Bartholin Gland Cyst - Treatment Overview

Treatment Overview

Most Bartholin gland cysts don't need treatment, or they go away on their own. However, if you have a cyst that is causing bothersome symptoms or that may be infected, see your health professional for treatment. Your treatment options will depend on how severe your symptoms are.

Treatment for a Bartholin gland cyst that is not infected

When a Bartholin gland cyst appears, but there are no symptoms or mild symptoms, treatment includes:

• Watchful waiting. Symptoms are observed without using medical treatment. Some Bartholin cysts never get worse.
• Soaking the genital area in a warm, shallow bath (sitz bath). This can reduce discomfort and helps the genital area to heal.
• Nonprescription pain medication, such as ibuprofen (Motrin, Advil) or acetaminophen (Tylenol) to relieve discomfort.

A Bartholin gland cyst can be present for months or years without causing any symptoms.

If sexual intercourse causes symptoms, see your health professional.

Treatment for a ruptured Bartholin abscess

An infected Bartholin gland cyst (abscess) that has burst open (ruptured) sometimes will heal on its own. In this case, your health professional may suggest sitz baths, nonprescription pain relievers, and watchful waiting. You may not need to take antibiotics once the cyst has ruptured.

Treatment for a Bartholin gland cyst that causes symptoms

A Bartholin cyst that is large, painful, or infected will be drained. If you have an abscess, you may take antibiotics after the procedure.

Simply draining a cyst and letting it heal shut will likely allow it to fill up again.² To keep the cyst from closing and filling up again, it is usually held open for a few weeks with:

• A Word catheter, which is a small drainage tube with a small balloon on one end. The balloon is inflated inside the cyst to keep the tube in place. After the gland has healed and the tube and balloon are removed, the opening remains. This is the most common way to treat a large or infected Bartholin gland cyst.
• A small piece of gauze which keeps the cyst from closing.
• Stitches, which prevent the cyst wall from reforming a closed sac. Bartholin gland cysts only recur about 10% to 15% of the time after this procedure.³

Less commonly, the cyst wall is damaged with a carbon dioxide laser or silver nitrate to prevent it from growing back.

Bartholin cyst treatment can be done with a local anesthetic in the doctor's office. However, a painful cyst is more likely to be surgically treated using general anesthesia.

For severe Bartholin cysts and abscesses that do not get better with repeated treatment, the entire Bartholin gland and duct can be removed. This is a surgery, also known as excision. Because excision is an involved procedure that can lead to blood loss and complications, it is done in a surgery center. Excision is only used when other treatments have repeatedly failed.

What to think about

To reduce the risk of infection after treatment, do not have sexual intercourse until the area is completely healed. This can take several weeks, depending on the treatment method that was used.

Excision is sometimes recommended for postmenopausal women who have Bartholin gland cysts or abscesses. This is because of general concerns about the risk of cancer in the pelvic area, which increases with age. However, simply draining a Bartholin cyst and testing the cyst tissue for cancer is also a reasonable first-time treatment for older women.

Treatment during pregnancy

If you are pregnant and have a Bartholin gland cyst, your treatment will depend on how severe your symptoms are and whether you have an infection.

• When possible, draining a cyst is delayed until after your baby is born. This is because the genital area has increased blood flow during pregnancy, so bleeding is more likely. However, a large cyst may need to be drained to prevent problems during delivery.
• Because having an infection can cause you to go into labor before your due date, an abscess is drained and treated with antibiotics. Antibiotics and local anesthesia are considered safe during pregnancy.