What to know about bilateral Bartholin gland cysts

There is one Bartholin gland on each side of the vaginal opening. Each gland drains through a small duct, and blockage can allow fluid to collect into a cyst. Bilateral means that swellings are present on both sides. The two sides may differ in size or tenderness, and either cyst can become infected and form an abscess. Because several vulval conditions can resemble gland cysts, symmetrical or separate lumps should not be diagnosed by appearance alone. A physical examination checks their exact position, texture, tenderness and any discharge.

Make an appointment for both swellings to be assessed, even if only one side hurts. Note when each lump appeared, whether either changes in size, and whether walking, sitting, sex or urination has become uncomfortable. Do not press, pierce or attempt to empty either lump. Warm sitz baths and clothing that does not rub may provide temporary comfort. Treatment is selected for each side according to symptoms and examination findings; a cyst without discomfort may be observed, whereas an infected or troublesome cyst may require drainage. Marsupialisation may be discussed for a cyst that needs a lasting drainage opening.

Contact a healthcare service promptly if either side becomes intensely painful, rapidly enlarges, leaks pus or develops spreading redness. Fever, chills or feeling significantly unwell alongside the swelling also warrant urgent assessment because infection may need drainage and medication. Difficulty passing urine requires timely care. If the lumps persist, recur or feel different from one another, arrange an examination rather than assuming both have the same cause.

You can ask whether both swellings arise from the Bartholin glands, whether one shows infection, and whether each side needs different management. Clarify how to keep the area comfortable, what drainage would involve, and which symptoms should bring you back urgently.