A Bartholin’s cyst may be identified by your doctor by:
- Taking your medical history
- Carrying out a pelvic exam
- Gathering a sample of your vaginal or cervix secretions to be tested for a sexually transmitted infection.
- If you are postmenopausal or older than 40, a test of the mass (biopsy) to look for cancerous cells is advised.
Your doctor might recommend a gynecologist who focuses in cancers of the female reproductive system if cancer is a concern for you.
A Bartholin’s cyst frequently does not need to be treated if it is asymptomatic. If treatment is required, it will depend on the size of the cyst, how uncomfortable it is for you, and whether the cyst is infected, which could lead to an abscess.
Your doctor might suggest the following therapies:
- Sitz baths. A small, infected cyst may burst and drain on its own after a few days of many times-daily sitz baths in a tub filled with a few inches of warm water.
- Surgical drainage. A big or diseased cyst may require surgery by a doctor to drain, which will be done under sedation or local anesthetic by making a tiny incision in the cyst, letting it drain, and inserting a tiny rubber tube (catheter) into the incision. To keep the incision open and allow for full drainage, the catheter is left in place for up to six weeks.
- Antibiotics. Your doctor will prescribe an antibiotic if your cyst is infected or if testing reveals that you have a sexually transmitted infection. But if the abscess is drained properly, you may not need antibiotics.
- Marsupialization. A marsupialization operation may be helpful if cysts reoccur or disturb you. A permanent aperture less than 1/4-inch (approximately 6-millimeters) long is made by your doctor stitching on either side of a drainage incision. For a few days following the treatment, a catheter may be implanted to encourage drainage and avoid recurrence.
Rarely, your doctor may advise surgery to remove the Bartholin’s gland if the chronic cysts are unresponsive to other treatments, which is done in a hospital under general anesthesia as surgery carries a higher risk of bleeding or post-operative problems.