Treatment of Bartholin Cyst in the Vagina

Understanding Bartholin Cysts

• Bartholin glands are located in the posterior vestibule at the 4 and 8 o'clock positions of the vaginal opening, and when infected, they present with swelling, erythema, and tenderness that can extend into the labia minora, and can be infected by various pathogens, including sexually transmitted infections such as gonorrhea and chlamydia 1

Diagnostic Approach

• Diagnosis is primarily clinical, based on physical examination showing a tender, fluctuant mass at the vaginal introitus 2
• Assessment should include evaluation for signs of cellulitis, systemic infection, or extensive inflammation 3

Antibiotic Therapy

• Antibiotics should be prescribed when there are signs of cellulitis or systemic infection, and for infections in the perineal area, appropriate antibiotic options include Metronidazole, Ciprofloxacin, Levofloxacin, or Ceftriaxone 3
• The American Academy of Pediatrics and the Infectious Diseases Society of America recommend antibiotic therapy when there are signs of cellulitis or systemic infection 4

Referral for Undetermined Bartholin Gland Lesions

Referral Indications

• Patients presenting with Bartholin gland lesions of undetermined etiology should be referred to a gynecologist for further evaluation (Pediatrics 2010) 5