Cysts are sac-like lumps filled with air, fluid, or other substances. In most cases, cysts are neither harmful nor painful.

Cysts range in size from too small to see to the size of an orange. These lumps can appear anywhere on the body, including the vagina.

Vaginal cysts may be caused by injury to the vagina through childbirth, by benign tumors in the vagina, or by a buildup of fluid.

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Some kinds of cysts are caused by injury during childbirth, surgery, or as a result of the material left behind after the baby is born.

Vaginal cysts occur in a variety of different forms. These include the following:

  • Bartholin's gland cysts: These are fluid-filled cysts that form on the Bartholin's glands, which sit on either side of the vaginal opening. The glands produce fluid that lubricates the outer lips of the vagina.
  • Inclusion cysts: Typically, these form on the lower back of the vaginal wall. They tend to be very small and unlikely to be noticed. They are also one of the most common forms of cysts that can develop on the vagina. They may be caused by injury during childbirth or surgery.
  • Müllerian cysts: These are another common type of cyst that form as a result of material left behind when a baby develops. They grow anywhere on the vaginal walls and often contain mucus.
  • Gartner's duct cysts: These can occur when ducts in a developing embryo do not disappear as they should after a baby is born. The leftover ducts can develop into vaginal cysts over time.

Causes and risk factors

Vaginal cysts are most likely to occur when a duct or gland becomes clogged, causing liquid and other materials to collect. The cause of a vaginal cyst usually determines its type.

For example, injury to the vaginal walls causes inclusion cysts.

The most likely risk factors for inclusion cysts are a rip or tear during childbirth, surgery that damages the lining of the vagina, or an episiotomy (small cut between the vagina and anus) made prior to childbirth to widen the opening of the vagina.

Bartholin's gland cysts occur when the opening to the Bartholin's gland becomes blocked by the flap of skin that covers it, causing a fluid-filled growth.

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A cyst will often go unnoticed until their discovery by a gynecologist during a regular exam.

Vaginal cysts are not likely to cause a woman any noticeable symptoms. Depending on the size and location, she may or may not feel the lump from the cyst.

Often, a gynecologist will discover cysts during a routine, yearly examination. The cyst might stay the same size or grow larger over time.

Most cysts will not be painful. However, some of the larger cysts may cause discomfort during sex, while walking or exercising, or inserting a tampon.

Cysts are most likely to cause pain if they become infected. Normal bacteria from the skin or sexually transmitted diseases may cause a vaginal cyst to develop an infection that may lead to an abscess.

Complications

The most likely complication from a cyst is an infection that causes an abscess. An abscess is a large collection of pus and fluid that can cause redness, pain, and swelling. If an abscess forms, it may need to be drained in order to heal.

A large number of bacteria both on the skin and from sexually transmitted diseases, such as chlamydia and gonorrhea, can cause a cyst to develop into an abscess. In other cases, bacteria normally found in the gut, such as E. coli, can lead to a Bartholin's abscess.

When to see a doctor

A woman should have an annual gynecological examination as part of normal, routine care. In addition, it is a good idea for a doctor to check any new lump on the vagina to ensure it is benign.

Women should also seek medical attention if a vaginal cyst or lump becomes painful or shows signs of infection.

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Sitz baths may be used to treat a cyst, causing it to burst and drain on its own.

In most cases of vaginal cysts, treatment is unnecessary. Treatment is usually given if a person experiences any discomfort or pain, because of the size of the cyst, or if there is infection.

If treatment is needed, one of the following options may be used:

  • Antibiotics, typically prescribed if a vaginal cyst is infected, or in cases when testing reveals that there is a sexually transmitted infection. If an abscess has formed and is drained properly, there may not be a need for antibiotics.
  • Sitz baths, which involve a woman soaking in a tub filled with a few inches of warm water several times a day for 3-4 days. This soaking may help a small, infected cyst to burst and drain with no further intervention needed.
  • Marsupialization, for frequently 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 promote drainage for a few days after the procedure and to help prevent recurrence.
  • Gland removal, conducted in rare cases of Bartholin cysts. However, this is not the case usually.

Surgical drainage may be required for infected or large cysts in order to remove their contents. This is often done using local anesthesia or sedation, and can take place in the doctor's surgery.

A doctor makes a small incision in the cyst, which is then drained. After draining the cyst, the doctor puts a small rubber tube in the incision. This allows the cyst to remain open for several weeks to drain completely.

Prevention

The growth of vaginal cysts is difficult to prevent. Prevention should focus less on stopping cyst formation as on keeping the vagina as clean as possible. Practicing safe sex can help prevent infection from sexually transmitted diseases.

Outlook

The outlook for women with vaginal cysts tends to be good. Many women are not aware of their vaginal cysts until they are spotted during a yearly examination.

In very few cases, a vaginal cyst may cause pain or become infected. A woman should seek treatment immediately and avoid activities that irritate the cyst. Rarely do vaginal cysts cause ongoing issues for women.