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Treatments and drugs
By Mayo Clinic staffOften, a Bartholin cyst requires no treatment — especially if the cyst causes no signs or symptoms (asymptomatic). When required, treatment of a Bartholin cyst depends on the size of the cyst, the amount of discomfort it causes and whether it's infected, resulting in an abscess. Here are some of the treatment options your doctor may recommend:
- Sitz baths. Sometimes, soaking in a tub filled with a few inches of warm water (sitz bath) several times a day for three or four days helps a small, infected cyst to rupture and drain on its own.
- Surgical drainage. A cyst that's infected or very large generally requires drainage by a doctor. Drainage of a cyst can be done in your doctor's office under local anesthesia, but in some cases, you and your doctor may opt for general sedation, if that makes you more comfortable. To do the drainage procedure, your doctor makes a small incision in the cyst to allow it to drain. Then he or she places a small rubber tube (catheter) in the incision. The catheter stays in place for up to six weeks to keep the opening from closing and to allow complete drainage. After that, the catheter may fall out on its own or be removed and the incision heals completely.
- Antibiotics. If the cyst is infected, or if testing reveals a sexually transmitted disease, your doctor may prescribe antibiotics to ensure that the bacteria causing the infection are destroyed. But if the abscess is drained properly, you may not need antibiotics.
- Marsupialization. If cysts recur or are bothersome to you, your doctor may perform a procedure called marsupialization. This method is usually effective in preventing recurrences. It's similar to the surgical drainage procedure, only your doctor places stitches on each side of the incision to create a permanent opening, less than 1/4 inch (about 5 millimeters) long. Your doctor may insert a catheter to promote draining for a few days to prevent recurrence. This procedure can be done in your doctor's office but, depending on the complexity of the cyst, is often done in an operating room in the hospital under general anesthesia. Since marsupialization isn't recommended when an active infection is present, your doctor will likely want to drain the abscess first and get rid of the infection, then perform the marsupialization.
If you have persistent recurrences and none of these procedures is successful, your doctor may recommend removal of the Bartholin's gland, but this is rarely necessary. Surgical removal is usually done in a hospital during general anesthesia.
Some doctors are using laser therapy to treat Bartholin cysts, but this type of treatment isn't widely available and is more expensive than other surgical treatments.
- Wechter ME, et al. Management of Bartholin duct cysts and abscesses. Obstetrical and Gynecological Survey. 2009;64:395.
- Chen KT. Disorders of Bartholin's gland. http://www.uptodate.com/home/index.html. Accessed Dec. 7, 2009.
- Patil S, et al. Bartholin's cysts and abscesses. Journal of Obstetrics and Gynaecology. 2007;27:241.
- Pundir J, et al. A review of the management of diseases of the Bartholin's gland. Journal of Obstetrics and Gynaecology. 2008;28:161.
- Gala RB. Benign disorders of the lower reproductive tract. In: Schorge JO, et al. Williams Gynecology. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aid=3150841. Accessed Dec. 7, 2009.
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