Vaginal Cysts and Treatments
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Summary
- Vaginal cysts can appear inside or outside the vaginal walls.
- The majority of vaginal cysts will go away on their own without requiring medical intervention.
- Although most vaginal cysts are harmless, some are prone to infection and can become red, swollen, and tender if left untreated. And some can even develop into cancer.
- If a cyst becomes infected, you may need to have it drained or surgically removed.
Cysts are closed pockets of tissue (sacs) filled with air, fluid, pus, or other material. They can form anywhere on the body, including on or under the lining of the vagina.
Vaginal cysts are (usually) harmless lesions in the anterior (front) vaginal wall, with a prevalence of 1 in 200 women. They are more common in women in their 30s and 40s.
Vaginal cysts are often asymptomatic (showing no symptoms), with dimensions of less than 2cm. They are frequently found during a gynecological examination when women make an appointment for something unrelated to cysts, mainly because they do not realize they have a cyst.
Since cysts are not always reported, their incidence may be underestimated. Large vaginal cysts sometimes present as symptomatic genital prolapses (when patients report a feeling of a bulge, pressure, or a protrusion from the vagina).
What is a Vaginal Cyst?
Vaginal cysts range in size from microscopic to the size of a golf or tennis ball, and they are usually painless and harmless.
Cysts may form due to injuries during childbirth, a buildup of fluid in the vagina, or because of benign tumors in the vagina. If the cyst is uncomfortable or painful, and if it keeps recurring, you may need to undergo surgery to remove it.
Women above 40 years of age are usually advised to have vaginal cysts removed because they could possibly become cancerous.
Types of Vaginal Cysts
There are four main types of vaginal cysts. To determine which type of cyst you have, it's important to note the cyst's location and size.
Inclusion cysts
These may form due to injury to the vaginal wall during childbirth or after surgery. Vaginal inclusion cysts may form after you’ve had an episiotomy during childbirth, or after surgery that has damaged the lining of the vagina. Inclusion cysts occur at the lower back of the vaginal wall.
They are the most common type of vaginal cyst and because they are very small, they’re often hard to notice.
Although inclusion cysts are asymptomatic most of the time, they may cause discomfort or pain during sex.
Bartholin’s gland cysts
The Bartholin glands, located on either side of the vaginal opening, produce mucus that lubricates the vaginal lips (labia).
When a fold of skin grows over the opening of the gland and fluid becomes trapped inside, it can lead to a buildup of liquid. This collection of liquid results in swelling (cyst), which is usually painless and goes away on its own.
There may, however, be slight pain or tenderness while sitting, walking, or having sex.
Sometimes a Bartholin cyst becomes infected, which may cause pus to form. The pus can inflame the vaginal tissues and result in an abscess.
Bartholin cysts can be caused by an injury or irritation to the opening of the vagina, sexually transmitted infections (STIs), or certain types of bacterial infections.
Approximately 28% of vaginal cysts are Bartholin gland cysts.
Gartner duct cysts
The Gartner duct is an organ that forms when a baby is developing in the womb. This duct typically disappears after childbirth. If it does not disappear and parts of the duct remain, it can collect fluid and form a Gartner duct cyst.
Gartner duct cysts make up about 18% of vaginal cysts, making them less common than other types.
They are so small — usually less than 2 centimeters — that they usually go unnoticed. It is only during a pelvic exam or an ultrasound that women tend to find out they have them.
Müllerian cysts
Like the Gartner’s duct, Müllerian ducts (also referred to as paramesonephric ducts), aid in the development of the fetal reproductive system, including the cervix, fallopian tubes, and uterus.
These ducts can form cysts in adults.
Müllerian cysts occur when embryonic remnants or other fetal material remains behind as a baby develops. The cysts can occur anywhere on the vaginal walls and — in most cases — they contain mucus.
About 30% of vaginal cysts are Müllerian cysts, making them a relatively common type.
They are small, painless, and usually go unnoticed until they’re noticed during a physical exam.
Symptoms
Women are often unaware that they have a vaginal cyst because, in most cases, there is no pain. You may be able to feel a small lump in or around the vaginal lips, but cysts are usually only diagnosed when you have a gynecological examination.
If a vaginal cyst keeps growing, it may result in discomfort when walking, inserting a tampon, or having sex. If an abscess forms, the pain can be extreme.
Common symptoms of a vaginal cyst in the advanced stages include:
- A feeling of pressure
- Painful sexual intercourse
- An obstruction in the urethra or vagina
- Abnormal vaginal bleeding
- Vaginal discharge
- Tenderness or pain at the site
- Discomfort or pain while sitting or walking
- Fever
Treatment
Treatment for a vaginal cyst depends on the size, and whether it is painful or infected. You do not always have to seek medical treatment for cysts because they often drain on their own.
If the cyst becomes infected and develops into a pus-filled abscess, you may need to take antibiotics and have a minor procedure to drain or remove it. There is a chance that the cyst will return.
Sitz baths
Sitz baths may be used to treat a cyst by causing it to burst and drain on its own.
Taking a sitz bath involves soaking in a tub filled with a few inches of warm water, several times a day for three to four days. This soaking may help small cysts to burst and drain with no further intervention needed. You can also hold a warm compress (a flannel or cotton wool warmed with hot water) against the affected area. Painkillers, such as paracetamol or ibuprofen, can also help with the pain or discomfort.
Antibiotics
Antibiotics are prescribed if a vaginal cyst becomes infected — but if an abscess has formed and it is drained properly, there may be no need for antibiotics.
Marsupialization
This procedure is carried out on recurring or bothersome cysts. A doctor places stitches on each side of a drainage incision to create a permanent opening. A rubber tube may be inserted to facilitate drainage for a few days after the procedure, and to help prevent recurrence.
Surgical drainage
This procedure may be necessary for infected or large cysts in order to remove their contents. It is usually done under local anesthesia or sedation.
The doctor will make a small incision in the cyst and drain it. After draining the cyst, the doctor will then insert a small rubber tube in the incision. This allows the cyst to remain open for several weeks to drain completely.
Key Point: Vaginal Cyst Surgery
- Your gynecologist may perform surgery to remove the entire cyst if it is large and painful.
- Surgery is also a good option for treating vaginal cysts that keep recurring.
- For women over the age of 40, it is advisable to undergo surgical removal of vaginal cysts, because they might end up becoming cancerous.
- Prior to having surgery, you may have to undergo a biopsy to rule out vaginal cancer. For this procedure, a small amount of tissue is removed from the cyst and examined under a microscope.
- You may find that after surgical removal of the cysts, they recur. Some women are only able to get rid of vaginal cysts after several surgeries.
- When at home after surgery, you should call your doctor if you develop a high fever that exceeds 100.4°F (38°C), or if you experience heavy bleeding.
- You should also see the doctor if you experience vaginal discharge with a foul odor. Other warning signs of post-surgery complications include developing a rash, nausea, and severe pain in the pelvic area — which does not go away even after taking medication.
When to See a Doctor
A woman should have regular gynecological examinations as part of her routine care plan. If you notice a lump on your vagina, a doctor will need to examine it and may recommend a biopsy to rule out cancer.
You should seek immediate medical attention if a cyst is painful or if there are signs of infection. A common symptom of infection is the presence of pus and a foul smell.
Contact your healthcare provider if you:
- Feel a lump inside or protruding from your vagina.
- Believe the area is infected.
- Have a fever.
- Have pelvic pain.
- Experience unusual vaginal discharge.
Contact your doctor if the cyst:
- Doesn't go away within a couple of months.
- Increases in size.
- Starts causing pain or other symptoms, like bleeding.
- Feels solid to the touch, which may indicate a tumor.
While most vaginal cysts are painless and harmless, some are prone to infection and can become red, swollen, and tender if left untreated.
Where Can I Learn More about Vaginal Cysts and Other Women’s Health Issues?
To learn more about vaginal cysts and other female-related medical issues, you can speak to a board-certified doctor or nurse practitioner from your computer or smartphone. Head over to LifeMD.com to make your first appointment.
Sources:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142777/
- https://www.insider.com/guides/health/vaginal-cyst
- https://www.medicalnewstoday.com/articles/316796
- https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/vaginal-cyst
- https://www.mountsinai.org/health-library/diseases-conditions/vaginal-cysts
- https://www.draliabadi.com/gynecology/vaginal-conditions/cysts-and-lesions/
- https://www.allwomenscarela.com/our-services/gynecology/removal-of-vaginal-cysts
- https://my.clevelandclinic.org/health/diseases/23452-vaginal-cysts
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