Cyst of Bartholin’s gland

Causes of cysts

Symptoms of a Bartholin gland cyst

Diagnostics

Bartholin gland cyst treatment

Complications

Cyst Bartholin gland is called a rounded education inside it, filled with a secret. It is separated by a dense capsule from other tissues. The cyst is formed as a result of the closure of the excretory duct of the gland.

Because of this, the separation of lubrication of the vestibule of the vagina is disrupted and discomfort occurs during intercourse. Large sizes of cysts can interfere with walking, and cysts themselves can often be complicated by infection and abscess formation (formation of a purulent focus).

Gland functions

Bartholin gland is a steam room, it lies in the zone of the vestibule of the vagina, more precisely within the tissues between the small and large labia, at their base. Excretory ducts of glands open on the surface of the inner edge of the labia minora.

The main function of these glands is to exude a viscous, gray-colored mucous secret, which, due to its composition, provides sufficient moisture to the entrance to the vagina, allowing normal sexual intercourse without discomfort.

Without secretions, dryness can occur, causing discomfort during sex.

Causes of cysts

If a sharp narrowing ( stenosis ) or complete closure of the Bartholin gland duct occurs, the normal outflow of the continuously formed secretion is disrupted.

Naturally, the secret begins to accumulate in the cavity of the gland and throughout the channel. There is swelling and inflammation of the gland, its walls are compacted – a cyst is formed. The sizes can vary from insignificant (1-2 cm), to large (5-8 cm).

Usually a cyst gland occurs when:

  • infection of the gland and ducts with genital infections (such as gonorrhea, chlamydia, ureaplasma, mycoplasma or trichomonas),     
  • with candidiasis of the vagina (thrush),  
  • with rapid reproduction of conditionally pathogenic flora due to weak immunity (E. coli, streptococcus or staphylococcus ) 

The development of a Bartholin gland cyst contributes to:

  • violation of intimate hygiene,
  • skin and genital lips injury during epilation, shaving,
  • wearing tight and breathable underwear
  • carrying out an abortion or other gynecological procedures and interventions,  
  • irregular, but very intense sexual intercourse, multiple, with grazes and injuries.

If the conditions for the existence of a cyst are unfavorable, infection, accumulation of pus and abscess formation can form. 

Symptoms of a Bartholin gland cyst

If the Bartholin gland cyst is not complicated, it usually looks like a round, painless focus of swelling in the region of the labia majora, closer to the anus.

With a small size, the course of the cyst may be imperceptible, it is detected by the gynecologist during the next examination.

If the Bartholin gland cyst grows to a significant size, discomfort is possible when walking, wearing tight clothes, during sexual intercourse.

The cyst may be complicated by suppuration, then a painful abscess is formed. When it is formed, the temperature rises, symptoms of intoxication (nausea, weakness) appear, and well-being deteriorates.

In place of a cyst, a tumor-like formation of up to 10 cm in size is formed, it is sharply painful, it can pulsate, gives a feeling of bursting into the perineal area. With any movements, the pain intensifies.

When spontaneous opening of the abscess of the gland, pus flows out, symptoms of infections of the genital sphere appear in parallel – vulvitis, vaginitis, abnormal vaginal discharge.  

Diagnostics

The gynecologist is engaged in the diagnosis and treatment of Bartholin gland cysts; in complicated forms, a surgeon can be connected to perform the operation.

The primary diagnosis is made on the basis of the examination in the gynecological chair.

When a Bartholin gland cyst is detected, microscopy of the vaginal smear and seeding for microbial composition are performed, with the exception of infections transmitted through sexual contact. According to the results of sowing, antibiotics are selected for treatment.

Bartholin gland cyst treatment

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For cysts of small size, up to 1-2 cm, which do not cause physical discomfort and are not inflamed, do not use active methods of treatment, especially surgical ones.

You can choose observational tactics – often cysts dissolve without a trace due to the spontaneous establishment of a secret outflow. Such cysts are removed at the request of the patient, especially with frequent relapses or for aesthetic purposes.

If the size of the cyst is large enough, there is discomfort during movement or sexual intercourse, surgical correction is necessary. It is aimed at restoring the normal outflow of fluid from the gland.

Apply methods:

  • Opening and draining the cyst (posing special drainage-tube with the creation of conditions for draining secretion). 
    The method has low efficiency, frequent relapses (re-formation of cysts). Often, after several relapses, the gland itself must be removed.
  • Marsupialization cyst. 
    This is its opening and removal of the secret with the further formation of a new duct of the gland along the edges of the wound. This method preserves both the gland itself and its duct.
  • Setting the word catheter. 
    A small incision is made with the contents removed, and a special silicone tube with a cartridge at the end is put in place of the wound. It is left in the cavity for several weeks, it allows you to create a new duct.
  • Puncturing cysts of Bartholin’s gland – a puncture needle with suction contents. This type of surgery is carried out in pregnant women and in case of temporary impossibility of the operation.

All these methods do not provide a full guarantee of recovery; when recurring, cysts resort to the complete removal of the entire gland.

With suppuration of the Bartholin gland cyst , the formation of an abscess, an obligatory necropsy, removal of pus and drainage are carried out. Only then can one of the above methods be carried out to form a duct.

After surgery, the treatment is complemented by physiotherapeutic methods, careful removal of genital infections and immunotherapy.

Complications

The main complications include chronic Bartholinitis – inflammation of the Bartholin gland.  

The second serious complication is suppuration of the cyst with the formation of an abscess. A purulent focus can burst out and a fistula may form, or there may be a breakthrough into the pelvic and internal genital areas.

Even with careful treatment of Bartholin gland cyst and surgical treatment, relapses may occur, and cysts develop again and again.

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