Bartholin Gland Anatomy

Mucus-secreting glands in the vulvar vestibule.

Orifices at five/seven o'clock position just outside hymenal ring.

Cyst Abscess
Usually small (1-3cm) May exceed 6cm diameter
Non-tender Typically extremely painful
Require treatment only if symptomatic unless patient over
Require I & D and broad-spectrum
40 (gland biopsy/ excision recommended to r/o
antibiotics
carcinoma)
Non-infectious/ caused by obstruction of duct orifice and N. gonorrhoeae is classic organism,
subsequent dilation but most abscesses with mixed flora.

Treatment (when needed)

I&D with Word Catheter Placement

 Make incision just outside hymenal ring in anterior/posterior direction to prevent vulvar
scarring
 Typically an abscess will have multiple septations which need to be broken down
 Word catheter – Balloon-tipped device placed into cavity and inflated to promote
epithelialization (2-4 weeks). End tucked into vagina to minimized discomfort. Can be
done in an outpatient setting, has replaced marsupialization as first-line treatment.

Marsupialization

 Excision of 1-2 cm oval portion of the roof of cyst behind hymenal ring. Duct wall then
everted and sutured to mucosa. Often used after failure of placement of Word catheter.
 10-15% of cysts recur.
 Rarely needed as Word catheter is less traumatic with same results.

Excision of gland and duct

 Definitive procedure for both cysts and abscesses, usually considered after other methods
have failed because must be done in OR with risks including bleeding, hematoma,
cellulitis, and dyspareunia.
 I. INTRODUCTION

Bartholin’s gland cyst, the most common cystic growths in the vulva, occurs in the labia
majora. Two percent of women develop a Bartholin’s gland cyst or abscess at some time in life.
Abscesses are almost three times more common than cysts. Gradual involution of the
Bartholin’s glands can occur by the time a woman reaches 30 years of age. This may account for
the more frequent occurrence of Bartholin’s duct cysts and gland abscesses during the
reproductive years, especially between 20 and 29 years of age.

The Bartholin's glands are located on each side of the vaginal opening. These glands
secrete fluid that helps lubricate the vagina. Sometimes the openings of these glands become
obstructed, causing fluid to back up into the gland. The result is relatively painless swelling
called a Bartholin cyst. At times, the fluid within the cyst may become infected, resulting in pus
surrounded by inflamed tissue (abscess). Typically only 1 of the 2 glands is affected. A Bartholin
cyst or abscess is common. Treatment of a Bartholin cyst depends on the size of the cyst, the
pain and whether the cyst is infected. Sometimes home treatment is all you need. In other cases,
surgical drainage of the Bartholin cyst is necessary. If an infection occurs, antibiotics may be
helpful to treat the infected Bartholin cyst.