What is a Bartholins gland?

There are 2 Bartholins glands and they lie at

the entrance of the vagina. They secrete a
fluid via a duct that keeps the vulva (external
genital area) moist.
What is a Bartholins cyst and abscess?
Under normal conditions the glands are not
noticeable, but occasionally the duct can
become blocked. Bartholins gland cysts and
abscesses are commonly found in women of
reproductive age, developing in approximately
2% of all women. A simple cyst will feel like a
hard lump in the vagina, but is not usually
painful. You may feel quite dry in the vagina,
however, because the lubrication will not be
able to flow. If the duct stays blocked, it can
become infected and create an abscess in the
gland, which will become swollen, red and
painful. You may also notice some smelly
discharge, or pus, leaking from the area.
What causes a Bartholins abscess?
In most cases there is no obvious cause.
However we do know that local infection,
sexually transmitted infections, large cysts or
injury to the vulval area can cause blockage
and infection of the gland. Diabetics are more
prone to abscesses. Even if you are not
known to be diabetic we will perform a simple
blood test to confirm your blood sugar level is
within normal limits.
How are these conditions treated?
Treatment depends on the size of the cyst,
whether it is painful or if it has developed into
an abscess. Admission to hospital usually
means a large abscess is present, you have
symptoms, and the gland needs to be drained.

You may also need antibiotics to help clear

any remaining infection.
What is a marsupialisation of a Bartholins
gland?
Marsupialisation is a relatively straightforward
procedure that is performed under a general
anaesthetic (whilst you are asleep). A tiny,
oval wedge of skin and underlying cyst wall is
removed and the edges are held back with
dissolvable stitches to encourage drainage of
the cyst or abscess. The skin edges are
sealed to minimise bleeding. The area heals
over time to allow normal drainage of the
gland. The recurrence rate after this
procedure is about 10%.
What are the alternatives?
The treatment offered is determined by your
individual needs and on discussion with your
doctor. The options are described below:
Small cysts that do not cause symptoms
can be left alone.
Some abscesses can burst on their own
and do not need to be surgically drained.
Hot compresses can encourage an
abscess to drain.
Antibiotics without any other treatment.
Insertion of a catheter this procedure
involves drainage of the abscess under
local anaesthetic (the area is numbed) and
then a catheter (rubber tube) is placed in
the gland and left for a few weeks to allow
complete drainage and healing.
Before your operation
Your doctor will ask you to sign your consent
form to give us permission to perform surgery.
You will not be allowed anything to eat or drink
for 6 hours before surgery. If you are able, we

advise that you have a shower or bath and

make sure all make-up including nail and toe
varnish is removed before you come into
hospital. Please remove as much jewellery as
possible and leave it at home.
After the operation
Nursing staff will monitor you regularly to make
sure you are recovering well from your
operation. You can have something to eat and
drink provided you feel well enough to do so.
You may be given some antibiotics; if given
you should always complete the course. Any
stitches you have will be absorbable, but you
may be advised to see your Practice Nurse in
five days to check the wound and make sure
you are comfortable.
You may have an antiseptic pack in the wound
for a short while; you will be given instructions
by the nurse if appropriate. You will have a
sanitary pad in place. You will need to check
any discharge from the wound and change the
pads frequently.
You may bathe using warm water to cleanse
the wound or shower. Long hot baths should
be avoided as should scented soaps, powder
and perfumes as they can irritate the area and
cause an infection.
Advice on discharge
You should continue with the frequent, warm
baths to cleanse the area at least twice a
day avoiding scented soaps, powder and
perfumes.
If given antibiotics you should complete the
course.

There is little chance of re-occurrence of the

affected side, but if you notice anything,
contact your GP.
A letter will be sent to your doctor giving
details of the operation and aftercare.

WOMEN & CHILDRENS

DIRECTORATE

You can resume normal activities when you

feel comfortable to do so. Do not use tampons
and avoid sexual intercourse until the area has
completely healed and you feel comfortable.
If you have any concerns please telephone the
following:
Day Care Unit, between the hours of 07:30
and 20:00 hours, Monday to Friday:
01322 428266

BARTHOLIN CYST
OR ABSCESS

Telephone your GP, Practice Nurse or NHS

Direct on 0845 4647 or go to
www.nhsdirect.nhs.uk
Telephone or go to the Accident & Emergency
Department at Darent Valley Hospital taking
your blue discharge letter with you. Telephone
number: 01322 428157
Useful contacts
Royal College of Obstetricians and
Gynaecologists on www.rcog.org.uk

Author: Kim Pennington, Matron

Implemented: July 2011
Reviewed: April 2014
Next Review: April 2017

Darent Valley Hospital

Darenth Wood Road
Dartford
Kent Da2 8DA
Tel: 01322 428265
www.dvh.nhs.uk