Bartholin's Cyst and Abscess

What it is

The Bartholin's glands are located on each side of the vaginal entrance and produce part of the lubrication. When the duct of one of them becomes blocked, fluid accumulates and forms a cyst — usually a painless lump, noticed when sitting or during intercourse. If the contents become infected, an abscess develops, with intense pain, redness, rapid swelling and, sometimes, fever. It is a common problem between ages 20 and 40. Small, symptom-free cysts can simply be monitored, with warm sitz baths. An abscess requires drainage, often with an antibiotic. When the problem recurs, the options are marsupialization, which creates a permanent drainage channel while preserving the gland, and laser excision of the gland (bartholinectomy), which removes it. The choice depends on each case and is decided during the consultation.

Most common symptoms

• A lump on one side of the vaginal opening
• Feeling of heaviness or discomfort when sitting or walking
• Pain during intercourse
• Intense pain, redness and rapid swelling with an abscess
• Fever and malaise when there is infection
• Discharge of fluid when the abscess ruptures

Causes and risk factors

• Blockage of the Bartholin's gland duct
• Infection by bacteria from the skin or intestine
• Sexually transmitted infections, such as gonorrhea and chlamydia
• Local trauma or previous surgery in the area
• A previous episode of cyst or abscess

How it is diagnosed

Diagnosis is made at the consultation, based on the symptoms described and the gynecological exam, in which your gynecologist identifies the lump at the vaginal opening and assesses its size, pain and signs of infection. Additional tests are generally not needed. When there is an abscess, fluid may be collected for culture and testing for sexually transmitted infections. In women over 40, or when there are unusual features, a tissue biopsy may be recommended to rule out other causes.

How we treat it at Femi Saúde

Small, symptom-free cysts can simply be monitored, with warm sitz baths that help with spontaneous drainage. An abscess needs drainage, performed under local anesthesia, often combined with an antibiotic. When the cyst or abscess forms again, Femi Saúde's gynecology team offers marsupialization, which creates a permanent drainage channel and preserves the gland, and CO₂ laser bartholinectomy, which removes the gland with greater precision and less bleeding, recommended for recurrent cases. The choice takes into account how often the episodes occur, the patient's age and preference, with guidance on care to prevent further episodes.

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