most Bartolino cysts do not cause any symptoms, although some may cause pain when walking, sitting or having sex ( dyspareunia ). They are usually between 1 and 4 cm, and are just medial to the labia minora.

It is not uncommon for a woman to have a Bartolino cyst and not know it until a doctor examines it. Commonly, there are no important symptoms, however, they may include:

Bulk : a small lump on the lips (the lips of the female genitals) is a minor symptom that may not be noticeable. The cyst usually only develops in one of the two glands.

Pain : larger cysts can cause discomfort and pain in the vulva, especially during sexual intercourse, or while walking or sitting.

Abscess : If an infection develops, there may be an accumulation of pus, which can be painful.

The abscess can develop very quickly. The skin on the affected area may become red, sensitive and hot. The patient may also have a fever.

Any symptoms or lumps similar to a cyst in the genital area should be reported to a doctor and should be checked for cancer.

Most Bartolino cysts only affect the left or right side (unilateral). Small cysts are usually not painful, but very large cysts can cause significant pain.

Causes

Bartholin’s glands, also known as the main vestibular glands, are a pair of glands between the vagina and the vulva that produce lubrication when stimulated.

Together with the minor vestibular glands, they help sexual intercourse by reducing friction.

The lubricating fluid goes from the Bartholin’s glands through small tubes (ducts) that are approximately 0.8 inches (2 cm) in length at the bottom of the vagina entrance.

If there is a blockage in these ducts, the lubricant accumulates. The ducts expand and a cyst forms. This is a Bartolino cyst. When the cyst is formed, there is a risk of infection in the area and a subsequent abscess.

It is more likely that a woman has a cyst of Bartolino’s gland when she is:

  • Young and sexually active.
  • She has not been pregnant yet.
  • He just had a pregnancy.

Cysts can vary in size from that of a lentil to a golf ball. Although Bartolino cysts are not sexually transmitted, gonorrhea (a sexually transmitted disease) is a common cause.

A cyst is a sac-like closed structure filled with fluid, which may be semi-solid or include gas.

A bacterial infection can cause blockage and subsequent cyst.

Examples include:

  • Gonococcus, which causes gonorrhea.
  • Chlamydia trachomatis, which causes chlamydia .
  • Escherichia coli, which can affect the water supply and cause hemorrhagic colitis.
  • Streptococcus pneumonia, which can cause pneumonia and middle ear infections.
  • Haemophilus influenzae (hib), which can cause ear infections and respiratory infections.

In a significant number of cases, the woman can not do much to prevent the appearance of a Bartolino cyst.

Sexually active people should use a barrier method of contraception, such as a condom.

Some people say that sitting in a warm bath can help the cyst burst, thus preventing the formation of an abscess.

Pathophysiology

The cyst of the Bartholin’s gland develops when the duct that drains the gland is blocked. The blockage can be caused by an infection or a mucus plug. The secretions of the Bartolino gland are retained, forming a cyst.

Diagnosis of Bartolino’s cyst

Other conditions that can occur in a similar way include hydradenoma papilliferum, lipomas, epidermoid cysts and cysts of the Skene duct, among others.

In those who are over 40 years of age, if menopause has begun, the doctor may recommend a biopsy of the cyst to rule out vulvar cancer is not present.

A doctor can usually diagnose this type of cyst during a pelvic exam.

The doctor can advise the patient to perform a test to detect possible STDs (sexually transmitted diseases). This would include urine or blood tests, as well as a swab from the genital area.

Treatment

Treatment may not be necessary when Bartolino cysts do not cause symptoms. Small asymptomatic cysts can be observed over time to assess their development.

The treatment of a Bartolino cyst depends on the size of the cyst, the amount of discomfort it causes and whether it is infected, resulting in an abscess.

A cyst that is infected or very large usually requires drainage by a doctor. Draining a cyst can be performed in your doctor’s office under local anesthesia, but in some cases, you and your doctor may choose general sedation, if that makes you feel more comfortable.

The intervention has a success rate of 85 percent, regardless of the method used, to achieve the absence of swelling and discomfort and the appearance of a free drainage duct.

Catheterization is a minor procedure that can be performed in an office. A small tube with a balloon on the end (known as a Word catheter) can be inserted into the cyst. The balloon is inflated to keep it in place.

The catheter remains in place for 2 to 4 weeks, draining the fluid and causing a normal opening of the gland to form, after which the catheter is removed.

Catheters usually do not impede normal activity, but intercourse usually abstains while the catheter is in place. In cases that require intervention, a catheter can be placed to drain the cyst.

If the cysts come back, your doctor can permanently open the cyst surgically to create a permanent pouch (marsupialization). This method is usually effective in preventing recurrences. It is similar to the surgical drainage procedure.

The procedure called marsupialization, in which a permanent opening is formed, less than a quarter of an inch (about 5 millimeters) long in the gland with stitches to keep the secretion channel open. The edges of the skin are stitched so that the secretions come out.

Some doctors are using laser therapy to treat Bartolino’s cyst, the carbon dioxide laser can create an opening to help drain the cyst. But this type of treatment is still in the experimental phase.

Needle aspiration a needle is used to drain the cyst. Sometimes, after draining the cyst, the cavity is filled with a liquid solution of 70 percent alcohol for a few minutes before being drained, to reduce the chances of infection.

Because marsupialization is not recommended when there is an active infection, it is likely that the doctor wants to drain the abscess first and get rid of the infection, then perform the marsupialization

The doctor may recommend the removal of the Bartholin’s gland, the excision of the gland is done if there are many recurrent cysts that do not respond well to any therapy, but this is rarely necessary. Surgical removal is usually done in a hospital under general anesthesia.

If a cyst is infected, it can break and begin to heal on its own after 3 to 4 days. If the cyst is infected or if the tests reveal a sexually transmitted disease, your doctor may prescribe antibiotics to make sure that the bacteria that cause the infection are destroyed.

Over-the-counter painkillers, such as ibuprofen, relieve pain and a sitz bath can increase comfort. But if the abscess is drained properly, you may not need antibiotics.

Warm compresses can speed healing, a warm bath can help the cyst burst. A warm compress against the affected area can help relieve symptoms.

If an abscess of the Bartolino gland returns several times, the gland and the conduit can be removed surgically.

Home remedies:

If your cyst is small, does not hurt and is not infected, there are many home remedies you can try to treat it.

However, if your symptoms do not go away within a few days, it is important that you consult a doctor for professional medical advice. The following treatments can help treat a small Bartolino cyst without the need for medication or surgery.

1) Seat bath:

Doctors often recommend a sitz bath daily or several times a day to treat a minor Bartolino cyst.

A sitz bath can be prepared with warm water that fills only a few inches of your tub. Simply taking a daily bath is often enough to resolve an infected cyst.

If you have undergone a surgical procedure to treat your cyst, frequent removal in a sitz bath is especially important.

A sitz bath can help keep the affected area clean, relieve pain and discomfort and even promote the drainage of your cyst.

2) Probiotics:

Probiotics are made up of healthy bacteria that are actually good for our body. They can help eliminate infection, stimulate the health of the immune system and balance the body’s bacteria.

A probiotic supplement can improve your overall health and also help destroy the bacteria responsible for the infected Bartolino cyst.

3) Apple cider vinegar:

If you do not have apple cider vinegar at home, then you are missing one of the most popular home remedies of the moment. Being so incredibly diverse, it’s not surprising that I make this list.

There is a lot of anecdotal evidence in the Bartolino cyst forums to suggest that it is a very effective treatment.

The most common method of using apple cider vinegar to treat a Bartolino cyst is to apply it to your cyst with a cotton ball or a cotton pad.

Take a sitz bath, dry thoroughly and then apply the apple cider vinegar directly into your cyst. If you consider that vinegar is too painful, it is best to dilute it with water first or stop using it completely.

4) Tea tree essential oil:

Tea tree essential oil has excellent antibacterial properties and is one of the most effective and diverse essential oils.

As with apple cider vinegar, the Internet is full of anecdotal evidence of women who have successfully treated their Bartolino cyst with tea tree oil.

It is very important that you dilute the essential oil from your tea tree in a carrier oil such as coconut oil before applying it to your cyst. While diluting the oil, it is unlikely to cause adverse reactions.

When applied topically, it can relieve discomfort and irritation and can help kill the bacteria responsible for any infection you may have.

5) Turmeric:

Turmeric has excellent medicinal qualities due to the presence of its main active ingredient, curcumin. It has excellent antibacterial and antiseptic properties and when applied to your cyst can help cure the infection and relieve discomfort.

Combine a little turmeric powder with enough virgin coconut oil to make a smooth paste and apply it to the cyst after taking a bath.

6) Vitamins C and D:

Making sure you are eating good nutritious foods with lots of vitamin C and D can help a lot. Both vitamins are natural antioxidants that can help stimulate the immune system and fight the damage caused by free radicals.

They can help your body have the necessary form to fight the bacteria that may be responsible for any infection of your cyst.

7) Alkaline diet:

Many people have had great success in following a strict alkaline diet. An alkaline diet basically involves eating lots of healthy fruits and vegetables.

Dark green leafy vegetables such as kale, spinach, broccoli and cabbage make up a large part of the diet.

It is also important to get plenty of nutritious fruit in your diet. Try eating your vegetables raw or lightly cooked, as they lose much of their nutritional value if they are cooked for too long.

Actually, it is a vegan diet and it is important to avoid any food that produces acid, such as dairy and meats that are also avoided. Try replacing your meat with something similar to tofu. You can also eat a lot of beans and certain nuts.

8) Other remedies:

Other potentially effective remedies that are mentioned less frequently include:

  • Packages of castor oil.
  • Sales of Epsom.
  • Coconut oil.
  • Silica supplements.

If you suffer from a Bartolino cyst, then we hope that one of these remedies works for you. Tell us if it was successful or not and let us know if you have other effective home treatments.

Bartolino cyst prognosis

While Bartolino cysts can be quite painful, they are not life threatening. New cysts can not be prevented, but the surgical or laser removal of a cyst makes it less likely that a new cyst will be formed in the same site.

Those with a cyst are more likely than those without a cyst to have one in the future. They can be repeated every few years or more frequently. Many women who have performed a marsupialization find that recurrences may decrease, but in reality they do not stop.

Epidemiology

Two percent of women will have a cyst of Bartolino’s gland at some point in their lives. They occur at a rate of 0.55 per 1,000 person-years and in women aged 35-50 at a rate of 1.21 per 1,000 person-years.

The incidence of Bartolino’s duct cysts increases with age until menopause , and decreases thereafter. Hispanic women may be affected more often than white women and black women.

The risk of developing a cyst of the Bartolino gland increases with the number of births.

Living with a cyst of Bartolino’s gland

It is possible that Bartolino’s gland cysts come back after treatment. This can happen even years later. If so, your doctor can treat the cyst again.

Your doctor can also completely remove Bartolino’s glands if the cysts recur frequently.

Questions to ask your doctor

  • I have a lump on one of my vaginal lips. Could it be a cyst of Bartolino’s gland?
  • Do I need any tests, like tests for sexually transmitted infections?
  • How serious is the cyst? Is he infected?
  • What are my treatment options? What treatment do you recommend?
  • Is it safe for me to have sex?