Bartholinitis. A harmless disease? Or should I see a doctor?

Bartholinitis is an inflammation of the paired Bartholin glands located in the vestibule of the vagina. Normally, the Bartholin's glands are quite small, about one centimeter in diameter, but they perform an important function by secreting a secretion to moisturize the vagina. The disease occurs on average in 2% of women.

The appearance of pathology is also possible during pregnancy - in this case, antibacterial therapy is carried out taking into account the safety for the fetus, and surgical treatment is postponed until after childbirth.

Anatomy of the female genital organs

The female genital organs are divided into internal and external. The external ones include the pubis, labia majora and minora, clitoris and vestibule of the vagina.

• Pubis. The soft tissue formation located above the external genitalia is slightly elevated due to subcutaneous fat.
• Big lips. Two longitudinal skin folds separated by a genital fissure, in the depths of the lower third of which are Bartolini’s glands (paired formations with a diameter of about 1 cm). The function of the Bartholin glands is to produce secretions necessary to moisturize the vaginal mucosa and lubricate during arousal.
• Small lips. Thin folds of skin located at the junction of the labia majora.
• Clitoris. Located between the labia minora (above).
• The vestibule of the vagina. The scaphoid cavity is located between the labia minora. It “collects” the opening of the urethra, the excretory ducts of the Bartholin glands and the entrance to the vagina.

What is bartholinitis

In women, on the eve of the vagina, in the transition zone between the labia majora and labia minora, there are two large (Bartholin's) glands. They reach a size of up to 1 cm and secrete a secretion that keeps the vagina moist.

Bartholinitis is a disease in which a large gland in the vestibule becomes inflamed. Inflammation of the gland during bartholinitis causes the woman significant discomfort and pain. The disease is not so rare - it occurs in 2% of women, usually of childbearing age.

The disease is caused by nonspecific microorganisms (streptococci, staphylococci, E. coli, fungi) and pathogens of sexually transmitted infections (gonococci, trichomonas, chlamydia, ureaplasma), which penetrate the glandular duct from the vagina and urethra and provoke an inflammatory process. Usually the process is one-way.

Diagnostics

It is not difficult to recognize bartholinitis; the doctor only needs a visual examination and manual examination, in which the swollen gland is clearly visible on one side.

To treat the pathology, the gynecologist will need additional data, so he will prescribe the woman a series of tests:

• general urine analysis;
• blood analysis;
• vaginal smear for pathogenic microflora;
• PCR diagnostics to detect sexually transmitted infections;
• blood test for syphilis and HIV;
• collection of discharge from the Bartholin glands canal;
• when opening an abscess - culture to determine the type of pathogen.

Depending on the data obtained, the doctor will determine the treatment strategy and decide on the need for surgery.

Causes of bartholinitis

Pathogenic microorganisms can penetrate the thickness of the Bartholin gland in several ways:

• Inflammation of the Bartholin gland in women with local tissue damage. In this case, the source of infection is localized in the woman’s genitals;
• In case of a generalized infection, when the transfer of microorganisms occurred through the circulatory or lymphatic system from other organs that are not anatomically connected to each other.

Normally, the body is able to independently cope with pathogenic flora and suppress its ability to reproduce and spread, but in the presence of such factors as:

• a woman’s failure to comply with personal hygiene rules and the use of uncomfortable synthetic underwear. Synthetic fabric can affect the balance between humidity and temperature, causing the growth of pathogenic bacteria. Thick underwear can put pressure on the perineum, preventing the secretion of secretions, which leads to swelling of the gland.
• excessive cleansing using alkaline soaps, frequent douching with antibacterial drugs that cause disturbances in the vaginal microflora.
• decreased immunity due to hypothermia, bad habits, poor nutrition, etc.;
• unprotected sex with different partners;
• trauma, scratching of the perineum;
• with vaginal dysbiosis due to long-term use of antibiotics;
• in case of chronic inflammatory diseases with the formation of a permanent focus of infection: chronic cystitis, urethritis, colitis, chronic sinusitis and even caries, the infection can enter the gland through the blood or lymphatic vessels;

When immunity declines due to diabetes and other diseases, the risk of bacteria entering the parenchyma and the development of inflammation of the Bartholin gland increases.

Causes

Bartholinitis develops against the background of infection of the gland by specific or nonspecific pathogens. Specific flora include ureaplasma, gonococcus, chlamydia, trichomonas. The list of nonspecific includes staphylococcus, E. coli, streptococcus, clostridium. Penetration of infection is possible in two ways: endogenous (from the inside) and exogenous (from the outside).

With the endogenous method of infection, pathogenic microorganisms are introduced into the gland through the bloodstream or downward, through the urinary canals. This is possible in the presence of foci of chronic infection, in particular pyelonephritis, cystitis, urethritis, vaginitis. Exogenous infection occurs during sexual intercourse, when using other people's hygiene products, or poor hygiene of the external genitalia. Factors that increase the likelihood of developing bartholinitis include:

• operations on the external genitalia;
• injuries;
• weakened immunity due to hypothermia, stress, hormone intake, viral infections (HIV);
• frequent change of sexual partners;
• wearing underwear that is too tight, disrupting the flow of secretions from the Bartholin glands;
• the presence of foci of chronic infection in the body.

Risk factors

Gynecologists take into account not only the immediate causes of the disease, but also possible forms of predisposition to the disease. This is heredity, lifestyle features and the history of a single woman. Negative external and internal influences increase the risk of infection of the genitals.

Possible risk factors:

• Trauma to the external genitalia. Complications of this condition may include infection, blockage of glandular ducts, or tissue inflammation.
• Medical interventions in the genitourinary area, such as bladder catheterization, surgery or instrumental gynecological examination.
• Failure to comply with personal hygiene rules. A woman herself can introduce an infection from the external environment or from another anatomical area.
• Wear tight underwear.
• Using hygiene products that irritate the skin of the genital organs.
• Disorders of innate and acquired immunity.
• Long-term use of antibiotics and corticosteroids without medical supervision.
• Unprotected sex with frequent ejaculation in the vaginal area.
• Inflammatory diseases of other genitourinary organs.
• Diabetes mellitus and unhealthy diet.
• Alcohol abuse, smoking.

Taking into account risk factors is necessary when examining diseases of the genitourinary system and carrying out preventive measures.

Diagnosis of bartholinitis in women

Bartholinitis is a fairly well-studied disease, which is easily detected during an examination in a chair. But there are diseases such as labia furuncle, paraproctitis or malignant formation, symptoms of which are similar to the clinical picture of inflammation.

To exclude them, the following diagnostic methods are used:

• bacterial culture of fluids obtained from the gland;
• general blood test;
• polymerase chain reaction.

The most important diagnostic measure that allows you to accurately determine the type of pathogen is the examination of smears. When a pathology is detected in a woman over 40 years of age, tests are required to exclude malignant tumors.

To select the correct treatment for bartholinitis in women, symptoms and manifestations should be analyzed by a gynecologist. At the diagnostic stage, the specialist may ask the woman the following questions:

1. about the presence of concomitant or past diseases of the reproductive system;
2. about intolerance to certain medications.

Additionally, the doctor may examine peripheral lymph nodes or examine the rectum.

Classification

Gynecologists know several forms of bartholinitis, which differ in the cause and nature of the inflammatory process. The most common form is a serous infection, in which heterogeneous microorganisms attack the gland. This disease does not cause acute symptoms. On the contrary, purulent bartholinitis is characterized by an increase in body temperature and tissue swelling. Serous inflammation can gradually be complicated by an abscess, since any infection causes active proliferation of opportunistic microorganisms in the tissues.

Forms of the disease according to the nature of the course:

• Acute bartholinitis. Symptoms of this condition come on suddenly and gradually get worse. Women mainly complain of pain in the perineum and increased body temperature. The acute form of the disease responds well to treatment.
• Chronic bartholinitis, which occurs in the absence of treatment or improper treatment of the disease. Patients periodically experience exacerbations with moderate symptoms, alternating with periods of disappearance of all unpleasant sensations. Chronic inflammation often requires long-term treatment.

Determining the form of the disease is very important when selecting drug therapy. In case of chronic bartholinitis, the gynecologist must determine the causative agent of the disease before treatment.

Types and forms

There are acute and chronic bartholinitis. In the acute course of the disease, two development options are possible:

• True abscess. With this form of bartholinitis, the Bartholin gland is directly infected. The disease is characterized by severe swelling, pain, and enlarged lymph nodes in the groin. The temperature rises to 40 degrees, fever and chills appear. If you release the pus, the condition will improve slightly, since the root cause of the disease has not been eliminated. You cannot remove the abscess yourself - there is a risk of blood poisoning.
• False abscess. The disease begins with the appearance of unilateral swelling in the labia area. Body temperature rises to 37.5-38 degrees, pain occurs, intensifying with movement. As the amount of purulent contents increases, a large and painful tumor develops.

Without timely and adequate treatment, the acute form of the inflammatory process turns into chronic bartholinitis. The woman feels a short-term improvement, then relapses occur. Exacerbations occur with decreased immunity, infectious diseases, and menstruation.

Bartholinitis is dangerous during pregnancy: it can negatively affect the condition of the child. The fact is that a pregnant woman’s immune system is weakened and cannot always resist the spread of infection. If pathogenic microorganisms penetrate through the umbilical cord into the womb of the expectant mother, there is a risk of improper formation of the child’s internal organs and systems, miscarriage, or infection of the baby during childbirth.

If you notice signs of bartholinitis during pregnancy, you should immediately inform your doctor. Treatment methods are selected depending on the condition of the expectant mother. Often the only option is artificial termination of pregnancy.

Symptoms of bartholinitis

The inflammatory process of the Bartholin gland begins with the labia minora and the formation of a dense lump. A woman may feel a slight burning sensation, which intensifies when walking and urinating. The mucous membrane begins to swell, and serous-purulent discharge appears. Possible increase in body temperature.

Purulent complications are accompanied by active swelling of the Bartholin gland with the appearance of severe pain and signs of general malaise. Symptoms of bartholinitis in women are especially pronounced when an abscess forms. Infectious complications, up to the progression of sepsis.

Leading specialists in the treatment of bartholinitis in the Southern Federal District

Ermolaeva Elvira Kadirovna is a well-known and recognized specialist in the treatment of bartholinitis in the North Caucasus. She is a gynecologist, ultrasound doctor, physiotherapist-resortologist. Women who want to improve the aesthetics of the genital organs, reduce the size of the vagina and refresh intimate relationships from all regions of Russia and foreign countries turn to Elvira Kadirovna .

Ermolaev Oleg Yurievich Candidate of Medical Sciences, operating gynecologist with 25 years of successful experience in treating bartholinitis. Able to see relationships that elude others.

Shchepkin Petr Sergeevich Gynecologist, specialist in the treatment of bartholinitis and marsupalization of the Bartholin gland. Experienced ultrasound doctor.

About the doctors of the Clinic in detail...

We work seven days a week and on holidays:

Monday - Friday from 8.00 to 20.00, Saturday, Sunday, holidays from 8.00 to 17.00.

Treatment of bartholinitis, opening of the Bartholin gland and marsupalization of the Bartholin gland by appointment by multi-line phone 8 (800) 500-52-74 (free call within Russia), or +7 (for foreign calls).

The cost of opening the Bartholin gland WITHOUT PAIN is 4250 rubles.

Make an appointment with a gynecologist

If there is severe bursting and throbbing pain in the labia majora, high body temperature (more than 38°C) and/or poor health, we accept without a prior appointment outside the queue.

Treatment of bartholinitis with the help of phytotherapeutic and physiotherapeutic agents allows one to achieve a complete cure and prevent the transition to a chronic form and the formation of an abscess (pseudo-abcess) and a cyst of the Bartholin gland.

With respect for the religion and different habits of our Patients, we achieve high efficiency and comfort of treatment.

We are at your FULL DISPOSAL if you have any doubts or wishes.

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After spontaneous opening of a pseudoabscess of the Bartholin gland, the outpouring of purulent contents, as a rule, does not occur completely.

The pyogenic (pyogenic) capsule is preserved. And after gluing and scarring of the fistula tract, the process begins to mature again.

Spontaneous opening of a Bartholin gland pseudoabscess leads to the formation of a rough scar.

The only consolation for this is the thought of limited access for contemplation...

The cost of opening the Bartholin gland WITHOUT PAIN is 4250 rubles.

Make an appointment with a gynecologist

Acute bartholinitis

Acute bartholinitis has the most obvious clinical manifestations. Causes severe pain, especially when walking. During an exacerbation, favorable conditions are created for the active reproduction of opportunistic microorganisms. Therefore, the inflammatory process often leads to formal purulent diseases.

The specialist prescribes antibacterial agents, drugs that relieve pain and restore the woman’s normal health. At an early stage, local cold is used to relieve the acute process, which is applied to the external genital area. The inflamed area is detected with antiseptics, and ointments with ichthyol are applied.

The development of acute bartholinitis can be provoked by the following unfavorable factors and diseases:

• failure to comply with personal hygiene rules;
• the use of thick underwear, which is especially important for natural ventilation of the skin;
• exacerbation of gynecological diseases, including thrush;
• damage to the mucous membrane of the genital organs, penetration of infectious pathogens from the rectum, vagina and urinary tract through small abrasions;
• hypothermia of the body;
• avitaminosis;
• severe stress;
• hormonal changes in the body.

Infectious pathogens enter the Bartholin gland, enter the bloodstream or through minor injuries to the external genitalia.

It is important to prevent the disease from becoming chronic. Prolonged course of the disease leads to the formation of abscesses requiring surgical intervention.

general information

The main function of the Bartholin gland is the production and secretion of mucous secretion during sexual arousal. If it is not in the required quantity, the vagina will be dry - there will be discomfort, itching and burning in the perineum and pain during intimacy. Normally, this is only possible during menopause due to a decrease in female estrogen hormones.

In women, gynecologists encounter bartholinitis in a variety of age groups and it requires immediate treatment. If you contact the clinic for help in a timely manner, inflammation can be successfully cured in a fairly short period of time.

Bartholinitis according to ICD-10

Diseases of the Bartholin gland (N75): → N75.0 Bartholin gland cyst; → N75.1 Bartholin gland abscess; → N75.8 Other diseases of the Bartholin gland (Bartholinitis); → N75.9 Bartholin's gland disease, unspecified.

Causes of inflammation of the Bartholin gland

The inflammatory process in the gland is caused more often by gonococci, staphylococci, less often by streptococci, E. coli, trichomonas and other microorganisms penetrating from the genital tract or urethra through its excretory duct, which opens into the vestibule of the vagina on the inner surface of the labia minora at the border between its posterior and middle third.

The causes of bartholinitis are a woman’s failure to comply with genital hygiene, weakening of the body, microflora disturbances, and venereal diseases. A lump on the labia can also pop up when the immune system is weakened (stress, hypothermia, vitamin deficiency) and after surgical interventions (surgery, medical abortion).

Constant rubbing of the external genitalia, combined with wearing tight clothing made from synthetic fabrics, also promotes the entry of germs. However, even the presence of sexually transmitted infections in the body does not always lead to inflammation of the Bartholin gland - much depends on the state of the immune system.

With bartholinitis, the infection can enter the gland through the blood from foci of a sluggish chronic inflammatory process (tonsillitis, sinusitis, caries, pyelonephritis).

Photo of bartholinitis (conditional comparison)

Photo 1. Bartholin's glands are normal.

Photo 2. Stages of progression of acute bartholinitis.

Photo 3. Bartholin gland cyst (abscess).

Symptoms of bartholinitis

Acute bartholinitis in women manifests itself with symptoms:

1. pain and the appearance of a tumor in the labia area, inside on one or both sides,
2. redness and then swelling, indicating the formation of an abscess,
3. body temperature often rises,
4. malaise and weakness are noted.

Usually there is unilateral inflammation. An acute process, developing, causes swelling, which blocks the excretory duct of the gland and causes its blockage with the formation of a lump of varying size at the base or between the labia. In turn, pus, which cannot come out, accumulates inside and leads to the formation of a cyst.

The Bartholin gland, which is usually invisible in a healthy woman, greatly increases in size as a result, which explains the characteristic symptoms: the disease is always accompanied by severe pain in the inflamed area, and the size of the enlarged gland can reach several centimeters in diameter, which gives the sensation of a foreign body, a tumor in perineum near the labia. This initial stage is called acute bartholinitis (see photo on the page below).

The patient's general condition worsens, the temperature can rise to 39C and higher, chills and pain in the intimate area appear. Swelling of the tissues of the labia is well expressed. The skin color is bright red, when pressure is applied there is a feeling of strong, “shooting” pain. Sometimes the inguinal lymph nodes become enlarged. With continued blockage of the excretory duct and retention of pus in it, the gland is painful, enlarged, sometimes reaching the size of a chicken egg - these are symptoms of progressive bartholinitis.

In an acute process, a purulent formation can spontaneously open with the flow of thick yellow-green contents, after which the condition improves. However, this does not mean that treatment for bartholinitis is not required. A relapse can occur at any time, so it is necessary to complete the course as quickly as possible. Otherwise, the disease may enter a chronic phase with constant exacerbations.

Chronic bartholinitis

When it becomes chronic, the disease has a wave-like course - a relatively stable state is replaced by a sudden exacerbation of the disease. At the same time, the external signs of the disease are not clearly expressed.

Symptoms of the chronic form of bartholinitis are often unexpressed; it occurs latently, without any special signs and is diagnosed during a gynecological examination. A gynecologist, when palpating the external genitalia, reveals an uneven compaction along the excretory duct (canaliculitis nodosa) or a retention cyst of the Bartholin gland near the base of the labia. With large sizes of this formation, patients complain of awkwardness when walking, difficulty during sexual intercourse.

Periodic exacerbations of chronic bartholinitis are possible with a minimum frequency of 2-3 times a year, often with the development of a false abscess.

Tests and diagnostics

A standard examination and tests for bartholinitis and the presence of a lump on the labia, which gynecologists will prescribe first, will be as follows:

• Gynecological examination,
• Microflora smear
• PCR tests for “hidden infections”,
• Clinical blood test,
• Blood test for syphilis, HIV, hepatitis B, C,
• Culture of pus for antibiotics,
• General urine analysis.

Chronic bartholinitis

If bartholinitis is not treated effectively at the initial stage, the inflammatory process may take a recurrent course. Treatment of chronic bartholinitis is more difficult and often requires surgical intervention.

During the period of remission, the disease does not have pronounced symptoms. Exacerbations can be triggered by sexually transmitted diseases, menstruation, hypothermia, and infectious processes in the pelvic organs. The chronic form of the disease is manifested by the preservation of a small process on the lips. From time to time, pus may be released from it. A woman suffers from dull pain in the genital area. The pain syndrome intensifies with active movements. During sexual intercourse, unpleasant sensations may occur, and frantic separation from the inflamed Bartholin gland may intensify.

How to treat bartholinitis

When the first symptoms appear, even a small and less painful lump, a “ball” in the perineum, urgent action will prevent the development of the disease and possible complications requiring surgical intervention. In the initial stages, when treating bartholinitis without compression of the labia, the woman is recommended to have bed rest, analgesic and antibacterial therapy, but if the condition worsens, hospitalization is necessary. The main goal of therapy at this stage of the disease is to suppress the pathogen and prevent the infection from becoming chronic. The attending gynecologist decides which antibiotics to take, but preference is given to drugs with a broad spectrum of antimicrobial action.

Treatment of bartholinitis at home

It is possible to treat inflammation of the Bartholin glands at home only with the permission of a gynecologist, if the situation allows it. In this case, sitz baths are made using antiseptic solutions (this can be a weak solution of potassium permanganate, miramistin, chlorhexidine, etc.). Antibiotics, ointment with ichthyol and Vishnevsky's balsamic liniment have proven themselves well. These procedures do not replace the need for tests, medications and, possibly, surgery.

Surgery for bartholinitis

Surgery to remove bartholinitis can be done in our clinic. With a progressive increase in the round formation in the labia area, surgical treatment may be required.

1. Open bartholinitis. → 2, Remove pus. → 3. Clean the cavity, rinse with an antiseptic. → 4. Place drainage/catheter. → 5. Send purulent discharge for bacterial culture. → 6. Apply a bandage with Vishnevsky ointment.

Brief description of the operation of opening bartholinitis

Opening a cyst or abscess of the Bartholin gland by a gynecologist involves making an incision in the mucous membrane on the side of the entrance to the vagina, above the suppurating gland to create an outflow of purulent contents. To do this, the abscess is opened under local anesthesia and its contents are removed. The doctor treats the cleaned cavity with a disinfectant solution, usually hydrogen peroxide. Drainage in the form of an elastic band or catheter is inserted inside, through which pus flows out. The drainage material is removed 5-7 days after surgery. The cleaned cavity is treated daily with antiseptics and then filled with a gauze swab with Vishnevsky ointment or levomekol. At the same time, after the operation, antibiotics are prescribed intramuscularly, suppositories with antispasmodics, and multivitamins.

If there is a formed Bartholin gland cyst, surgery is the only way to solve the problem. Surgical options are marsupialization, i.e. the process of secretion outflow is ensured by creating an artificial channel, and extirpation, i.e. removal of the gland itself completely.

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Where to go with bartholinitis in Moscow

You can recover from bartholinitis, remove an abscess or a festering cyst using the least traumatic and most effective method from the gynecologists of our medical clinic. Progressive, modern techniques and adequate pain relief during surgery are the key to high efficiency and excellent results of treatment for inflammation of the Bartholin gland. Gynecologists on this problem are presented at the bottom of the page.

Cost of services

Outpatient care within a reasonable time frame

Diagnosis of the disease

Diagnosing a Bartholin gland cyst is not difficult. A round, painless and unwanted formation is palpated in the thickness of the labia majora. Externally, the labia majora may be enlarged; the pole of the cyst partially covers the entrance to the vagina. Unlike a cyst, with bartholinitis the formation is painful, tense; when an abscess forms, the skin over the formation becomes motionless, the formation itself is dense, hot to the touch, sharply painful, so it is impossible to touch it. Possible enlargement of the inguinal lymph nodes.

However, it is necessary to carry out a differential diagnosis to exclude bartholinitis-like diseases in their manifestations, such as lipoma, folliculitis and a number of others.

To assess the formation, it is informative to perform an ultrasound of this area - performed with a conventional vaginal sensor. A Bartholin gland cyst on ultrasound looks like a thin-walled oval-shaped cavity, in which there may be septa, but the contents are homogeneous, “transparent”, the internal contour is uniform. With bartholinitis, the walls of the cyst are thickened, the internal contour is uneven, and the contents are heterogeneous.

TREATMENT OF BARTHOLIN'S GLAND CYST IS AVAILABLE IN THE BRANCHES:

Treatment of Bartholin gland cyst in the Primorsky region

Address: St. Petersburg , Primorsky district, st. Repisheva, 13

Treatment of Bartholin gland cyst in the Petrograd region

Address: St. Petersburg , Petrogradsky district, st. Lenina, 5

Treatment of Bartholin gland cyst in Vsevolozhsk

Address: Vsevolozhsk , Oktyabrsky Prospekt, 96 A

Treatment of bartholinitis

Small, asymptomatic cysts should not be treated. They are usually removed only for cosmetic purposes. Only large cysts - from 3 cm or more, which not only disrupt the aesthetic appearance of the external genitalia, but also interfere with daily activities and sexual activity - are subject to surgical treatment.

There is no need to simply open or puncture the cyst or abscess. This can lead to recurrence as the tissue edges close very quickly during the puncture or incision due to the rapid healing process.

The main goal of surgical treatment is to preserve the Bartholin gland and its functionality, and to form a channel for the outflow of secretions. There are several treatment options. Let's look at each of them.

Treatment methods

Treatment of bartholinitis depends on the severity of the disease. The inflammatory process of mild to moderate severity can be eliminated with conservative therapy; in severe and advanced cases, surgery is necessary.

Even if there is a chance to cure bartholinitis without surgery, it is important to maintain bed rest. Reducing physical activity during treatment will help reduce the severity of pain and reduce the risk of re-infection. If bed rest is not possible, you should at least limit physical activity.

To eliminate unpleasant symptoms, complex therapy is recommended. Swelling can be reduced by applying a small ice pack wrapped in a thick cloth. Cold also reduces pain and inflammation.

Local antibacterial and antimicrobial drugs are applied to the affected area:

• Vishnevsky ointment;
• Levomekol;
• ichthyol ointment.

Preparations for external use are applied as a tampon and changed periodically.

Broad-spectrum antibiotics are used to suppress the activity of pathogenic bacteria. They can be supplemented with antifungal agents, vitamins and drugs to maintain intestinal microflora.

If conservative treatment measures are ineffective, surgery is performed to remove the Bartholin gland. It comes in two types:

• Extirpation. The inflamed gland is completely removed. After the operation, it is necessary to undergo rehabilitation and abstain from sexual activity for a while in order to avoid infection.
• Marsupialization. A new excretory duct is formed. If the incisions stick together some time after surgery, this may lead to recurrence of the disease. In this case, acute bartholinitis develops again.

Surgical intervention may be repeated. To avoid the appearance of unsightly scars and a long rehabilitation period, special ring-shaped catheters are used. They pass through the body of the gland and are installed for up to 2 months. The catheter forms an additional excretory duct and reduces the risk of re-infection.

If an abscess has formed, the only option is surgery. The cavity is opened and drained, then washed with a disinfectant solution. Antibiotic therapy and physiotherapy reduce the risk of relapse.

During the recovery period, ultraviolet irradiation, magnetic therapy, and physiotherapy are prescribed. They accelerate the healing of postoperative sutures and tissue regeneration. It will take a long time for a complete recovery to occur.

Catheter placement

This is a modern method of surgical treatment of cysts. This is especially true when it recurs.

Under local anesthesia, the cystic area is opened with a small incision of about 5 mm, after which its contents are removed and sent for bacteriological examination, then the cyst cavity is washed and a Ward catheter is installed. This is a silicone tube 55 mm long and 5 mm in diameter, inside of which there is a channel with thinner walls at the end. By inflating a 3 ml rubber tip with 0.9% saline sodium chloride solution, the doctor fixes the catheter in the cyst cavity. For better fixation and to prevent loss during movements, it is recommended to apply 2-3 interrupted absorbable sutures along the contour of the outlet part of the catheter. The other end of the catheter is inserted into the vagina.

The catheter remains in the cyst cavity for six weeks. This is necessary to form a channel for the passage of secretions, the walls of which will not grow together. Research shows that the Word catheter is easy to use, inexpensive to install, and has acceptable short-term effects.

While the catheter is in the cavity of the cyst, the patient is recommended to be at sexual rest to avoid its loss. In some countries, such a restriction does not exist, since subsequent studies have noted that the painful symptom caused by both the cyst itself and the presence of a catheter in its cavity completely disappears by the sixth day.

As an alternative, a Jacobi ring is used. This catheter is more rigid, has no channel and is shaped like a ring. It is inserted through two punctures in the mucous membrane and in the capsule of the cyst, then the two ends of the catheter are fixed to each other.

Marsupialization of the cyst

Marsupialization of a cyst is a simple outpatient procedure. It is performed under local anesthesia for 20-30 minutes. An oval flap 1.5 cm long is cut out in the most convex part, the cyst itself is dissected in the same way, after which it is cleaned and washed. Then the cyst wall is sutured to the mucous membrane of the lip, forming an artificial duct. The wound does not need to be sutured; it heals on its own.

On the second day after surgery, the patient is shown warm sitz baths, and on the third day, stool softeners are prescribed. They are necessary for the prevention of constipation, since hard stool increases pain in the postoperative area, and its stagnation in the colon contributes to the accumulation of harmful microbes that can penetrate through the tissues in the postoperative area. Sometimes antibiotics are prescribed based on the results of a microbiological test. You can resume sexual activity as early as the fourth week after surgery.

The probability of relapse after masculipialization is extremely low - about 10%. The operation itself can be performed several times, as it is simple and less traumatic than complete removal of the Bartholin gland.

CO2 laser

CO2 laser surgery is also an effective treatment for cysts and can be performed on an outpatient basis. An incision is made in the skin with a focused laser beam, then the capsule is opened to remove the contents of the cyst, followed by internal evaporation of the damaged capsule.

Carbon dioxide ensures complete healing in an average of 22 days without the appearance of scars, bruises and wound infections. You will be able to return to your daily routine in about two days. Patients who undergo traditional surgery require 14 days to return to daily activities and 28 days for the surgical wound to fully heal. For this reason, and with the minimal risk of complications that may occur during or after surgery, CO2 laser surgery is more cost-effective than traditional treatment.

Removal of Bartholin's gland

If the cyst recurs frequently with the formation of an abscess, doctors recommend removing the cyst along with the gland. The operation requires a lot of experience and precision from the surgeon. It is performed under intravenous anesthesia. This is often performed in a hospital setting.

The incision is made outward from the labia minora, since the opposite side of the mucous membrane is usually thin, as a result of which the cyst capsule can be accidentally cut. The cyst is removed carefully with gauze napkins, while the incised fiber is moved to the side. The gland is also removed. The wound is sutured in layers with absorbable sutures. It is very important to remove the entire gland. Incomplete removal may cause recurrence of the cyst or abscess. If the other Bartholin gland is functioning normally, there will be no problems with secretion after this operation.

It should be understood that during surgery the cyst capsule may rupture. This can slow down the duration of the operation and lead to contamination of the wound. In addition, the practitioner may experience bleeding from the vessels of the cyst bed, but this is easily stopped with the help of submersible sutures.

After removal of the Bartholin gland, a rectovaginal fistula, an abnormal channel between the rectum and vagina, may occur. It appears as a result of ongoing inflammation and “melting” of surrounding tissue.

In this case, patients may complain of pain in the perineum that occurs during sexual intercourse and defecation. To establish and confirm the diagnosis, you must contact a coloproctologist, undergo a gynecological and rectovaginal examination, as well as additional examinations. The tissue defect is corrected using an autograft, a biological collagen plug or a titanium clamp. If a fistula is discovered during pregnancy, natural childbirth is prohibited.

Bartholinitis during pregnancy

The occurrence and exacerbation of bartholinitis during pregnancy is dangerous for both the mother and the fetus. The infection threatens the normal intrauterine development of the child and can even lead to his death. And the presence of a purulent focus in the vestibule of the vagina during childbirth is generally unacceptable, since its rupture will lead to infection of the woman and child and the development of infectious complications.

The principles of treating bartholinitis during pregnancy remain the same. But the difficulty is that many antibiotics cannot be used in pregnant women, and the operation is more risky. Therefore, treatment of bartholinitis in pregnant women is carried out in a hospital.

When preparing for pregnancy, it is necessary to conduct an examination and, if necessary, treatment of identified infections to prevent bartholinitis.

Prevention of bartholinitis

To prevent the development of the disease, it is necessary to visit a gynecologist every six months, who can promptly detect the presence of various infections and inflammatory processes. Thanks to this, you can begin the necessary treatment on time, which guarantees a complete recovery.

In addition, to prevent infection with diseases transmitted through sexual contact, it is necessary to use protective equipment: condoms, promiscuity should be avoided.

Proper nutrition, hardening and the absence of bad habits are of great importance for maintaining the body in a healthy state. Thanks to this, the body’s immune system will fully function and prevent the development of various diseases, including bartholinitis.

Possible complications

Without timely treatment, the inflammatory process can cause dangerous complications.

Possible negative consequences of the disease:

• Formation of pathological communications between the vagina and other organs, such as the rectum or bladder. Fistulas occur as a result of the fusion of tissue with pus.
• Deformation of the vulva.
• The spread of infection to the bladder, cervix, epididymis and other organs, leading to severe inflammation.
• Penetration of pathogenic microorganisms into the bloodstream with the development of sepsis. This is a serious condition accompanied by poisoning of the body with toxins.

If complications occur, surgical treatment is always performed. The disease usually does not affect pregnancy.

Treatment prices

FAQ

How is bartholinitis treated during pregnancy?

In case of an acute process, local treatment is used in full: baths, ointments, compresses. Only antibiotics are prescribed that will not harm the fetus. The abscess is punctured only when necessary. For chronic bartholinitis, surgical treatment is carried out after childbirth.

Are antibiotics needed to treat bartholinitis?

Necessary because the infection can only be eliminated with antibiotics. Broad-spectrum drugs are used or selected taking into account the sensitivity of the identified microorganisms.

Do folk remedies help with bartholinitis?

Traditional recipes can only be used in conjunction with traditional medicine methods. Otherwise the process will only get worse.

What to do to avoid relapses of bartholinitis?

The chronic process leads to relapses, which can be caused by self-opening of the abscess and subsequent re-infection. Opening a purulent focus should be carried out only in a hospital setting, where antiseptic treatment of the abscess is carried out, complete emptying of the cavity from pus and proper care of the wound. If the abscess opens spontaneously, it is also necessary to consult a doctor who will carry out complete drainage and, if necessary, form a new gland duct. It is mandatory to maintain personal hygiene, avoid tight underwear, and adhere to all preventative standards.

How many days does bartholinitis last?

Each stage of the disease lasts a certain time (acute canaliculitis 1-4 days, false abscess from 2 to 7 days, true abscess - until opening). Post-operative recovery may take from a week to a month (depending on the severity of the initial situation). Chronic bartholinitis can last for years until a woman finally consults a doctor and begins treatment.

What are the complications of bartholinitis?

As a rule, most often bartholinitis gives complications such as the development of a cyst (capsule with purulent contents), the formation of a fistula (a pathological canal (socket), the exit from which can be located anywhere), various diseases of the genitourinary system (vulvitis, urethritis, cystitis, pyelonephritis , colpitis, etc.), as well as sepsis (blood poisoning and infection of the whole body).

Is it possible to cure bartholinitis at home?

It is advisable to treat bartholinitis in a hospital setting, under the supervision of a doctor, to avoid the inflammatory process becoming chronic. In addition, under no circumstances should you open abscesses yourself, and if the temperature rises and symptoms of intoxication appear, urgent medical attention is required. At home, it is possible to carry out conservative treatment (only with the permission of a doctor) if all instructions are followed.

Treatment

Treatment can be conservative or surgical.

Conservatively, the disease can be treated on an outpatient basis with antibiotics, but exacerbation of bartholinitis requires inpatient treatment. The goal of therapy is complete elimination of the inflammatory focus. As a result, the patient has pain, discomfort in the perineum, and swelling is eliminated. Timely treatment of bartholinitis will help prevent the development of abscess and cyst formation.

In the conservative treatment regimen the following is used:

• medications – antibacterial agents, anti-inflammatory drugs, painkillers;
• local therapy - represented by cold compresses to reduce swelling, warm baths of saline or disinfectant solutions, baths with herbal decoctions are also used;
• physiotherapy is a powerful supportive treatment method in which the patient is prescribed magnetic therapy, UHF, laser therapy;
• As additional methods of strengthening the immune system, a course of vitamin therapy and immunomodulatory agents is recommended.

If surgical intervention is indicated for bartholinitis, i.e. If an abscess has developed, the ducts have festered, a fistula has opened, or a cyst has formed, then the doctor will remove the purulent contents of the abscess, and if there is a cyst, he will remove it while preserving the organ. For five weeks, a catheter is placed in the gland to form an outlet through which exudate is removed.

Removal of the gland is an extreme measure, which doctors resort to only in exceptional cases, when the favorable time for conservative and surgical treatment has been missed, but the pathology persists, and relapses become more frequent. In case of a complicated course of the disease, fistulas that do not heal for a long time are formed, and a rupture inward is life-threatening - in this case, going to the clinic should be urgent.