Cysts and Abscesses of the Bartholin Glands
The Source of Pain and Pleasure
The vulva, also known as the pubic triangle, consists of the external genital organs of females. The labia majora, mons pubis, labia minora, clitoris, bulb of vestibule, vulvar vestibule, vestibular glands and the opening of the vagina are all part and parcel of this area of a woman's body. This area serves as the outer portal to the uterus, protecting the vagina and inner sanctum of womanhood. Functionally, the vulva contains the opening of the female urethra and as such, provides the function of passing urine. This area is richly innervated and has glands that supply lubrication to keep the area moist, providing comfort and pleasure when stimulated.
The Bartholin Glands - Tiny but Effective
Occasionally, this area can become agitated with various types of discomforts ranging from rashes to lumps and swelling. Within the vulva there are mucus glands called Bartholin glands. A Dutch anatomist by the name of Caspar Bartholin first described them in 1677. There are two of these tiny organs near the opening of the vagina and are typically nonpalpable, meaning they are obscure and not easily seen. Their function is to maintain the moisture of the vaginal opening's surface.
Bartholin Gland Cysts and Abscesses
A Bartholin gland cyst or abscess can form either in the gland or in the duct that drains the gland. Usually found in women of reproductive age, the cyst and abscess are easy enough to distinguish from one another. A cyst will obstruct the duct causing distention in either the duct or the gland itself. This usually happens as a reaction to an inflammation or trauma. Often the cyst is between one and three centimeters in size and there is little pain associated with it. However, larger cysts may cause pain and pain during intercourse.
A Bartholin abscess is the result of an infection of the gland itself or an infected cyst. This situation has a lot of pain associated with it that is acute gets worse, eventually causing intense vulvar pain. The research shows that these abscesses are not generally linked to STDs sexually transmitted; rather they are caused by micro-organisms. Only one or two percent of all vulvar malignancies are linked to adenocarcinoma of the Bartholin gland - in other words, cancer of these glands is extremely rare.
What's the Difference?
Usually a cyst or abscess of the Bartholin gland occurs in women between the ages of 20 and 30. If it does occur in a woman over the age of 40, she will be referred to a gynecologist for a biopsy. Cysts usually present without pain but with swelling in the labia. An abscess may occur spontaneously or it might follow on the heels of a cyst. The following symptoms usually accompany a Bartholin gland abscess:
· Acute, painful unilateral (one-side) swelling of the labia
· Pain when walking or sitting
· Sudden relief of pain followed by discharge of pus - this would indicate a spontaneous rupture in which case an obvious mass may not be present.
· A mass that is very tender and changeable with swelling and redness
· In some cases, fever may occur
· Inflammation and infection of the tissue surrounding the abscess may be present
A Bartholin abscess is generally painful and usually requires incision and drainage.
Bartholin cysts present differently and with far fewer symptoms:
· Painless mass without inflammation or infection that appears on one side of the labia
· If the cyst is large, there may be some tenderness
· The discharge will not be pus
Bartholin cysts that are not infected are filled with mucous rather than infected pus. Studies done in the 1970s and 1980s identified gonorrhea and Chlamydia trachomatis as the common bacteria to cause cysts. More recent studies has implicated the staphylococcus species of bacteria as predominant, especially the Escherichia coli strep bacteria.
When There is Potential for More
Women who are 40 years old and older may require a biopsy if they have a cyst or abscess in the vulvar region. Bartholin gland malignancy is suggested with the presence of the following signs:
· Age is above 40 years
· Chronic or gradually progressive but painless mass in the labia
· Solid, immoveable, painless mass
· Prior history of labial malignancy
Vulvar cysts occur in many women. Usually they are nothing to be overly concerned about. However, they often require some type of treatment. To learn more about the various vulvar conditions, read the articles in this section.