The various tissues and organs that make up the female genitalia act together to form a complex physiological structure. Since the genital area in women is open to the outside, it is a favorable area for various disorders, primarily infection. If left untreated, these conditions can lead to serious diseases and symptoms. Therefore, infections and cysts in the vaginal area should be taken into consideration and timely intervention should be made. One of the disorders seen in the vaginal part after puberty is the bartholin cyst.
There are bartholin glands, one on each side of the vagina. This gland is activated during puberty when sexual development occurs and causes the formation of secretion. The fluid secreted from the Bartholin glands provides wetness and lubrication to the vaginal area. Thus, it ensures that sexual intercourse and penetration are simple. Bartholin glands activated by sexual stimulation are normally not noticeable. When the glands cannot secrete the secretion it produces as a result of stimulation into the vagina, it causes this cyst to form. This cyst is formed as a result of secretion accumulation in the glands. Cysts, which are generally seen in one area, can sometimes be seen in two parts. When this cyst is not treated and becomes infected, bartholin abscess occurs.
What are the Symptoms of Bartholin Cyst?
Since Bartholin cysts are formed as a result of the accumulation of secretion in the gland, the symptoms differ according to the rate of accumulation and whether infection occurs. Newly formed small cysts the size of a chickpea are usually asymptomatic and unrecognized. Over time, as the accumulation continues, they increase in size and become noticeable. In addition to the disease caused by the swelling felt in the vagina, one of the most common symptoms is pain. This leads to dyspareunia and painful sexual intercourse. In addition, when a bartholin cyst occurs, the accumulated secretion cannot be released from the vagina, causing vaginal dryness and may adversely affect the sexual life of the individual. Symptoms are also exacerbated when the cyst becomes infected and a bartholin abscess occurs. Along with swelling, redness and pain, fever, fatigue, sensitivity of the vagina, intense pain during sexual intercourse, problems in walking and moving.
Why does a Bartholin Cyst Occur?
The main cause of Bartholin cyst formation is the accumulation of secretion in the gland after a blockage in the secreted duct. This blockage, which prevents the secretion from being released into the vagina, can occur for various reasons. The causes of cyst formation after obstruction in the secretory duct are as follows;
Trauma After the part at the entrance of the vagina receives a physical blow or as a result of irritation of that part with various chemicals, obstruction occurs in the channels. Friction during sexual intercourse can also cause this wear. During the healing time after the trauma, the surrounding tissues cause the canal to become blocked.
Surgical operation Although there is a small chance, blockage of the secreted part can occur after surgical operations.
Infection: Viral or bacterial infections can cause edema and inflammation in the structures, leading to obstruction. One of the most common infectious bacteria in the area is Escherichia Coli, which is transmitted through the anus.
Microorganisms Microorganisms that cause sexually transmitted diseases, Chlamydia Trachomatis, Neisseria Gonorrhoeae, commonly known as gonorrhea, are among the causes of bartholin abscess.
Abnormal growth As a result of abnormal growth in the vulva and vagina after puberty due to hormonal problems and irregular menstruation, tissues can shrink the canal and cause obstruction.
How is a Bartholin's Cyst Diagnosed?
Forthe diagnosis of Bartholin's cyst , the specialist takes a comprehensive anamnesis from the patient and then checks the pelvic area by performing a physical examination. Even if the diagnosis is largely made after the physical check, various tests are performed to obtain information about the cause. Along with blood tests, fluid is taken from the vagina and a culture test is performed to check for the presence of bacteria that cause sexually transmitted diseases. If the patient is over the age of 40, cancer screening tests are performed, taking into account the danger of cancer, and a biopsy is performed if necessary. After all tests are examined, the bartholin cyst and its cause are diagnosed and appropriate treatment is started.
How is a Bartholin Cyst Treated?
Various treatment methods are performed according to the size of the Bartholin cyst, the complaints and infection status. In general, cysts of very small size do not even require treatment because they do not cause complaints. In such cases, measures can be taken to prevent the growth of the cyst with treatment methods performed at home. When the cyst grows, drug treatment is applied as it will start to cause complaints. Surgical intervention may be required when the size of the cyst reaches a significant size or infection occurs. Treatment methods applied in Bartholin cyst formation are as follows;
Home treatment: When this cyst starts to form, first of all, sitting baths are performed at home to prevent the cyst from growing. With home treatment, the fluid accumulated in the cyst can be drained before it grows. The sitz bath, which is done with warm water several times a day, continues for 1 week.
Drug treatment: When a Bartholin's cyst is treated with medication, anti-inflammatory drugs are administered to reduce pain. If there is an infection in the cyst, broad-spectrum antibiotic treatment is given.
Drainage application: This procedure is often used in medicine. This allows the fluid to drain out. Surgical drainage is performed under general anesthesia or local anesthesia. After the fluid is drained, silver nitrate or word catheter procedure is performed to prevent the cyst from reoccurring.
Marsupialization: In this procedure, after the obstruction in the secretory duct is opened, the wall of the gland is sutured towards the outer part and the mouth is opened, thus preventing re-obstruction. Since the stitches are self-dissolving, no further treatment is required.
Surgical operation Removal of the Bartholin gland is the last method. Because when the gland is removed, vaginal dryness occurs and the sexual life of the individual is badly affected and dyspareunia may occur during sexual intercourse. When the Bartholin's cyst is incurable or recurs too often, it may be necessary to remove the cyst surgically.