Nabothian and Bartholin’s Cysts Flashcards
Nabothian Cysts
Fluid-filled cysts often seen on the surface of the cervix
Pathophysiology of nabothian cysts
Columnar epithelium of the endocervix produces cervical mucus.
Squamous epithelium of the ectocervix slightly covers the mucus-secreting columnar epithelium, the mucus becomes trapped and forms a cyst.
When do nabothian cysts normally occur
After childbirth
Minor trauma to the cervix or cervicitis secondary to infection
Presentation of nabothian cysts
Asymptomatic - incidental finding on speculum
If large - feeling of fullness in the pelvis
Appearance of nabothian cysts
Smooth rounded bumps on the cervix, usually near to os.
Have a whitish or yellow appearance.
Management of nabothian cysts
Reassurance - resolve spontaneously
If the diagnosis of nabothian cyst is unclear
Colposcopy
Excision and biopsy (occasionally)
Bartholin’s glands
Pair of glands located either side of the posterior part of the vaginal introitus (the vaginal opening).
Usually pea-sized and not palpable.
Role of bartholin’s glands
Produce mucus to help with vaginal lubrication
Pathophysiology of Bartholin’s cyst
When the ducts become blocked, the Bartholin’s glands can swell and become tender
Bartholin’s abscess
Infected bartholin’s cyst
Presentation of bartholin’s abscess
Hot, tender, red and potentially draining pus
Presentation of bartholin’s cyst
Unilateral swelling which is fluid filled
Management
Supportive
- good hygiene
- analgesia
- warm compresses
How to diagnose a bartholin’s cyst
History and examination
When to do a biopsy for a Bartholin’s cyst
If vulval cancer is suspected
Particularly if over 40+
Investigations for Bartholin’s abscess
Swab - microscopy, sensitivity and culture
Chlamydia and Gonorrhoea specific swabs
What is the common causative organism for Bartholin’s abscess
E. Coli
Management of Bartholin’s abscess
Word catheter (Bartholin’s gland balloon) – requires local anaesthetic
Marsupialisation – requires general anaesthetic
Word catheter
Catheter inserted into the abscess space, and inflated
The balloon fills the space and keeps the catheter in place.
Fluid can drain around the catheter, preventing a cyst or abscess reoccurring.
The tissue heals around the catheter, leaving a permanent hole.
The catheter can be deflated and removed once epithelisation of the hole has occurred.
Marsupialisation
Incision is made
and the abscess is drained.
The sides of the abscess are sutured open.
Allows continuous drainage of the area and prevents recurrence of the cyst or abscess
