The two Bartholin’s glands are located on either side of the lower vaginal entrance. They secrete fluid which helps to lubricate the introitus. The glands are about the size of a pea and are not normally palpable. The mucus secretion passes to the skin surface along a narrow duct which is about 2 cm long; this can become blocked by exfoliated skin cells, trauma or infection of the gland. This leads to swelling of the glands causing a Bartholin’s cyst which can be palpable and painless (see Figure 4.2). If the secretions within the blocked gland become infected the cyst will become painful and can increase greatly in size and distort or obscure the entrance to the vagina. The common bacteria that can cause infection are Escherichia coli and Staphylococcus spp. and sexually transmitted pathogens such as chlamydia and gonorrhoea.
Figure 4.2 Bartholin’s Cyst
Used with permission of Mayo Foundation for Medical Education and Research, all rights reserved
Bartholin’s cysts and abscesses develop in three per cent of women and are more common in those aged 20-30 years.(17) Rarely in women over 40 years the cyst can be malignant.(18)
Occasionally, the cyst will spontaneously discharge the accumulated secretions but if large, ...
Buy now
1.
Madhivanan P, Krupp K, Chandrasekaran V, Karat C, Arun A, Cohen CR, et al. Prevalence and correlates of Bacterial Vaginosis among young women of reproductive age in Mysore, India. Indian J Med Microbiol. 2008; 26(2):132-7.
Close
2.
Forcey D, Vodstrcil LA, Hocking JS, Fairley CK, Law M, McNair RP, et al. Factors associated with Bacterial Vaginosis among women who have sex with women: a systematic review. PLoS ONE. 2015; 10(12):e141905.
Close
4.
Pirotta M, Fethers KA, Bradshaw CS. Bacterial Vaginosis: more questions than answers. Aust Fam Physician. 2009; 38(6):394-7.
Close
5.
Gottschick C, Zhi-Luo D, Vital M, Clarissa M, Abels C, Pieper DH, et al. Treatment of biofilms in Bacterial Vaginosis by an amphoteric tenside pessary-clinical study and microbiota analysis. Microbiome. 2017; 5(119).
Close
7.
2015 Sexually Transmitted Disease Treatment Guidelines [Internet]. Centers for Disease Control and Prevention; 2015. Disease Characterized by Vaginal Discharge; [updated 2015 June 4; cited 2015 July 14]. Available from: https://www.cdc.gov/std/tg2015/vaginal-discharge.htm.
Close
9.
Bradshaw C, Morton AN, Hocking J, Garland SM, Morris LM, Moss LM, et al. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis. 2006; 193(11):1478-86.
Close
10.
Car P. Chronic vaginal discharge: causes and management O&G. 2014; 16(3).
Close
11.
Saxon C, Edwards A, Rautemaa-Richardson R, Owen C, Nathan B, Plamer B et al. British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis (2019).[Internet]. British Association for Sexual Health and HIV: Clinical Effectiveness Group (CEG). 2019. Available from: https://www.bashhguidelines.org/media/1223/vvc-2019.pdf.
Close
12.
Fischer G. Coping with chronic vulvovaginal candidiasis. Medicine Today. 2014; 15(2):33-40.
Close
13.
Matheson A, Mazza D. Recurrent vulvovaginal candidiasis: A review of guideline recommendations. Aust N Z J Obstet Gynaecol. 2017; 57(2):139-45.
Close
21.
Fischer G, Bradford J. The Vulva: a Practical Handbook for Clinicians. 2nd Ed. Sydney, Australia: Cambridge University Press; 2016.
Close
22.
Nunns D, Mandal D, Byren M, McLelland J, Rani R, Cullimore J, et al. Guidelines for the management of vulvodynia. British Journal of Dermatology. 2010;162(6):1180-5.
Close
23.
Lynch PJ, Moyal-Barrocco M, Bogliatto F, Micheletti L, Scurry J. ISSVD classifications of vulvar dermatoses: pathologic subsets and their clinical correlates. J Reprod Med. 2007; 52(1): 3-9.
Close
25.
Ampt A, Roach V, Roberts CL. Vulvoplasty in New South Wales, 2001–2013: a population-based record linkage study. Med J Aus. 2016;205(8):365-9.
Close
