Treatment Overview
Most
Bartholin gland cysts don't need treatment, or they go
away on their own. However, if you have a cyst that is causing bothersome
symptoms or that may be infected, see your health professional for treatment.
Your treatment options will depend on how severe your symptoms are.
Treatment for a Bartholin gland cyst that is not infected
When a Bartholin gland cyst appears, but there are no symptoms or
mild symptoms, treatment includes:
- Watchful
waiting. Symptoms are observed without using medical treatment. Some
Bartholin cysts never get worse.
- Soaking the genital area in a
warm, shallow bath (sitz bath). This can reduce discomfort
and helps the genital area to heal.
- Non-prescription pain
medication, such as ibuprofen (Motrin, Advil) or acetaminophen (Tylenol)
to relieve discomfort.
A Bartholin gland cyst can be present for months or years without
causing any symptoms.
If sexual intercourse causes symptoms, see your health
professional.
Treatment for a ruptured Bartholin abscess
An infected Bartholin gland cyst (abscess) that
has burst open (ruptured) sometimes will heal on its own. In this case, your
health professional may suggest sitz baths, non-prescription pain relievers,
and watchful waiting. You may not need to take antibiotics once the cyst has
ruptured.
Treatment for a Bartholin gland cyst that causes symptoms
A Bartholin cyst that is large, painful, or infected will be
drained. If you have an abscess, you may take antibiotics after the procedure.
Simply draining a cyst and letting it heal shut will likely allow
it to fill up again.2 To keep the cyst from closing
and filling up again, it is usually held open for a few weeks with:
- A Word catheter, which is a small drainage
tube with a small balloon on one end. The balloon is inflated inside the cyst
to keep the tube in place. After the gland has healed and the tube and balloon
are removed, the opening remains. This is the most common way to treat a large
or infected Bartholin gland cyst.
- A small piece of gauze which
keeps the cyst from closing.
- Stitches, which prevent the cyst wall
from reforming a closed sac. Bartholin gland cysts only recur about 10% to 15%
of the time after this procedure.3
Less commonly, the cyst wall is damaged with a
carbon dioxide laser or silver nitrate to prevent it
from growing back.
Bartholin cyst treatment can be done with a
local anesthetic in the doctor's office. However, a
painful cyst is more likely to be surgically treated using
general anesthesia.
For severe Bartholin cysts and abscesses that do not get better
with repeated treatment, the entire Bartholin gland and duct can be removed.
This is a surgery, also known as
excision. Because excision is an involved procedure
that can lead to blood loss and complications, it is done in a surgery centre.
Excision is only used when other treatments have repeatedly failed.
What to think about
To reduce the risk of infection after treatment, do not have
sexual intercourse until the area is completely healed. This can take several
weeks, depending on the treatment method that was used.
Excision is sometimes recommended for
post-menopausal women who have Bartholin gland cysts
or abscesses. This is because of general concerns about the risk of cancer in
the pelvic area, which increases with age. However, simply draining a Bartholin
cyst and testing the cyst tissue for cancer is also a reasonable first-time
treatment for older women.
Treatment during pregnancy
If you are pregnant and have a Bartholin gland cyst, your
treatment will depend on how severe your symptoms are and whether you have an
infection.
- When possible, draining a cyst is delayed
until after your baby is born. This is because the genital area has increased
blood flow during pregnancy, so bleeding is more likely. However, a large cyst
may need to be drained to prevent problems during delivery.
- Because
having an infection can cause you to go into labour before your due date, an
abscess is drained and treated with antibiotics. Antibiotics and local
anesthesia are considered safe during pregnancy.