I have a painful swelling in my vulval area. It is very big in size, roughly  an egg size. It is extremely painful. I have difficulty in sitting and in walking. I had similar swelling last year, it ruptured by itself and I got relief in pain. What is this? How did it occur? Do I need to go to the doctor or wait, so that it ruptures again . What should I do? What will the doctor do for it?

Answer (by Dr. Neelam Dhamija): It appears from your complaints that the swelling is nothing but a bartholin cyst. When the opening of Bartholin gland (a gland which is present on both the sides near the opening of vagina) gets obstructed, then its  secretions cannot find their way out and gets collected to form a cyst. This is called Bartholin cyst. When this cyst is infected then abscess called bartholin abscess is formed. First to appear is bartholin cyst and its infection results in bartholin abscess. Relief in pain occurs when the cyst/abscess burst, and when all the collected pus come out. Applying (or soaking in) slightly hot or warm  water to the swelling, three to four times a day will give relief from pain and many times the swelling will rupture, there will be significant relief in pain as the collected fluid/pus is drained out. When the cyst bursts on its own the opening is so small that it closes again and abscess often returns. It is better to go to the doctor, she may open the swelling by a  small cut given on it, after giving local anesthesia so you will not feel pain during the procedure. The material (fluid/pus inside the cyst) will be sent for examination to know the type of infection. A small rubber drain is kept inside which allows complete drainage of the cyst. After a day or two after the operation, you need to do dressing of the operated area with some antiseptic cream or lotion and also need to apply ( or soak in) warm water to the area to speed up the healing process. You will be given antibiotics and pain killers by your doctor. It will be better to consult your doctor.

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