What Is Bartholin's Gland?

Bartholin's gland is a gland located near the vaginal opening. This anatomical structure is named for the physician who first noted it in the 17th century. There are usually two of these glands, located around the lower area of the opening. Bartholin's glands secrete lubricating fluids and rarely cause medical problems for patients. Many women are unaware of the presence of these glands, in fact, and the bulk of vaginal lubrication comes from secretions higher up in the vagina.

In healthy patients, these glands, located just inside the labia, are usually difficult to identify. They are too small to palpate and their openings are also very small, making them difficult to spot during a basic physical examination. When women are aroused, a few drops of fluid may emerge from the opening of the gland, but under regular circumstances, the glands do not secrete any lubricating mucus.

One health problem known to occur with the Bartholin's gland is a cyst or abscess. If the opening becomes blocked, mucus can build up inside the gland, forming a swelling that can become as large as a grapefruit, in addition to being very painful. The cyst is usually not caused by an infection, but it can be, and if a patient has repeated cysts, a doctor may recommend taking a culture to check for bacteria or other microorganisms that might be contributing to cyst reformation. More rarely, cells inside the gland can become cancerous and develop into a tumor.

Treatment for a Bartholin's gland abscess can include implanting a temporary drain to allow the mucus to drain completely while the opening clears. The cyst can also be surgically drained with an incision and manual expression of the mucus. Women who have recurrent cysts may discuss other treatment options with their gynecologists. Because the gland is not the sole source of lubrication, it can potentially be removed to prevent future cysts without jeopardizing a woman's health or comfort.

Women who notice pain and swelling around the opening of the vagina may have an inflammation of a Bartholin's gland. It is advisable to consult a gynecologist for diagnosis and treatment. The gynecologist can confirm the cause of the swelling and eliminate sexually transmitted infections and other potential causes of the symptoms in order to provide appropriate treatment. If an infection of a Bartholin's gland is suspected, antibiotics may be given to address it, and patients may also be offered anti-inflammatory drugs to reduce the swelling and increase comfort.

Bartholin's cysts often resolve without treatment. If yours is not causing discomfort, you can monitor it and wait for it to go away. If you want to try to drain it, you can soak it in a bathtub filled with a few inches of warm water several times a day for three to four days. You can also try holding a warm compress against the area. This may help the cyst burst and drain on its own. If your cyst is infected or very large, you may need to see a doctor for treatment.

The Bartholin gland plays a small role in lubricating the vagina for sexual intercourse. Research on the sexual function of women who had their Bartholin gland removed did find that the women who had the procedure reported reduced sexual function. However, the study found that women who had the gland removed had less reduction in function than women who had marsupialization procedures instead and that removal of the gland did not impede sexual function. Risks of the surgical procedure include bruising, bleeding and infection.

Marsupialization is a surgical technique used to treat recurrent Bartholin cysts. Your doctor may suggest this treatment if your cysts keep coming back, your cyst interferes with walking, sitting or sexual intercourse, causes significant pain or frequently becomes infected and abscessed. 

The procedure can be done in a doctor's office or an outpatient facility using a local anesthetic. The doctor begins the procedure by cleaning and sterilizing the area. The doctor then uses a scalpel to make an incision in the cyst to drain the fluid. Next, the doctor stitches the skin so that a small permanent opening remains for fluid to drain from. The doctor may place a catheter for a few days to allow additional drainage to occur. The procedure usually takes 10 to 15 minutes.

Bartholin gland carcinoma is a rare cancer that can occur in the Bartholin gland. This type of cancer makes up 1% of all vulvar malignant neoplasms. It occurs most commonly in women in their mid-60s. The majority of cysts in the Bartholin gland are not malignant. If your Bartholin cyst is irregularly shaped or you are over the age of 40, your doctor may test for cancer.

Several techniques may be used to treat a Bartholin cyst.

A balloon catheter insertion creates a permanent way for fluid to drain out of the gland. This may help prevent cysts from coming back. The patient is given a local anesthetic and a small cut is made in the cyst or abscess to drain the fluid. The doctor then inserts a balloon catheter, which is a thin plastic tube attached to a small inflatable balloon, into the empty cyst or abscess. 

Once the balloon is inside the cyst, it is filled with a small amount of saltwater so that it fills the entire cyst or abscess. Stitches may be used to hold the catheter in place. The catheter remains while the skin grows around it. After about four weeks, the balloon is drained and the catheter is removed. This leaves a permanent passage for fluid to drain from. The procedure is about 80% effective in preventing cysts from recurring.

To perform this procedure, a doctor cuts the skin surrounding the vagina and the wall of the abscess or cyst. The abscess or cyst is drained and a stick of silver nitrate is placed into the empty abscess or cyst. The silver nitrate causes the cavity to transform into a small, solid lump. After two to three days, the remains of the cyst and the silver nitrate are removed if they have not fallen out on their own. There is a risk that the silver nitrate may burn skin on the vulva. This happens in about 20% of the cases.

This procedure uses a carbon dioxide laser to make an opening in the skin of the vulva to drain the cyst. The cyst is then either destroyed with the laser, removed or left in place with a small hole for drainage.

A needle and syringe are used to drain the cyst in this procedure. Needle aspiration may be combined with alcohol sclerotherapy. Alcohol sclerotherapy involves filling the drained cyst with a liquid that is 70% alcohol and leaving it in the cavity for five minutes before draining it.