Introduction:
The vagina is a muscular canal made up of mucus membranes and nerves. The vagina connects the cervix and uterus to the outside of the body, which helps with sexual intercourse, menstruation, and childbirth. Vagina has a self-cleansing property because it hosts many bacteria and fungi that keep it healthy. The vagina flora contains tiny organisms that coexist in the ecosystem. The good bacteria in the vagina help it to be infection-free. The vagina extends from the cervix, which connects the vagina to the uterus. Vaginal cysts are also called Bartholin’s gland cysts. It is a unilateral, asymptomatic blockage of the Bartholin gland discovered during a pelvic exam. The vaginal cyst is a fluid-filled lump located near the vagina. The Bartholin glands are great vestibular glands in the left and right portions of the vaginal introitus. The Bartholin gland is a mucous-secreting gland that plays a vital role in the lubrication of the vagina. The vaginal cyst occurs mainly after puberty, and the incidence decreases after menopause.
What Is a Vaginal Cyst?
Vaginal cysts are rare, benign, and fluid-filled lesions on the vaginal walls. The vagina connects the uterus to the outside of the body. The cervix forms the interior end of the vagina. The vaginal cyst is found on the lips (labia) of the vagina. They can also be found inside the vagina (the canal connecting the cervix to the outside body).
What Are the Common Causes and Symptoms of Vaginal Cysts?
Vaginal cysts occur when the gland or the duct gets clogged, causing the mucous liquid or material to clog inside. The causes depend on the type. The causes can be tears in the vaginal tissue during childbirth, any surgery that damages the lining, or a small cut between the vagina and the anus. This cut is made to widen the opening of the vagina during childbirth. There will not be any noticeable symptoms. Sometimes the women may not feel the lump. The cyst can remain the same size or can grow over some time. The cysts are painless, but large cysts can cause pain if infected. Any bacteria from sexually transmitted diseases or the skin cause a vaginal cyst.
What Are the Types of Vaginal Cysts?
The different types of vaginal cysts are:
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Bartholin Gland Cysts - The Bartholin or vulvar cyst is usually a unilateral, asymptomatic, and benign (non-cancerous) condition. It forms on either side of the labia (vaginal lips). The gland produces the mucus (fluid) that helps to lubricate the vagina. The Bartholin gland is a part of the vulva of the female reproductive system. The cyst occurs when the blockage happens in the gland openings. The mucus starts building up and forms a lump. Some Bartholin cysts are very small and asymptomatic (without any symptoms). An abscess (collection of pus) if the cyst gets infected with bacteria. The cyst can also occur if the opening to the gland becomes blocked by a skin flap, causing a fluid-filled growth.
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Inclusion Cysts - They are found in the walls of the vagina. Cysts that develop on the vulva are inclusion cysts. They can form because of injury to the vagina after childbirth or any surgery in the vagina. They are tiny sacs that have tissue from the vulvar surface. The vulvar cyst contains secretions from the sebaceous glands near the follicles. They are the common cyst of the vulva. Inclusion cysts are common due to tears caused during the baby's delivery. The tissue from the vulva surface is trapped under the surface, contributing to cyst formation.
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Epidermal Cysts - These types of cysts occur due to blockage of the ducts of the sebaceous glands. The secretions from these glands accumulate under the skin's surface. Later, it enlarges and becomes infected. The infected cysts are tender and painful. These kinds of cysts are asymptomatic and not painful, but they irritate.
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Gartner’s Duct Cyst - Gartner duct cysts or GDCs can develop along the mesonephric duct parts, also known as the Wolffian duct. The remnants of the mesonephric duct are called the Gartner duct. Gartner ducts are usually located on the lateral and anterior parts of the vaginal wall. It rarely occurs in the posterolateral wall. The remaining Gartner ducts are identified in approximately 20 percent of all female adults, but only one percent will develop the condition. The GDCs are present from birth. They are not identified until adolescence and late middle age, from 45 to 60.
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Mullerian Cysts - They are the most common type of vaginal cyst. The cyst is small with solitary mucin-filled painless lesions. It is soft and is compressed manually without difficulty. It accounts for 40 percent of vaginal cysts. The cyst develops from Mullerian epithelium that can develop from any part of the vaginal wall. It is found anywhere in the vaginal wall that is asymptomatic. Sometimes it can become sufficiently large, causing pain and discomfort. It is lined by columnar endocervical and tubo-endometrial cells that resemble the lining of the fallopian tube and endometrium. The predisposing factors are trauma to the vagina during birth, vaginal tumors, invasive procedures such as endocervical curetting, colposcopic exams, and laser therapy.
What Are the Complications of a Vaginal Cyst?
When the cyst turns into an abscess, there will be a large collection of pus and fluid that cause pain, swelling, and redness. The cyst has to be drained before it heals. Sexually transmitted diseases such as chlamydia and gonorrhea consist of bacteria that cause a cyst to develop into an abscess. The infected cysts can cause fever if it is swollen and tender.
How Is the Vaginal Cyst Diagnosed?
The vaginal cysts are diagnosed through physical examination. They look for or examine the cyst through a physical exam. To rule out cancer or other diseases, the following tests are taken:
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Taking a biopsy of the tissue.
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Extracting the fluid from the vagina to test for sexually transmitted diseases.
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An ultrasound or MRI (magnetic resonance imaging) is done to visualize the cyst in greater detail.
What Is the Treatment for Vaginal Cysts?
Often they do not require treatment because they regress on their own. To experience relief from the discomfort, the person can sit in a bathtub filled with warm water several times a day. The cyst is treated with the help of a healthcare provider. The cyst should not be drained at home. The following are the treatment options-
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Marsupialization - In this procedure, the cyst is surgically opened through an incision and drained. Then the edges of the cyst wall are stitched to form a permanent pocket for continuous drainage.
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Surgical Draining - A small catheter (tube) is inserted into the cyst to drain the fluid.
Conclusion:
Sometimes it requires surgery to remove the entire cyst if it causes more discomfort because it can develop into cancer after age 40. These cysts do not reoccur after the surgery. It is always better to seek professional help if someone feels a lump in the vagina. A healthcare provider should plan the appropriate care and treatment.
