A female of reproductive age presents for evaluation of vulvar pain and swelling that has developed over the past 2 to 3 days. Pain is increased when walking and sitting. On physical examination in the lithotomy position, there is a unilateral (occasionally bilateral), tender, fluctuant, mildly erythematous swelling at the 4-o’clock or 8-o’clock position within the posterior labium minora (Fig. 86.1).