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# Bartholin gland cyst and abscess

A Bartholin cyst is a swelling at the back of the vaginal opening from a blocked Bartholin gland duct; if it becomes infected it forms a painful abscess.

Updated 2026-10-29

## Structures involved

Tap one to see what it is and open it in 3D.

- [Bartholin glands](https://durgical.com/en/anatomy/greater-vestibular-gland/)
- [Labia minora](https://durgical.com/en/anatomy/labium-minus-of-vulva/)
- [Labia majora](https://durgical.com/en/anatomy/labium-majus-of-vulva/)
- [Vagina](https://durgical.com/en/anatomy/vagina/)

## Why it happens

- [Outcomes of acute inflammation: resolution, abscess, scar or chronic inflammation](https://durgical.com/en/general-pathology/outcomes-of-acute-inflammation-resolution-abscess-scar-or-chronic-inflammation/)
- [Glands: exocrine vs endocrine, secretion types](https://durgical.com/en/histology/glands-exocrine-vs-endocrine-secretion-types/)

## What it is

A fluid-filled swelling of a Bartholin gland, at the back of the vulvar vestibule, caused by blockage of its duct. When the fluid becomes infected it forms a painful abscess.

## Who gets it

Most often seen in women of reproductive age; uncommon before puberty and after menopause. Abscesses are seen more often than simple cysts in emergency and gynaecology services.

## Causes

- Blockage of the Bartholin duct by mucus, scarring, trauma or swelling
- Infection of the retained fluid, usually polymicrobial (skin, vaginal and bowel organisms such as Escherichia coli and anaerobes)
- Less often sexually transmitted organisms such as Neisseria gonorrhoeae or Chlamydia trachomatis

## Risk factors

- Reproductive age
- Previous Bartholin cyst or abscess
- Local trauma or vulvar surgery
- Sexually transmitted infection
- Diabetes or immunosuppression (abscess)

## Pathophysiology

The paired [Bartholin glands](https://durgical.com/en/anatomy/greater-vestibular-gland/) lie at about the 4 and 8 o'clock positions of the vestibule and secrete mucus through short ducts that open just outside the hymen. When a duct is obstructed, secretions build up and dilate it into a cyst. Bacteria entering the cyst or the gland produce an abscess with surrounding cellulitis.

## Classification

- Bartholin duct cyst: usually painless, may be found by chance
- Bartholin gland abscess: acute, painful and inflamed
- Recurrent cyst or abscess

## Symptoms and signs

- Soft, round swelling on one side of the lower vulva, at the entrance of the [vagina](https://durgical.com/en/anatomy/vagina/)
- Small cysts often cause no symptoms
- Discomfort when walking, sitting or during intercourse with larger cysts
- Abscess: rapidly growing, very painful, red, hot and tender lump
- Fever is uncommon; the abscess may drain on its own

## Red flags

- Hard, fixed or irregular mass, especially in a woman over about 40 or after menopause (exclude carcinoma)
- Spreading cellulitis, fever or signs of sepsis
- Signs of necrotizing infection: pain out of proportion, skin discolouration, crepitus
- Recurrence despite treatment

## Diagnosis

**Clinical**
Usually a clinical diagnosis on pelvic examination: a unilateral swelling in the lower lateral vestibule, fluctuant and tender if abscessed.

**Tests**
Culture of pus when there is an abscess; tests for gonorrhoea and chlamydia when there is risk. Biopsy of the gland in older or postmenopausal women or when the mass is solid (age thresholds vary between texts).

**Imaging**
Rarely needed; ultrasound or MRI if the diagnosis is unclear or a deeper mass is suspected.

## Differential diagnosis

- Skene duct cyst
- Epidermal inclusion cyst or sebaceous cyst
- Gartner duct cyst
- Hidradenitis suppurativa or folliculitis
- Lipoma or fibroma
- Vulvar or Bartholin gland carcinoma

## Goal of treatment

Relieve pain, drain infection and create lasting drainage of the gland to prevent recurrence, while excluding cancer in women at risk.

## Treatment

**Conservative**
Small, painless cysts can be observed; warm sitz baths and simple analgesia can help a cyst or early abscess drain on its own.

**Procedure**
Incision and drainage of an abscess with placement of a small balloon catheter (Word catheter) for several weeks so a new duct opening forms; simple incision alone tends to recur.

**Surgical**
Marsupialization (suturing the cyst wall open to the [skin](https://durgical.com/en/anatomy/skin/)) for recurrent cysts or abscesses; excision of the gland is kept for repeated recurrence or suspicion of cancer.

**Medical**
Antibiotics are added when there is surrounding cellulitis, systemic signs, immunosuppression or a confirmed sexually transmitted infection.

## Complications

- Recurrence
- Spreading cellulitis
- Bleeding or haematoma after surgery
- Scarring and dyspareunia
- Rarely necrotizing fasciitis
- Missed Bartholin gland carcinoma (rare)

## Prognosis

Excellent. Most cysts and abscesses resolve with drainage; recurrence is reduced by catheter drainage or marsupialization compared with simple incision.

## Prevention

- Condom use and treatment of sexually transmitted infections
- Early care of small cysts before they become infected

## Test yourself

Think of the answer, then tap the question to see it.

## Where are the Bartholin glands located?

In the posterolateral vulvar vestibule, at about the 4 and 8 o'clock positions, with ducts opening just outside the hymen.

## Why is a Word catheter placed after draining a Bartholin abscess?

To keep the incision open for several weeks so a new duct opening epithelializes, lowering the recurrence seen with simple incision.

## Which organisms usually cause a Bartholin abscess?

A polymicrobial mix of skin, vaginal and bowel flora such as Escherichia coli and anaerobes; sexually transmitted organisms are less common.

## When should a Bartholin gland mass be biopsied?

When it is solid, fixed or irregular, or in older and postmenopausal women, to exclude carcinoma (age cut-offs vary).

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/conditions/bartholin-gland-cyst-and-abscess/)

## Related conditions

- [Gonorrhoea](https://durgical.com/en/conditions/gonorrhoea/)
- [Chlamydia infection](https://durgical.com/en/conditions/chlamydia-infection/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Bartholin Gland Cyst](https://www.ncbi.nlm.nih.gov/books/NBK532271/) (StatPearls (NCBI Bookshelf), 2025).

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/bartholin-gland-cyst-and-abscess/