Vaginal cysts are fluid-filled or semi-solid sacs that develop under the skin of the vaginal wall or entrance. They are a relatively common occurrence, and in most cases, they are entirely benign and do not indicate a serious health problem. Many individuals are unaware they have a cyst because the formations remain small and produce no noticeable symptoms. These growths can develop at any age, typically related to localized blockages or minor tissue changes within the genital area. Understanding their nature clarifies that they are a frequent and usually harmless finding.
Understanding Vaginal Cysts
A vaginal cyst is a closed sac structure lined with epithelial tissue that contains fluid, air, or semi-solid material. These formations typically arise when a gland or duct becomes obstructed, leading to a buildup of secretions that cannot drain properly. They can vary in location, appearing along the interior or exterior soft tissues of the vulva and vagina. Generally, they are slow-growing and range in size from a few millimeters to several centimeters.
It is important to distinguish a cyst from a tumor. A cyst is a non-cancerous, fluid-filled sac, while a tumor refers to an abnormal mass of tissue that can be either benign or malignant. Vaginal cysts are overwhelmingly benign and do not pose a threat of spreading. Unless the cyst becomes infected, most individuals experience no pain or discomfort.
The Most Common Types
Bartholin’s Gland Cysts
The Bartholin’s gland cyst is the most well-known type due to its frequent occurrence. The Bartholin’s glands are a pair of small, pea-sized structures located on either side of the vaginal opening. Their function is to secrete lubricating fluid into the vaginal vestibule through small ducts. A cyst forms when the opening of one of these ducts becomes blocked, often due to inflammation, infection, or trauma. This blockage traps the fluid, causing the gland to swell and form a palpable, sometimes tender, lump just inside the labia.
Vaginal Inclusion Cysts
Another frequently encountered type is the vaginal inclusion cyst, which typically forms as a result of trauma to the vaginal wall tissue. These cysts commonly develop following events like childbirth, episiotomy, or pelvic surgery. During the healing process, surface tissue is inadvertently trapped beneath the lining. The displaced tissue continues to shed cells and keratin, leading to the accumulation of debris and the formation of a small, firm cyst. They are often found on the lower posterior wall of the vagina and are generally asymptomatic unless they grow large enough to cause physical obstruction.
Gartner’s Duct Cysts
The Gartner’s duct cyst originates from remnants of a structure present during fetal development. During embryonic growth, the Wolffian duct system, also known as the mesonephric duct, is involved in forming parts of the reproductive system. In females, this duct usually regresses completely, but small portions can persist along the side walls of the vagina. If these remnants fail to fully disappear, they can later secrete fluid and expand, creating a cyst. These are typically located high on the anterior or side walls of the vagina and are congenital in origin.
Recognizing Symptoms and Seeking Diagnosis
While many vaginal cysts are benign, certain signs indicate the need for a medical evaluation. These include a sudden increase in size, the development of intense pain, or changes in appearance such as redness or localized heat. These symptoms often suggest the cyst has become infected, leading to an abscess that requires prompt medical intervention. Any cyst that begins to bleed or interferes with sexual intercourse, walking, or urination should also be assessed by a healthcare provider.
The diagnostic process typically begins with a thorough physical and pelvic examination. This allows the provider to visually inspect and manually palpate the cyst to determine its size, mobility, and tenderness. The provider will also review the patient’s medical history to identify any previous trauma or surgical procedures. To rule out other conditions, such as sexually transmitted infections (STIs) or other types of lesions, a swab or culture of the area may be taken.
In cases where the cyst has an unusual appearance, grows rapidly, or occurs in an individual over 40, a biopsy may be performed to definitively rule out malignancy. This procedure involves removing a small tissue sample for microscopic examination by a pathologist. This step confirms the benign nature of the growth and determines the specific type of cyst, which then guides the management strategy.
Treatment and Management
The approach to managing a vaginal cyst depends on its size, symptoms, and the presence of infection. For small, asymptomatic cysts confirmed to be benign, the standard course of action is often watchful waiting. This involves monitoring the cyst over time, as many small cysts resolve on their own without intervention. Regular self-checks and routine gynecological exams are recommended during this period.
When a cyst becomes symptomatic, infected, or significantly large, medical intervention is necessary. For a painful, infected cyst or abscess, the initial treatment often involves simple incision and drainage to relieve pressure and remove the accumulated fluid. For recurrent cysts, particularly Bartholin’s cysts, a procedure called marsupialization may be performed. This technique involves surgically opening the cyst and stitching the edges of the incision to keep the drainage site open, preventing future fluid accumulation.