Ask the Experts: Bartholin Cysts

Question:

I have been having Bartholin cysts for many years. I went for a minor surgery before, but was informed that it would keep coming back from time to time. At times, it is so painful that I can hardly walk properly. It is even worse when I am having my periods as I have to use sanitary pads. What I can do to prevent it from recurring? Are there any types of food I should avoid?

Answer:

Bartholin glands are located at the entrance to a woman’s vagina, one on each side. They are small and cannot be seen or felt when they are normal. Their function is to secrete fluid onto the mucosal (inner) surface of the labia – the liplike skin surrounding the vagina. The function is to keep the area lubricated.

Problems arise when the opening of the glands become blocked, causing a backlog of fluid in the gland thus forming a collection; Bartholin cyst, which are relatively painless enlargements of the gland. Pain is felt when the area becomes infected; this is when the condition is referred to as a Bartholin abscess.

Bartholin abscess formation can be caused by any of a number of bacteria. These include bacterial organisms that cause sexually transmitted diseases such as chlamydia and gonorrhea as well as bacteria normally found in the intestinal tract, such as Escherichia coli, Group B streptococcus etc. It is common for these abscesses to involve more than one type of organism. Therefore, antibiotics are usually prescribed. If the cyst is not causing any pain, sometimes it may spontaneously resolve on its own with antiseptic creams and prompt treatment with sitz baths may prevent the development of an abscess.

The simplest form of sitz bath is to sit in the bathtub filled with a few inches of warm water; sometimes a little table salt may be added to the water. The water should not be so hot as to burn the skin but should be fairly warm. These soaks should be done for 10-15 minutes at a time, three to four times daily. This treatment is frequently all that is needed to treat Bartholin cysts.

For Bartholin abscesses and cysts that are symptomatic (large or painful), the treatment is drainage. An abscess is an infection within an enclosed space. As antibiotics do not adequately enter into the enclosed space, therefore, treatment of an abscess almost always requires that the infection be drained. Most women would feel much better within 24 hours of drainage.

Some have problems with recurrent cysts or abscesses. If that is the case, there is a procedure called marsupialization, which can be performed to destroy the cyst and prevent future episodes.

Marsupialization is usually done in a surgical setting. An incision is made into the skin over the cyst and then carried down through the cyst wall. This drains the fluid from the cyst and then the lining of the cyst wall is sutured to the overlying skin in such a way as to create a permanent drain site. This usually prevents recurrence of the cyst.

Unfortunately, there are no foolproof methods for preventing Bartholin cyst except to keep the area clean and to use the sitz bath when the discomfort arises. The recurring cyst formation is not associated with any particular dietary intake, thus there is no need for any food restrictions.