Clinical Summary

Bartholin glands and ducts are located over the lower third of the introitus near the labia minora. A cyst or abscess can result from an obstructed duct, which usually occurs secondary to scarring from trauma, delivery, or episiotomy. Infection of the cyst is usually with mixed vaginal or fecal flora (Escherichia coli) but may also contain Neisseria gonorrhoeae and Chlamydia trachomatis. Progressive enlargement and infection lead to increasing pain, swelling, and dyspareunia. A tender, fluctuant cystic mass with surrounding labial edema is easily appreciated on examination. Epidermal inclusion cysts and sebaceous cysts of the labia majora, hidradenitis suppurativa, vulvar hematomas, leiomyomas, lipomas, and fibromas may be confused with a noninfected Bartholin cyst.

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