Bartholin's cyst - Treatment 

  • Overview

Treating a Bartholin's cyst 

If a Bartholin's cyst is small and does not cause any symptoms, it's often better to leave it alone. However, you should still see your GP if you notice a lump.

If the cyst is painful, your GP may recommend:

  • soaking the cyst for 10 to 15 minutes in a few inches of warm water (it's easier in the bath) – it's best to do this several times a day for three or four days if possible
  • holding a warm compress (a flannel or cotton wool warmed with hot water) against the area
  • using painkillers such as paracetamol or ibuprofen

Always read the manufacturer's instructions when using over-the-counter medication.

Treating an abscess

If the cyst becomes infected and an abscess (a painful collection of pus) develops, you may be prescribed antibiotics to clear the infection.

Once the infection has been treated, your GP may still recommend having the cyst drained, particularly if the abscess is large.

Draining cysts and abscesses

There are a number of techniques that can be used to drain a Bartholin's cyst or abscess and reduce the chances of the problem recurring. The main procedures used are described below.

Balloon catheter insertion

Balloon catheter insertion, sometimes known as catheter placement or fistulisation, is a procedure used to drain the fluid from the abscess or cyst and create a permanent passage to drain away any fluid that builds up in the future.

This is performed as an outpatient procedure, which means you won't need to stay in hospital overnight. It is usually carried out under local anaesthetic (where you remain conscious, but the area is numbed so you cannot feel anything), but can be done under general anaesthetic (where you are unconscious and cannot feel anything).

During the procedure, a cut is made in the abscess or cyst and the fluid is drained. A specially designed balloon catheter is inserted into the empty abscess or cyst. A balloon catheter is a thin, plastic tube with a small, inflatable balloon on one end.

The balloon is then filled with a small amount of salt water. This increases the size of the balloon so that it fills the cyst or abscess. If you experience any pain, some of the solution can be removed to reduce the pressure slightly. Stitches may be used to partially close the incision and hold the balloon catheter in place.

The catheter will stay in place while new cells grow around it (epithelialisation). This means the surface of the wound heals, but a drainage passage is left in place. This usually takes around four weeks, although in some cases it may take longer. After epithelialisation, the balloon is drained and the catheter removed during another appointment.

A few small studies have reported that after balloon catheter insertion, more than 80% of women healed well and their cysts or abscesses did not recur.

Possible complications of balloon catheter insertion include:

  • pain while the catheter is in place
  • pain or discomfort during sex
  • swelling of the labia (the lips around the opening of the vagina)
  • infection
  • bleeding
  • scarring

Marsupialisation

If a cyst or abscess keeps coming back, a surgical procedure known as marsupialisation may be used. In marsupialisation, the cyst is first opened with an incision and the fluid is drained out.

The edges of the skin are then stitched in a way that prevents further fluid build-up by allowing it to drain out. This creates a small pouch, similar to a kangaroo's pouch, hence the name marsupialisation.

When the procedure is complete, the treated area may be loosely packed with special gauze to soak up fluid from the wound and stop any bleeding. This will usually be removed before you go home.

Marsupialisation usually takes about 10 to 15 minutes and is normally performed as a day case procedure, so you will not have to stay in hospital overnight. It is most often carried out under general anaesthetic, but it can be done using local anaesthetic instead.

Although complications after marsupialisation are rare, they can include:

  • infection
  • the abscess recurring
  • bleeding
  • pain – you may be given painkillers to ease any pain in the first 24 hours after the procedure

You will normally be advised to take things easy for a few days after marsupialisation. You should avoid having sex until the wound has completely healed, which usually takes about two weeks.

Removing the Bartholin's gland

Surgery to remove the affected Bartholin's gland may be recommended in some cases where other treatments haven't been effective and you have repeated Bartholin's cysts or abscesses.

This operation is usually performed under general anaesthetic and takes about an hour to complete. You may need to stay in hospital for two or three days afterwards.

Risks of this type of surgery include bleeding, bruising and infection of the wound. If the wound does become infected, this can usually be treated with antibiotics prescribed by your GP.

Alternative procedures

These procedures are alternative ways of treating a Bartholin's cyst, but are less commonly used or are not widely available.

Silver nitrate gland ablation

Silver nitrate is a mixture of chemicals sometimes used in medicine to cauterise (burn) blood vessels to stop bleeding. In silver nitrate gland ablation, a small solid stick of silver nitrate, which is 0.5cm wide and 0.5cm long, is used.

An incision is made in the skin of your vulva (your external sexual organs) and the wall of the cyst or abscess. The cyst or abscess is then drained and the stick of silver nitrate is inserted into the cavity (the empty space that is left after draining the fluid).

The silver nitrate causes the cyst cavity to form into a small, solid lump. After two or three days, the piece of silver nitrate and the cyst cavity are removed, or they may fall off on their own.

It is possible for the silver nitrate to burn some of the skin of your vulva when it is first used. One small study reported that this occurs in about one in every five women.

Carbon dioxide laser

A carbon dioxide laser can be used to create an opening in the skin of your vulva so that the cyst can be drained.

The cyst can then be removed, destroyed using the laser, or left in place with a small hole in it to allow fluid to drain from it in the future.

Needle aspiration

During needle aspiration, a needle and syringe are used to drain the cyst.

Sometimes this is combined with a procedure called alcohol sclerotherapy, where the cavity is then filled with a liquid that is 70% alcohol. This is left in the cyst cavity for five minutes and then drained out.

Advice after surgery

To help your wound heal and reduce the risk of infection after surgery, you may be advised to:

  • avoid having sex and using tampons for up to four weeks
  • avoid the use of perfumed bath additives for up to four weeks
  • if you had general anaesthetic, you should not drive or perform tasks that need careful attention for 24 to 48 hours

Page last reviewed: 25/11/2013

Next review due: 25/11/2015

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The 12 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Cinziamarie88 said on 15 November 2013

Hi was seeing if I could get some advise
I found a cyst last week and it became very painfull and big so I ended up having it drained on Monday just gone..and having a bloon catheter in place to help it heal..I only felt relief for a few hours and now I'm in severe pain with it and cannot barely walk/stand literally has me in tears.i noticed yesterday that my labia on the right side have gotten swolen and very tender...is this normal? I have spoke to the doctor and he prescribed me co omoxiclav but I'm very worried as I'm in so much pain...is this normal? Please help

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cherrymare said on 09 November 2013

Hi I've just had a balloon catheter fitted two days ago I had put having anything done to my cyst for 14 years it never bothered me it never got infected but it just caught me out a few times when I sat down a little I heavy! Anyway I would recommend the drain and balloon catheter to anyone it hasn't caused me any pain so far however the I can feel the catheter and it does itch slightly but I can cope with that! So if anybody is worried about option of treatment to take this I found was less painful I had local anaesthetic which has left me with a headache since but that is how I react to it, I bath twice daily just to keep the area clean hope this helps anybody that is indesicive of what treatment to have xx

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sau said on 27 July 2013

I have been having a Bartholin's cyst since 1998, In the same place. In the beginning it was scary but as time has gone on, it has become a rather usual occurrence. I have had it drained a few times, have had marsupialisation e.t.c to avoid it re occurring and as I have experienced, there is no guarantees. Sometimes I have gone to A@E when I have suspected infection and depends on who you meet, you have to wait hours as it is not classified as emergency. After 15 years of suffering I only go to hospital when I am in agony, otherwise I manage it at home and it comes up to a size of a plum. When there is no pain of discomfort, I just soak it in hot bath and normally it bursts itself. When I get pain and discomfort and inflammation I normally see the Gp or walk in centres for broad spectrum Antibiotics. It is not a nice condition to have but I am one of the unlucky 2% of women who suffer from this. On average the re occurrence is every 6 months. Pregnancy and contraception sometimes make it re occur more frequently. I have been advised to have the gland removed completely but if it is the one that produces lubrication during sex then I am not keen. May be when I get to 60 years and still having them I will consider the option. I also have yearly sexual health checks to make sure everything is in order. I have to say that it is been so long and does not depress me any more. Once it comes up it is over and done with in 3 to 6 days depending. Get to know your body and use a mirror to have a good look, you will soon know when you need antibiotics or whether you need to go to hospital or whether you need to stay at home and self treat. From my research once you start having a Bartholin's cyst and you are still sexually active they do re occur. If you are pregnant mention it to the midwife especially in the last trimester, as I had once a difficult birth and retained a placenta and all the plodding led to an infection which I suspect may have resulted from this.

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heatherleigh said on 20 May 2013

Im 22 & about 26 weeks pregnant. I have had this cyst for about a year but it never caused any pain til Feb. Back in Feb it kinda grew over night into the size of a giant grape. Idid the sitz baths then had it drained at the hospital & it was an instant relief. About 2 weeks ago it can back. I tried to go have it drained again this past thursday but when they drained it they said much didn't come out. They gave me antibiotics & sent me home. I followed up w/ my ob the next day being that im pregnant they told me to take the antibiotics and it should go down.. well just the opposite happened. I returned to the hospital today and they measured it as 5cm deep & 3 cm long. I literally can not walk or sit without unbearable pain. At first they were gonna drain it again but the dr from Thursday said they think that would be a bad idea. They called my OB & recommended that they completely remove the cyst. Now im all for it because I can't take the pain any longer. But I was told I need general anesthesia and im extremely nervous being that im pregnant. I just pray everything works out & it actually feels better.

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Painfreeanne said on 09 May 2013

Ladies if you are reading this because you are concerned, please take some action. I noticed a small swelling on Thursday but thought it might be new shower gelreaction, I can be a bit sensitive, did nothing other than bathe. By Friday lunch it was the size of a large grape, tried to see GP but couldn't get an appointment. Spoke with Pharmacist who suggested paracetamol and ibuprofen but encouraged me to see GP. By Saturday lunch I had a fever, the swelling was the size of a golf ball which 'throbbed'. I couldn't sit, walk, stand. I rang 111 who arranged an appointment with urgent care who examined me and arranged my admission to hospital and I had an operation at 11pm that evening. I'm so relieved that the pain has gone, although still sore. I had a bad reaction to the antibiotics but I'm hopeful all will be well. I have never experienced pain like it. I don't have an STI, I've never had a cyst there before. So please don't ignore any signs, go get checked out. It's not pleasant showing your bits but do, it's not worth the pain. I was due a full leg and bikini wax on the Saturday so I'm sure you can imagine my horror but embarrassment is not painful.
Take care

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User762505 said on 07 April 2013

I had a bartholin cyst for 15 years, it didn't disturb me, however it became abscess in very short time like few days last week. It grow to lemon size in few days when abscess occurred. I was not able to sit or walk w/o pain. I had general anesthesia and Silver nitrate gland ablation. procedure took half an hour and once I was awaken from anesthesia I was able to walk out of the hospital by myself in half hour. I used low dose antibiotic and antibacterial and a pain reliever next few days thats all. Third day doctor squeezed out remainder stuff from the gland,not too painful, like squeezing acne. I feel much better than even before abscess. I am glad I got rid of this whole cyst completely. No scars or whatsoever.

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ls2701 said on 18 March 2013

AT the age of 64, I am having my first Bartholin's abcess! It came up quite quickly about a week ago, on a saturday and by the time I saw the doctor on the monday, it was already the size of a large grape. Doctor prescribed strong antibiotics four times a day for 10 days, but to go back if swelling got bigger. It did, so I saw GP again and she sent me directly to the hospital with a view to have it "cut and drained". I was very uncomfortable, so I thought great, going to get this thing sorted out now, but the doctor at the hospital didn't think it necessary to do anything with it and just sent me home again to carry on with the antibiotics. Saturday came around and I woke up around 3.30am to feeling really poorly - flu-like symptoms and a temperature, headache etc. Phone hospital, still didn't want to help me and said to take paracetamol and get some Diclofenac to help with inflammation. Saw an out of hours doctor on saturday morning who gave me the prescription and told me to take warm salt baths 4 or 5 times a day. He said hospital probably wouldn't do anything yet as this is only my first abscess. It is now Monday evening and while my flu symptoms have subsided, I have done the baths all over the weekend and taken the tablets, am still on antibiotics for another 2 days and the abscess is still very much there - no sign of it bursting - which would be a great relief. I will probably have to return to my GP if it doesn't clear up after the antibiotics, but not sure what, if anything can be done at this stage. Just feeling rather down at the fact that this might return - that's when it does actually go, that is. Read on the 'net that older women should have biopsy to rule out cancer, but not been offered this at all, only a swab taken at the hospital. :(

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Mrspitbull said on 23 January 2013

In November 2012 I had a large swelling, not sure what it was went to see my gp on a friday,who was fab, and very concerned. She tried to refer me as an emergency the same day, but as this cyst had caused no pain, I declined. I was however given the emergency number for the local gynie clinic which I was told to call if anything changed over the weekend, which it didn't. Was given a course of antibiotics, which seemed to reduce the swelling after a few days. Returned to gp week later, gp wasn't so concerned , but had another week of antibiotics. Referral was sent , and I was offered an appointment with gynie at the beginning of January- not too keen to be poked about during my period I postponed it. Having been to the clinic I was offered next day surgery, for a marsupilisation, which I should have taken at the start! I have no guarantee that the cysts wont reoccur, but at least i know what they are now, and wont put off seeing the doc.
But just to say, please don't leave a cyst , it can be dealt with quickly and easily! My gp was great, would be good if they were all as understanding as her!

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Ali888 said on 12 July 2012

I have had a few of these things now. The first when I was in my 20's and it ended up about the size of a golf ball. It was agony I could not sit or stand without it hurting. I have them on and off now though touch wood not that often. I am 40 soon so have had them a while. Doctors I see dont seem that bothered, they have clearly never experienced the pain. By the time the antibiotics kick in if they bother to give me any the thing has burst. The hot bath helps it to swell and burst then the pain goes in minutes. Not sure I want any of these procedures by the sound of it.

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User659023 said on 23 March 2012

After 10 days of the worst pain, in the world, 2 GP appointments, and a ton of Medication, I had a Marsupialisation done, Wednesday. Waiting of course for 7 hours, mostly without pain relief, how do I think it went....Dreadful, I feel mutilated by whole experience, no nice round circular wound for me, a massive 4cm cut, with rough ragged stitches that are sore as hell, and feeling totally depressed by the whole thing. Anyone with one of this beast insist on getting to see someone immediately, not just the GP they will fob you off, I should have been see on day 2, but had to go around in agony for 10 days. I am really despressed and unhappy now, I have pain cannot sit down comfortably, feel upset and sick most of the time, and really low. These things are evil, I hope to god I never get another one. I must add in Hospital I was made to feel 100 times worse by being told I was last on the list because my condition was classed as Dirty....Just what I wanted to hear. Thank you thoughtless Nurse. I felt bad enough already, now just feel totally upset by the whole thing.

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dh25 said on 16 February 2012

This problem is very annoying. I discovered a cyst abt 2 years ago and went to the ER and was told to take sitz baths which worked...but it came right back. Sitz baths no longer worked after the 2nd reoccurence. Then they did a needle aspiration and it got infected. then they cut it open, drained it and packed with gauze. I remained cyst free for abt 3 months but it came back. I recently got the balloon catheter insertion done. Its very uncomfortable and painful and so is the procedure. I truly don't wish this on anyone. And I pray that this is the last time I have to go through this and that goes for anyone else who's had this problem. I had no idea what I'd go through when I discovered this cyst 2 years ago. I am trying my best to stay positive :-(

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Eurydice said on 21 January 2011

Reoccurences occur even after marsupialisation.

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