Health Questions and Answers

Question: How is a Bartholin’s cyst treated?

Answer:

Not all require treatment. They are usually only treated if they are symptomatic. There are three levels of treatment: incision and drainage, marsupialization, and excision. Most Bartholin’s duct cysts respond to incision and drainage. The incision is made medially toward the vagina and hymenal ring. After making a 5-mm stab incision, a Ward catheter is placed to keep the cyst wall open and allow for continued drainage. The optimal goal is for the catheter to stay in place for weeks to allow epithelialization of the opening. However, the catheter frequently falls out prior to removal. 

For women with recurrent Bartholin’s duct cysts, the cyst or duct wall can be opened widely and the edges sutured back to leave an open structure. This procedure is called marsupialization. 

If problems with the duct cyst persist despite marsupialization, the gland and dilated duct can be excised in toto. This involves significant dissection and requires regional or general anesthesia. 

Reference:

  1. Stenchever MA, Droegemueller W, Herbst AL, Mishell DR (eds): Comprehensive Gynecology, 4th ed. St. Louis, Mosby, 2001.
  2. Lee YH, Rankin JS, Alpert S, et al. Microbiological investigation of Bartholin’s gland abscesses and cysts. Am J Obstet Gynecol 129:150-153, 1977. Medline Similar articles 

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