Your 24-year-old female patient complains of tenderness at the entrance of the vagina on the right side. She cannot sit comfortably because of the soreness in the perineal area
On pelvic exam, there is of a tender, inflamed, fluctuant cyst at the introitus on the right side. These signs and symptoms are indicative of:
A. Possible malignancy
B. Bartholin cyst
C. Nabothian cyst
D. Candidiasis
ANS: C
The two Bartholin's glands are mucus-secreting glands, one located in each lateral wall of the vagina at the introitus. They can become abscessed in acute or chronic inflammatory processes, usually as a result of STD infection or from other bacteria that are prevalent in the vaginal and perineal area but also by thickened mucus or congenital narrowing of the duct. In postmenopausal women, a malignant cause should be considered in the differential diagnosis. Acutely, Bartholin's abscesses are extremely painful, in part due to their anatomical location, which makes sitting difficult. The area becomes swollen with the presence of a tender, inflamed, fluctuant cyst that is easily visualized.
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