Vaginal and Vulval Disorders

Question 1

What is a bartholins cyst?

Answer 1

Fluid-filled sac within one of the Bartholin’s glands of the vagina

Question 2

Outline the pathophysiology of a batholins cyst

Answer 2

Gland function = secrete mucus to lubricate vagina

Gland location = deep to the posterior aspect of the labia majora

Build up of mucus secretions = gland blocked = cyst devel

Can become infected = abscess

Question 3

List the signs and symptoms of a bartholins cyst

Answer 3

Small = asymptomatic

Large = pain, superficial dyspareunia

Bartholin’s cyst: typically soft, fluctuant and non-tender

Bartholin’s abscess: typically tense and hard, with surrounding cellulitis

Question 4

When should a bartholins cyst be biopsied?

Answer 4

Women >40 to exclude vulval carcinoma

Question 5

Outline the treatment of a bartholin cyst

Answer 5

Small = no treatment, warm baths

Larger =

• Word catheter (tube)
• Marsupialisation (vertical incision)

Suspected malignancy = removal

Systemically unwell = Abx