Patient information · Women's health
Bartholin's cyst and abscess
painless it can wait; painful it usually cannot
The Bartholin's glands sit either side of the vaginal opening and lubricate it. If a duct blocks, fluid collects and forms a cyst. If that becomes infected it forms an abscess, which is extremely painful and needs draining — often the same day.
Seek same-day assessment if you have
- a rapidly enlarging, exquisitely painful lump making it hard to sit or walk
- fever, shivering or feeling generally unwell
- spreading redness into the surrounding skin or thigh
- inability to pass urine
- a lump with severe pain out of proportion and rapidly worsening
- these symptoms with diabetes or a weakened immune system
A Bartholin's abscess is one of the few gynaecological problems where prompt drainage transforms the pain within minutes. Rapidly spreading infection of the perineum is rare but serious and needs emergency assessment. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Cyst or abscess
- Cyst — a soft, usually painless swelling on one side of the vaginal opening, from pea-sized to golf-ball-sized. May cause discomfort with sitting, walking or sex. Many need no treatment at all.
- Abscess — the cyst becomes infected: red, hot, swollen and severely painful, often over one to three days, sometimes with fever. This needs draining.
- Both occur on one side only. It is not sexually transmitted, though sexually transmitted infections can occasionally be involved and swabs are usually taken.
Self-care for a small painless cyst
- Warm baths or sitz baths — sitting in a few inches of warm water for 10 to 15 minutes, three or four times a day. This sometimes allows a small cyst to drain on its own.
- Paracetamol or ibuprofen for discomfort.
- Loose cotton underwear and clothing.
- Avoid soap, bubble bath and perfumed products on the area; wash with water or a plain emollient.
- Avoid sex while it is uncomfortable.
- Do not attempt to squeeze or lance it — this forces infection into the surrounding tissue.
Treatment for an abscess
- Incision and drainage under local anaesthetic gives immediate relief. The difficulty is that simple drainage alone has a high recurrence rate, because the cavity reseals.
- A Word catheter — a small balloon-tipped catheter left in place for two to four weeks after drainage — keeps a channel open so a new duct forms. This substantially reduces recurrence and is now the preferred approach for a first abscess. It is uncomfortable but tolerable, and normal activity continues with it in place.
- Marsupialisation — a small operation stitching the cyst wall open to create a permanent opening — is used for recurrent cysts.
- Antibiotics alone rarely resolve an abscess and are added where there is surrounding cellulitis, fever, or particular risk. Drainage is the treatment.
- Recurrence occurs in a proportion whatever is done, and a second procedure is not a failure.
Over the age of 40
A new Bartholin's lump in a woman over 40 should be biopsied or excised rather than simply drained. Carcinoma of the gland is rare, but it presents exactly like a cyst, and simple drainage of a mass that is not a cyst delays diagnosis. This is not a reason for alarm — the great majority are entirely benign — but it is the reason your clinician may recommend sending tissue for analysis rather than just relieving the swelling.
Afterwards
- Continue warm baths daily while a catheter is in place, and keep the area clean and dry.
- Some discharge and spotting for a few days is normal.
- Avoid sex, tampons and swimming until healed or the catheter is removed.
- Contact us for increasing pain, fever, heavy bleeding, or if the catheter falls out early.
Why come to us. A Bartholin's abscess is painful enough that waiting is genuinely miserable, and it is a straightforward procedure done well. We offer discreet women's health appointments seven days a week with a female clinician available on request, swabs and sexual health screening on site, and incision, drainage and Word catheter insertion performed in clinic under local anaesthetic — usually the same day, with fees published in advance. Where excision or biopsy is appropriate we arrange it promptly.
Drained in clinic, usually the same day
Female clinician available, published fees. Seven days a week.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.