To diagnose a Bartholin’s cyst, your doctor may ask questions about your medical history, perform a pelvic exam. Take a sample of secretions from your vagina or cervix to test for a sexually transmitted infection.
Recommend a test of the mass (biopsy) to check for cancerous cells if you’re postmenopausal or over 40
Often a Bartholin’s cyst requires no treatment — especially if the cyst causes no signs or symptoms. When needed, treatment depends on the cyst’s size, your discomfort level, and whether it’s infected, which can result in an abscess.
Treatment options your doctor may recommend include:
Sitz baths. Soaking in a tub filled with a few inches of warm water (sitz bath) several times a day for three or four days may help a
small, infected cyst to rupture and drain on its own.
Surgical drainage. You may need surgery to drain a cyst that’s infected or very large. Drainage of a cyst can be using local anesthesia or sedation.
For the procedure, your doctor makes a small incision in the cyst, allows it to drain, and then places a small rubber tube (catheter) in the incision. The catheter stays in place for up to six weeks to keep the incision open and allow complete drainage.
Antibiotics. Your doctor may prescribe an antibiotic if your cyst is infected or if testing reveals that you have a sexually transmitted infection. But if the abscess drain properly, you may not need antibiotics.
Marsupialization. If cysts recur or bother you, a marsupialization (mahr-soo-pee-ul-ZAY-shun) procedure may help. Your doctor places stitches on each side of a drainage incision to create a permanent opening less than 1/4-inch (about 6-millimeter) long. An inserted catheter may promote drainage for a few days after the procedure and help prevent the recurrence.
Rarely, for persistent cysts that aren’t effectively treated by the above procedures, your doctor may recommend surgery to remove the Bartholin’s gland. Surgical removal usually does in a hospital under general anesthesia. Surgical removal of the gland carries a greater risk of bleeding or complications after the procedure.