Trauma or infection may involve Bartholin’s duct, causing obstruction of the gland. Drainage of secretions is prevented, leading to pain, swelling, and abscess formation. The infection usually resolves and pain disappears, but stenosis of the duct outlet with distention often persists. Reinfection causes recurrent tenderness and further enlargement of the duct.
The principal symptoms are periodic painful swelling on either side of the introitus and dyspareunia. A fluctuant swelling 1-4 cm in diameter in the inferior portion of either labium minus is a sign of occlusion of Bartholin’s duct. Tenderness is evidence of active infection.
Pus or secretions from the gland should be cultured for gonococci, chlamydiae, and other pathogens and treated accordingly ; frequent warm soaks may be helpful. If an abscess develops, aspiration or incision and drainage are the simplest forms of therapy, but the problem may recur. Marsupialization, incision and drainage with the insertion of an indwelling Word catheter, or laser treatment will establish a new duct opening. An asymptomatic cyst does not require therapy.
Revision date: July 3, 2011
Last revised: by Janet A. Staessen, MD, PhD