• Clinical science

Bartholin gland cyst and abscess


The Bartholin glands are located in both sides of the inner labia and serve primarily to produce the mucus that moisturizes the vaginal mucosa. The mucus is secreted into two ducts that appear in the posterior vaginal introitus. A Bartholin gland cyst is usually caused by blockage of the duct as a result of inflammation or trauma; a Bartholin gland abscess occurs when the obstructed duct becomes infected. The most common symptoms are swelling and, in the case that an abscess develops, pain as well as possibly fever. Both Bartholin gland cysts and abscess are clinical diagnoses. First-line treatment includes sitz baths, which may promote spontaneous rupture or resolution of the cyst after a few days. An abscess, however, usually requires incision and must be drained surgically.



Epidemiological data refers to the US, unless otherwise specified.

Bartholin gland cyst

  • Pathophysiology: blockage of the duct by inflammation or trauma
  • Clinical features: often asymptomatic but can cause mild dyspareunia
  • Diagnostics
    • Pelvic exam: unilateral, palpable mass in the posterior vaginal introitus
    • Biopsy is indicated if any of the following apply :
      • > 40 years of age
      • Progressive, solid, and painless mass found during pelvic exam
      • Not responsive to treatment
      • History of malignancy in the labia
  • Treatment:
    • Sitz baths to facilitate rupture of the cyst
    • Consider surgery for symptomatic cysts (see “Treatment” of Bartholin gland abscesses below)

A Bartholin gland cyst is generally a clinical diagnosis based on physical examination!References:[1][4][2][3]

Bartholin gland abscess

  • Pathophysiology: Bartholin gland or cyst becomes infected
  • Clinical features
    • Acute unilateral pain and tender swelling
    • Dyspareunia
    • Pain especially while walking and sitting
    • Fever (∼ 20% of cases)
    • Prompt pain relief with discharge (indicates spontaneous rupture of abscess)
  • Diagnostics
    • Pelvic exam: unilateral, tender mass surrounded by edema and erythema in the posterior vaginal introitus
    • Possible culture
    • STD testing at the request of the patient .
    • Consider biopsy to rule out malignancy (see “Diagnostics” of Bartholin gland cyst above)
  • Treatment
    • Incision and drainage followed by irrigation and packing
    • Fistulization with a Word catheter
    • Marsupialization
      • Indicated for recurring abscesses
      • The labia minora is cut longitudinally to expose the cyst or abscess. Once the cyst or abscess is displayed, it is slit open longitudinally and drained. The slit edges of the cyst or abscess are then everted and sutured to the slit edges of the labia minora, which forms a new opening to allow free drainage.

Bartholin gland abscess is usually a clinical diagnosis based on physical examination!


Differential diagnoses


The differential diagnoses listed here are not exhaustive.