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How to treat a bartholin cyst ?

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I have a few questions.
How likely is the cyst to become infected and turn into an absess?
If it does turn into an absess will I be given antibiotics or will I have to have the op on an emergency basis?
What would cause the cyst to become infected?
When it is removed will the incision be made on the inside or outside of the labia?
Do they come back? The forum seems to suggest they do.

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replied January 16th, 2009
Vaginal and Uterus Health Answer A5391
"Diagnosis that has been suggested: Bartholini cyst
Current medical status: I have been diagnosed as having a bartholin cyst and I have an appointment with the hospital gyn in February
Current medical treatment: None"

The Bartholin glands are a pair of pea-sized, vulvovaginal, mucous-secreting vestibular glands that are located in the labia minora in the 4- and 8-o’clock positions. A Bartholin cyst is a fluid-filled sac that develops in one of the Bartholin glands or ducts when the duct that drains the fluid from the gland becomes blocked and causes the duct and gland to swell. A Bartholin gland abscess develops sometimes either when a Bartholin cyst becomes infected or when the Bartholin gland itself becomes infected (usually due to low levels of hygiene or as a sexually transmitted infection).

Different techniques exist for the treatment of Bartholin cysts and abscesses. At the moment, doctors favor the use of the Word catheter. If a Word catheter is not available, incision and drainage (with traditional packing) may be performed.

Home treatment of Bartholin cysts and abscesses involves sitz baths, which promote drainage. Special sitz bath basins are available, but the simplest method is to sit in the bathtub in a few inches of warm water. The water should not be so hot as to burn the skin but should be fairly warm. These soaks should be done for 10-15 minutes at a time, 3-4 times daily. This treatment is frequently all that is needed for Bartholin cysts.

Abscesses often require drainage by a gynecologist. For a small Bartholin cyst that is not too painful, treatment consists of sitz baths with follow-up if the cyst enlarges or becomes painful. Especially with recurrent cysts, treatment with antibiotics and sitz baths are performed with the goal of cooling off the infection.

If antibiotics and sitz bath clear up the infection, a surgical procedure called a marsupialization can be done later to prevent possible recurrence. This is usually done in an outpatient surgical setting. An incision is made into the skin over the cyst and then carried down through the cyst wall (the approach, whether on the inside or outside of labia, depends on the surgeon). This drains the fluid from the cyst and then the lining of the cyst wall is sutured to the overlying skin in such a way as to create a permanent drain site. This usually prevents recurrence of the cyst.

After drainage of an abscess, antibiotic treatment is usually not necessary. However, if there is a concern about sexually transmitted infections or if there is evidence of urinary or vaginal infection, an antibiotic may be prescribed. In some cases, antibiotics will be prescribed a couple of days after the initial treatment, after the results of any laboratory cultures are received.

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