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'{{Infobox medical condition | | Name = Bartholin's cyst | Image = Barthonlincyst2011.png | Caption = Bartholin's cyst of the right side | ICD10 = {{ICD10|N|75|0|N|70}} | ICD9 = {{ICD9|616.2}} | ICDO = | OMIM = | MedlinePlus = 001489 | MeSH = | GeneReviewsNBK = | GeneReviewsName = }} <!-- Definition and symptoms --> A '''Bartholin's cyst''', also known as '''Bartholinitis''' occurs when a [[Bartholin's gland]] is blocked and the gland becomes inflamed.<ref>{{cite book|author1=Sue E. Huether|title=Pathophysiology: The Biologic Basis for Disease in Adults and Children|date=2014|publisher=Elsevier Health Sciences|isbn=9780323293754|pages=817|url=https://books.google.ca/books?id=l9XsAwAAQBAJ&pg=PA817}}</ref> Sizes range from that of a pea to that of an egg and form just within each side of the lower part of the opening of the [[vagina]]. An [[abscess]] may form if the cyst becomes infected.<ref name=Omole2003/> In this case it often becomes red and painful when touched.<ref name=Omole2003/> <!-- Cause --> A Bartholin's cyst is not an [[infection]], although it can be caused by an infection, inflammation, or physical blockage (mucus or other impediment) to the Bartholin's ducts (tubes which lead from the glands to the vulva). If infection sets in, the result is a Bartholin's abscess. Cysts are not sexually transmitted. There is no known reason for their development and infection is rare. With an abscess, a bacterial infection, but usually not an STD, is the cause.<ref name=Rosen2014Chp137>{{cite book|last=Marx|first=John A. Marx|title=Rosen's emergency medicine : concepts and clinical practice|date=2014|publisher=Elsevier/Saunders|location=Philadelphia, PA|isbn=1455706051|pages=Chapter 137|edition=8th|chapter=Skin and Soft Tissue Infections}}</ref> <!-- Treatment --> Treatment depends on the severity of symptoms.<!-- <ref name=Omole2003/> --> If there are no symptoms, no treatment may be needed.<!-- <ref name=Omole2003/> --> If a cyst is causing problems, drainage is recommended.<!-- <ref name=Omole2003/> --> The preferred method of drainage is the insertion of a Word catheter for four weeks. Simple [[incision and drainage]] may allow the cyst to reform.<!-- <ref name=Omole2003/> --> A surgical procedure known as [[marsupialization]] may be used for cysts, but should not be used if they are infected.<!-- <ref name=Omole2003/> --> If the problems persist, the entire gland may be removed.<!-- <ref name=Omole2003/> --> Removal is sometimes recommended in those older than 40 to ensure [[cancer]] is not present.<!-- <ref name=Omole2003/> --> [[Antibiotics]] are not generally needed.<ref name=Omole2003/> <!-- Epidemiology --> Bartholin's cysts are most likely in women of childbearing age.<!-- <ref name=Omole2003/> --> About two percent of women have the problem at some point in their life.<ref name=Omole2003/> ==Signs and symptoms== Most Bartholin's cysts do not cause any symptoms, although some may cause pain during walking, sitting,<ref name=Omole2003/> or sexual intercourse ([[dyspareunia]]).<ref name=Eilber2003 /> They are usually between 1 and 4&nbsp;cm, and are located just medial to the [[labia minora]]. Most Bartholin's cysts only affect the left ''or'' the right side ([[unilateral]]). Small cysts are usually not painful, but very large cysts can cause significant pain. ==Pathophysiology== A Bartholin's gland cyst develops when the duct that drains the gland becomes blocked.<ref name=Eilber2003>{{cite journal|last=Eilber|first=Karyn Schlunt|author2=Raz, Shlomo|title=Benign Cystic Lesions of the Vagina: A Literature Review|journal=The Journal of Urology|date=September 2003|volume=170|issue=3|pages=717–722|doi=10.1097/01.ju.0000062543.99821.a2|pmid=12913681}}</ref> Blockage may be caused by an infection or a mucus plug.<ref name=Eilber2003 /> The secretions from the Bartholin's gland are retained, forming a cyst.<ref name=Omole2003/> ==Diagnosis== Other conditions that may present similarly include [[hidradenoma papilliferum]], [[lipoma]]s, [[epidermoid cysts]] and [[Skene's duct cyst]]s among others.<ref name=Omole2003/> In those who are more than 40 years of age a [[biopsy]] may be recommended to ensure cancer is not present.<ref name=Omole2003/> ==Treatment== Treatment may not be necessary when Bartholin's cysts cause no symptoms. Small, asymptomatic cysts should simply be observed over time to see whether they grow. In cases that require intervention, a catheter may be placed to drain the cyst, or the cyst may be surgically opened to create a permanent pouch (marsupialization). Intervention has a success rate of 85%, regardless of the method used, for the achievement of absence of swelling and discomfort and the appearance of a freely draining duct.<ref>[http://bestpractice.bmj.com/best-practice/monograph/1060/treatment/step-by-step.html Bartholin's cyst] from BestPractice, BMJ Publishing Group. Last updated: Apr 26, 2013</ref> Catheterization is a minor procedure that can be performed in an office setting. A small tube with a balloon on the end (known as a [[Word catheter]]) may be inserted into the cyst.<ref name=Omole2003/> The balloon is then inflated to keep it in place. The catheter stays in place for 2 to 4 weeks, draining the fluid and causing a normal gland opening to form, after which the catheter is removed. The catheters do not generally impede normal activity, but sexual intercourse is generally abstained from while the catheter is in place. Cysts may also be opened permanently, a procedure called [[marsupialization]],<ref name="pmid17355304">{{cite journal |vauthors=Haider Z, Condous G, Kirk E, Mukri F, Bourne T |title=The simple outpatient management of Bartholin's abscess using the Word catheter: a preliminary study |journal=Aust N Z J Obstet Gynaecol |volume=47 |issue=2 |pages=137–140 |date=April 2007 |pmid=17355304 |doi=10.1111/j.1479-828X.2007.00700.x }}</ref> in which an opening to the gland is formed with stitches to hold the secretion channel open. If a cyst is infected, it may break open and start to heal on its own after 3 to 4 days. Nonprescription pain medication such as [[ibuprofen]] relieves pain, and a [[sitz bath]] may increase comfort. Warm compresses can speed healing. If a Bartholin gland abscess comes back several times, the gland and duct can be surgically removed. ==Prognosis== While Bartholin cysts can be quite painful, they are not life-threatening. New cysts cannot absolutely be prevented from forming, but [[surgery|surgical]] or [[laser surgery|laser]] removal of a cyst makes it less likely that a new one will form at the same site. Those with a cyst are more likely than those without a cyst to get one in the future. They can recur every few years or more frequently. Many women who have marsupialization done find that the recurrences may slow, but do not actually stop. ==Epidemiology== Two percent of women will have a Bartholin's gland cyst at some point in their lives.<ref name=Omole2003>{{cite journal|last=Omole|first=F|author2=Simmons, BJ|author3= Hacker, Y|title=Management of Bartholin's duct cyst and gland abscess|journal=American family physician|date=Jul 1, 2003|volume=68|issue=1|pages=135–40|pmid=12887119}}</ref> They occur at a rate of 0.55 per 1000 person-years and in women aged 35–50 years at a rate of 1.21 per 1000 person-years.<ref name=":1">{{Cite journal|pmid=23618035|year=2013|last1=Yuk|first1=JS|last2=Kim|first2=YJ|last3=Hur|first3=JY|last4=Shin|first4=JH|title=Incidence of Bartholin duct cysts and abscesses in the Republic of Korea|volume=122|issue=1|pages=62–4|doi=10.1016/j.ijgo.2013.02.014|journal=International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics}}</ref> The incidence of Bartholin duct cysts increases with age until [[menopause]], and decreases thereafter.<ref name=":1" /> Hispanic women may be more often affected than white women and black women.<ref name=Omole2003/> The risk of developing a Bartholin's gland cyst increases with the number of childbirths.<ref name=Omole2003/> ==References== {{reflist}} {{Diseases of the pelvis and genitals}} {{DEFAULTSORT:Bartholin's Cyst}} [[Category:Inflammatory diseases of female pelvic organs]]'