Conditions - Bartholin's Cyst/Abscess

Question 1

What is the definition of Bartholin’s Cyst/Abscess?

Answer 1

Swollen and tender Bartholin’s glands = Bartholin’s cyst

If a Bartholin’s cyst becomes infected = Bartholin’s abscess

Question 2

What is the aetiology/risk factors of Bartholin’s Cyst/Abscess?

Answer 2

The Bartholin’s glands are a pair of glands either side of the vaginal opening involved in vaginal lubrication. When the ducts for secretion become blocked, the glands swell and become tender, a Bartholin’s cyst. If a cyst becomes infected, they become a Bartholin’s abscess.

RFs

• Infection
• Injury or surgery in the area
• Nulliparous + child-bearing age
• STIs

E. Coli most common cause of abscess.

Question 3

What is the epidemiology of Bartholin’s Cyst/Abscess?

Answer 3

2% of women develop one at some time in life

Question 4

What are the presenting symptoms of Bartholin’s Cyst/Abscess?

Answer 4

Cyst – Unilateral tender vaginal swelling between 1-4cm

Abscess – As with cyst but + hot, tender, red, potentially pus-draining

Question 5

What are the appropriate investigations for Bartholin’s Cyst/Abscess?

Answer 5

Cyst – Biopsy may be needed to exclude vulval malignancy (esp >40y)
Abscess – swab of the pus draining for culture + Abx sensitivities
- (send specific swabs for chlamydia and gonorrhoea)

Question 6

What is the management plan for Bartholin’s Cyst/Abscess?

Answer 6

Conservative – good hygiene, sitz bath, analgesia, warm compress
Surgical (requires local anaesthetic) – marsupialisation/Word catheter drainage +/- oral broad-spectrum antibiotics

Marsupialisation – suturing abscess open allowing continuous drainage + prevent recurrence