II. Epidemiology

  1. Bartholin's Gland Duct Cysts and abscess Incidence: 2%
  2. Most common in adult women under age 30 years

III. Pathophysiology

  1. Bartholin's Gland
    1. Vaginal vestibular glands provide moisture
    2. Located at bilateral inferior labia minora
    3. Drain via ducts at 4:00 and 8:00 positions of labia
    4. Normal Bartholin's gland size <1 cm
  2. Bartholin's Gland Duct Cyst
    1. Results from distal duct obstruction
  3. Bartholin's Gland Abscess (more common than cysts)
    1. May occur spontaneously or as infection of duct cyst

IV. Causes: Bacterial

V. Symptoms

  1. Vulvar Pain worse with walking and intercourse

VI. Signs

  1. Firm swelling at posterior vaginal introitus
    1. Occurs at 5:00 and 7:00 positions (where Bartholin Gland ducts exit)
    2. Posterior labia minora affected

VII. Labs

  1. Consider screening for Sexually Transmitted Disease (see causes above)

VIII. Differential Diagnosis

  1. Epidermal Inclusion Cyst (at labia majora)
  2. Skene's Duct cyst (at Urethral meatus)
  3. Other benign growth (mucous cyst, fibroma, Lipoma)
  4. Squamous Cell Carcinoma (esp. postmenopausal woman)

IX. Management: Word Catheter Placement for cyst or abscess

  1. Betadine prep overlying abscess wall at labia
  2. Administer Local Anesthesia with Lidocaine 1%
  3. Make 5 mm stab incision over abscess with #11 blade
    1. Incision should be oriented vertically
    2. Incision should lie outside hymenal ring
  4. Insert Word Catheter into incision
    1. Inflate Word Catheter balloon with 2-3 c saline
  5. Word Catheter remains in place for 4-6 weeks minimum
    1. Up to 3 months are required in some cases for adequate recanalization

X. Management: Other measures

  1. Marsupialization of Bartholin's Gland Cysts
    1. Only use for cysts (contraindicated for abscess)
    2. Cyst wall excised
  2. Excision of of Bartholin's Gland Abscess
    1. Indicated if refractory to other measures
    2. Procedure timed when no infection present
    3. Refer to Gynecology or Surgery for procedure

XI. References

  1. Apgar in Pfenninger (1994) Procedures p. 596-600
  2. Omole (2003) Am Fam Physician 68(1):135-40 [PubMed]

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Ontology: Abscess of Bartholin's gland (C0004766)

Concepts Pathologic Function (T046)
ICD9 616.3
ICD10 N75.1
SnomedCT 67624004, 155983009
Italian Ascesso della ghiandola di Bartolini, Ascesso della ghiandola del Bartolini
Dutch abces van klieren van Bartholin, abces; glandula Bartholini, abces; vulvovaginale klier, vulvovaginale klier; abces, Abces van glandula Bartholini, abces van Bartholin, gl.Bartholini; abces
French Abcès de Bartholin, Abcès de glande de Bartholin, Abcès de la glande de Bartholin
German Abszess der Bartholin-Druese, Abszess Bartholin, Bartholin-Abszess, Abszess der Bartholin' Druese
Portuguese Abcesso das glândulas de Bartholin, Abcesso da glândula de Bartholin, Abcesso de Bartholin
Spanish Bartolinitis, absceso de la glándula de Bartolino (trastorno), absceso de la glándula de Bartolino, absceso de la glándula vestibular mayor, absceso de la glándula vulvovaginal, Absceso de la glándula de Bartholin
Japanese バルトリン腺膿瘍, バルトリンセンノウヨウ
English abscess of Bartholin's gland, Bartholin's gland abscess, abscess of Bartholin's gland (diagnosis), abscess of Bartholin's gland (physical finding), Abscess Bartholin's, Bartholin's glnd abscess, Abscess of Bartholin gland, bartholin's gland abscess, Abscess;Bartholin, abscess bartholins, bartholin's abscess, abscess bartholin gland, bartholin abscess, bartholin gland abscess, abscess bartholin, Abscess of Bartholin's gland, Vulvovaginal gland abscess, Bartholin's abscess, Abscess of Bartholin's gland (disorder), abscess; bartholin's gland, abscess; vulvovaginal gland, vulvovaginal gland; abscess, gl.Bartholin; abscess, Bartholins abscess
Czech Absces Bartholiniho žlázy
Korean 바르톨린샘의 고름집(농양)
Hungarian Bartholin mirigy tályog, Bartholin-tályog

Ontology: Cyst of Bartholin's gland duct (C0004767)

Concepts Disease or Syndrome (T047)
ICD9 616.2
ICD10 N75.0
SnomedCT 57044006, 155982004, 27978000
LNC LP175662-8, MTHU047584
Italian Cisti della ghiandola di Bartolini, Cisti della ghiandola del Bartolini
Dutch Bartholincyste, Bartholin; cyste, cyste; Bartholin, cyste; glandula Bartholini, Cyste van glandula Bartholini, Bartholinische cyste, gl.Bartholini; cyste
French Kyste de glande de Bartholin, Kyste des glandes de Bartholin
German Zyste der Bartholin-Druese, Bartholin-Zyste
Portuguese Quisto da glândula de Bartholin, Quisto de Bartholin
Spanish Quiste de la glándula de Bartholin, quiste de la glándula de Bartolino (concepto no activo), quiste de la glándula de Bartolino, quiste de la glándula vestibular mayor, quiste del conducto de la glándula de Bartolino (trastorno), quiste del conducto de la glándula de Bartolino, quiste del conducto de la glándula vestibular mayor, Quiste de Bartolino
Japanese バルトリン嚢腫, バルトリン腺嚢腫, バルトリンセンノウシュ, バルトリンノウシュ
English Cyst of Bartholin's duct, Bartholin gland cyst, Bartholin duct cyst, Bartholin duct cyst (diagnosis), Bartholin gland cyst (diagnosis), Bartholin Cyst, Bartholin's Cyst, Cyst of Bartholin gland duct, bartholin cyst gland, Cyst;Bartholin, bartholin cyst/abscess, bartholin cysts, bartholin gland cyst, abscesses bartholin cyst, bartholin's cyst, abscess bartholin cyst, bartholin cyst, bartholin cysts gland, bartholin's duct cyst, bartholins cyst gland, bartholins's cysts gland, bartholin's cysts, bartholin's cysts gland, bartholin's gland cyst, Cyst of Bartholin's gland (disorder), Bartholin cyst, Cyst of Bartholin's gland, Bartholin's gland cyst, Bartholin's cyst, Bartholin's gland duct cyst, Cyst of Bartholin's gland duct, Cyst of Bartholin's gland duct (disorder), cyst; Bartholin, cyst; bartholin's gland, Bartholin; cyst, gl.Bartholin; cyst, Bartholin's duct cyst, bartholins cyst
Czech Cysta bartholinské žlázy, Bartholinská cysta
Korean 바르톨린샘의 낭포
Hungarian Bartholin-cysta, Bartholin-mirigy cysta

Ontology: Bartholin Glands (C0004768)

Definition (NCI) The two mucous secreting glands on either side of the vaginal opening.
Definition (MSH) Mucus-secreting glands situated on the posterior and lateral aspect of the vestibule of the vagina.
Concepts Body Part, Organ, or Organ Component (T023)
MSH D001472
SnomedCT 87176006, 181443008
English Bartholin Glands, Bartholin's Glands, Bartholins Glands, Glands, Bartholin's, Bartholin gland, Tiedemann's gland, Duverney's gland, Glandula vestibularis major, Vulvovaginal gland, Bartholin's Gland, Bartholin Gland, Bartholin gland structure, bartholin's gland, greater vestibular gland, bartholin glands, bartholins glands, bartholin gland, glands major vestibular, bartholin's glands, bartholins gland, Bartholins gland, [SO]Bartholin gland, Major vestibular gland, Bartholin's gland, Greater vestibular gland, Bartholin's gland structure (body structure), Bartholin's gland structure
French Glandes de Duverney, Glandes de Tiedmann, Glandes de Bartholin, Glandes vestibulaires majeures, Glandes vulvo-vaginales, Glandes vulvovaginales
Swedish Bartholins körtlar
Czech Bartholiniho žlázy
Finnish Bartholinin rauhaset
Latvian Bartolīndziedzeri, Bartolīna dziedzeri
Polish Gruczoł przedsionkowy większy, Gruczoł Bartholina
Norwegian Glandulae vestibularis majores, Bartholinske kjertler, Bartholins kjertler
Spanish Glándula Vestibular Mayor, Glándula de Bartolino, Glándulas de Bartolino, Glandula Vestibularis Major, Glándula de Bartholin, Glándulas de Bartholin, estructura de la glándula de Bartolino (estructura corporal), estructura de la glándula de Bartolino, glándula de Bartolino, glándula vestibular mayor, Glándulas Vestibulares Mayores
Portuguese Glândula de Bartholin, Glandula Vestibularis Major, Glândula Vestibular Maior, Glândulas de Bartholin, Glândulas Vestibulares Maiores
German Glandulae vestibulares majores, Bartholin-Drüsen
Italian Ghiandole del Bartolini
Dutch Bartholini, klieren van, Glandulae vestibulares majores, Klieren van Bartholini