KEY FACTS
Terminology
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Bartholin glands (or greater vestibular glands) are mucus-secreting glands located in vulvar vestibule, just lateral and inferior to vaginal introitus
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Occlusion of Bartholin glands resulting in cyst formation
Imaging
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Cystic structure on posterolateral distal vaginal wall, medial to labia minora, and at level of introitus
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Anechoic when simple
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Mixed echogenicity if complicated by hemorrhage or infection; → septations and thick wall
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Size ranges 1-4 cm
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No internal vascularity, may see reactive hyperemia around Bartholin abscess
Top Differential Diagnoses
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Sebaceous cyst
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Thrombophlebitis/other infections/varices
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Hematoma, endometrioma
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Skene gland cyst
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Gartner duct cyst
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Malignancy
Pathology
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Most common vulvar cystic mass; ~ 2% of women
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Usually asymptomatic
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Superimposed infection can develop
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Increase in size or preexisting cyst; local pain, dyspareunia
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Malignancy very rare
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Squamous and adenocarcinoma most common types
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Clinical Issues
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Usually found incidentally
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Palpable and sometimes visible mass
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Perineal pain, tender labial mass when infected (Bartholin abscess)
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Simple drainage can result in recurrence up to 38%
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Incision/drainage ± silver nitrate cautery, marsupialization or excision, placement of Word catheter
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Scanning Tips
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Use higher frequency transducer for transperineal scanning
, which is multiloculated with thick septa 
and internal debris 
. The patient had a history of recurrent abscesses.
with internal debris 
.
