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Highlights & Basics
- A Bartholin duct cyst is a noninfectious occlusion of the distal Bartholin duct with resultant retention of secretions. They are thought to be relatively common, although the exact incidence and prevalence remains unknown.
- Diagnosis is made on clinical exam. The classic appearance is a medially protruding cystic structure at the inferior aspect of the labia majora, in the 5 or 7 o'clock position, crossed by the labium minus.
- Bartholin cysts are most commonly seen in women of reproductive age. In postmenopausal women with a vulval mass, malignancy should be considered.
- A Bartholin gland abscess may result from polymicrobial infection of the cyst fluid or, less commonly, from primary infection of the gland or duct.
- Treatment of a cyst can be conservative or surgical and depends on size, symptoms, presence of infection, and whether the cyst is recurrent.
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Bartholin cyst
Bartholin abscess: erythema, edema, with cyst abscess posterior to labia minora
Squamous cell cancer
Bartholin duct cyst at posterior labia minora, which crosses central portion of cyst with half of the enlargement medial and the other half lateral to this line
Vulval lipoma
Marsupialization of a Bartholin cyst. The site is cleaned and anesthetized, and then a 1.5 to 2 cm incision is made just distal to the hymen ring within the introitus into the region of the normal duct opening. The cyst/abscess cavity is irrigated and loculations are broken down if necessary. The incised cyst/abscess wall is then approximated to the edge of the vestibular skin.
Insertion of a Word catheter to treat a Bartholin's cyst. The site is cleaned and anesthetized, and then a small stab incision (3 to 4 mm) is made into the cyst/abscess cavity (parallel to the hymen ring). The Word catheter is introduced into the cyst/abscess cavity after the contents have drained. The balloon is filled with sterile saline and a suture is tied around the catheter to prevent leaking or deflation. The catheter end is then tucked into the vagina.
Citations
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Omole F, Kelsey RC, Phillips K, et al. Bartholin duct cyst and gland abscess: office management. Am Fam Physician. 2019 Jun 15;99(12):760-6.[Abstract][Full Text]
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