Chapter 4 – The Vagina and Vulva

Bartholin’s cysts

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