My daughter has definitely started puberty, but her period is yet to come. However she has developed a swell just outside her vaginal open ending that seems to me exactly like a bartholin's cyst. She even took a warm bath and it shrunk a lot, but came back. It is right on the inside of her vaginal opening and when it's extra swollen the whole area swells up. She has labia minors hyper trophy just as a heads up. What could this be?
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Is a bartholin's cyst possible for a girl who hasn't started menstration?
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Featured Answer
Absolutely. Girls may have Bartholin's cyst. Symptopms include painful swelling adjacent to introitus, usually at the 4 to 5 o-clock positions. Infection agents include mixed bacterial flora, mostly with gram-positive and anaerobic organisms. The distal obstruction of the duct can be caused by both sexually transmitted and not-venereal infections. The cyst may drain spontaneously.
Management:
Unless infected or tender, no treatment is needed. Given the picture you have presented, there is no abscess within the duct. Thus no marsupialization is necessary. However, she will need antibacterial treatment: both, per os and local applications.
FYI: Other vulvar cysts observed in girls may include:
- cyst of the Nuck's canal (peritoneal cyst adjacent to the round ligament; these recur if only drained);
-mesonephric duct remnant (cyst extending up lateral vagina);
- accessory breast tissue in vulva (small nonspecific nodule, usually unnoticed until pregnancy, which needs intervention only during the pregnancy);
- epidermal (sebaceous) cysts (usually multiple, less than 1 cm in diameter, solid per palpation, non-tender if not infected).
Management:
Unless infected or tender, no treatment is needed. Given the picture you have presented, there is no abscess within the duct. Thus no marsupialization is necessary. However, she will need antibacterial treatment: both, per os and local applications.
FYI: Other vulvar cysts observed in girls may include:
- cyst of the Nuck's canal (peritoneal cyst adjacent to the round ligament; these recur if only drained);
-mesonephric duct remnant (cyst extending up lateral vagina);
- accessory breast tissue in vulva (small nonspecific nodule, usually unnoticed until pregnancy, which needs intervention only during the pregnancy);
- epidermal (sebaceous) cysts (usually multiple, less than 1 cm in diameter, solid per palpation, non-tender if not infected).
It appears to be a Bartholin duct cyst since it decreases in size with warm bathes. It could be infected making it a Bartholins duct abscess. She may benefit from antibiotics if the swelling doesn't go down completely or it is very tender. Usually these resolve eventually but are prone to recur over time sometimes necessitating surgical excision of the gland.