Vaginal Cyst

Types of vaginal cysts

Bartholin cyst and abscess

The two Bartholin glands sit at the vaginal opening and make fluid that lubricates the vulva. If a duct becomes blocked, fluid builds up and forms a cyst, usually 1 to 3 cm, on one side. Bartholin cysts are most common in women aged 20 to 30.

If the fluid becomes infected, an abscess forms: a tender, hot, swollen lump that can make walking and sitting very painful, sometimes with fever. Infection is usually from common skin or bowel bacteria, and occasionally from sexually transmitted infections.

Symptoms

• a soft, painless lump in the vagina or at the opening
• pain or discomfort during sex or tampon insertion
• discomfort when walking or sitting with larger cysts
• pain, redness, warmth and swelling if infected

Many vaginal cysts cause no symptoms and are only found during a pelvic exam.

Conditions that can look like a cyst

• cystocele (bladder prolapse) or rectocele, which bulge from the front or back wall and are worse when straining
• urethral diverticulum, a pouch from the urethra, which can cause dribbling and pain
• skin conditions such as folliculitis or hidradenitis suppurativa
• genital warts
• rarely, vaginal or vulvar cancer, more likely with a firm, irregular or growing lump in older women

Diagnosis

• pelvic examination of the lump's size, location and tenderness
• swab of discharge or pus for infection, including STI testing if appropriate
• biopsy of a Bartholin gland lump in women over 40, or of any unusual lump, to rule out cancer
• ultrasound or MRI for deep cysts or to check for connections with the urinary tract

Treatment

No treatment

Small, painless cysts often need only monitoring.

Home care

• sitz baths: sitting in a few inches of warm water for 10 to 15 minutes, several times a day for 3 to 4 days, can help a Bartholin cyst drain
• over-the-counter pain relievers, following the label dose
• wear loose underwear

Do not try to squeeze or pop a cyst.

Medical procedures

• incision and drainage of an abscess, often with a small balloon-tipped tube (Word catheter) left in place for several weeks so a new duct opening can form
• marsupialization: a small permanent opening is created by stitching the cyst edges, for recurrent Bartholin cysts
• antibiotics if there is surrounding cellulitis, an STI or a high risk of complications
• surgical removal of the cyst or gland for repeated recurrence or suspicious lumps
• excision of symptomatic vaginal wall cysts

Outlook

Most vaginal cysts are benign and cause no long-term problems. Bartholin cysts and abscesses can recur, but procedures such as marsupialization reduce recurrence.

Frequently asked questions

What is a vaginal cyst?

A vaginal cyst is a closed pocket of fluid or other material on or under the vaginal lining or near the vaginal opening. Most are small, painless and harmless. Common types include Bartholin gland cysts, inclusion cysts and Gartner duct cysts.

What causes a Bartholin cyst?

A Bartholin cyst forms when the duct of one of the Bartholin glands, which lubricate the vaginal opening, becomes blocked and fluid builds up. If the fluid becomes infected, it can turn into a painful abscess.

Will a vaginal cyst go away on its own?

Many small cysts stay the same size and cause no problems, and some Bartholin cysts drain on their own, especially with warm sitz baths. Cysts that grow, become infected or cause discomfort may need a procedure.

Is a lump in the vagina cancer?

Most lumps in the vagina are benign cysts. However, a firm, irregular or growing lump, especially after 40 to 50, or one with bleeding or sores, should be checked by a doctor, who may take a biopsy to rule out cancer.

How is a Bartholin abscess treated?

A Bartholin abscess is usually drained through a small cut, often with a Word catheter left in place for a few weeks so a new opening can form. Antibiotics may be added. Repeated abscesses may be treated with marsupialization or removal of the gland.