Bartholinitis is an inflammatory disease of the Bartholin glands, a paired organ found deep in the subcutaneous fat in advance of the vagina at the very base of the large labia. Bartholin glands produce a viscous protein secret – a lubricant that lubricates the vagina during intercourse – this is the main, and indeed, their only function. These glands were named after the Danish doctor Kaspar Bartolin, who in the distant 1677 first described these glands in terms of woman’s anatomy. Also in the literature, some authors call bartholin glands large vestibular glands.
The appearance of dense formation of various sizes in the area of the entrance to the vagina. Sometimes this compaction completely blocks the entrance to the vagina.
Pain when you feel the inflammation. The appearance of bright red spots around it. The skin above the site of inflammation is hot.
Severe pain when walking, sometimes a woman can not move at all.
Raise body temperature to 39 ° C. Chills, fever.
Lethargy, increased fatigue.
The appearance of a purulent abscess of the Bartholin gland is a kind of “lump” at the entrance to the vagina. In size, the abscess can reach the size of a chicken egg.
Symptoms of bartholinitis differ slightly depending on its shape – acute or chronic. With acute bartholinitis, a false abscess usually occurs and acute pain, which is difficult to walk, reaches a temperature of 39 ° C. Over time, the abscess breaks (or it is opened in the hospital). If you uncover this abscess at home on your own, then the risk is high that not all pus will be removed. In this case, the symptoms soften, but do not disappear completely – so the chronic form of the disease begins.
Symptoms of chronic bartholinitis are practically the same, unless the pain is not so acute and the temperature does not always rise. They usually appear during menstruation, with hypothermia, weak immunity, seasonal exacerbations are possible.
Often, bartolinitis occurs simultaneously with sexual diseases, so the symptoms of these infections are also present – itching in the vagina, burning, discharge, red spots, etc.
Causes of occurrence.
The most common cause of bartholinitis is the infection in the Bartholin glands. Usually, the infection penetrates the glands through the opening of the excretory duct. Bacteria penetrate into the glands deeper and begin to multiply actively, resulting in inflammation, and in some cases, suppuration of the Bartholin glands. In most cases, only one gland inflames.
First, there is a slight tightness on the eve of the vagina. This compaction leads to plugging of the excretory ducts and the entire secret that is secreted by the Bartholin glands begins to accumulate in the duct – thus forming a cyst. But the inflammation continues: pus appears, the compaction grows in size, the infection penetrates even deeper into the gland – there is an abscess of the Bartholin gland. The abscess is filled with a thick yellowish-greenish pus with a characteristic odor.
The main causes of bartholinitis.
Diseases transmitted sexually – gonorrhea, trichomoniasis, chlamydia. Gonococci, Trichomonas and chlamydia are precisely those bacteria that provoke various kinds of inflammatory processes. Gonorrheal bartholinitis is especially difficult to treat.
Non-observance of the rules of hygiene of the external genital organs – bacteria can accumulate and penetrate into the Bartholin glands. Especially careful hygiene should be with concomitant candidiasis (thrush.
Risk factors for the appearance of bartholinitis – weak immunity, hypothermia, menstruation, sexual acts with menstruation, wearing tightening underwear.
Bartholinitis in pregnancy.
The course of bartholinitis during pregnancy does not have any of its features. However, it is important to remember that an infection can harm a baby. Penetrating through the placenta and umbilical cord into the fetal blood system, infection can significantly affect the laying of the child’s organs. Thus, the most dangerous bartolinite in the first trimester of pregnancy – or rather, from the first to the fourteenth week. Determine the extent of bartolinite exposure on the baby is difficult enough, but a severe infection can lead to fetal death.
It is important for a woman to remember: with the first symptoms of bartholinitis during pregnancy, you need to see a doctor as soon as possible. Any delay can significantly increase the risk of infection of the child.
The diagnosis of bartholinitis begins with a standard examination of the external and internal genitalia of the patient at the gynecologist. Sealing is detected without much difficulty. In addition, the doctor will ask the woman about some symptoms and possible causes of inflammation. In any case, a laboratory study of the secretions from the Bartholin glands is carried out for the precise determination of the causative agent of the disease. Also takes a swab from the vagina – maybe the infection has penetrated and there. Based on the diagnostic results, the doctor decides on additional tests and prescribes treatment.
Treatment of bartholinitis.
It is advisable to treat bartholinitis in a hospital under the supervision of a doctor, especially if it is an acute form of the disease. When forming a cyst Bartholin gland surgical treatment. In case of abscess, doctors open it, remove all pus. It happens that it is necessary to remove the bartholin gland. After removal of the abscess, antibacterial therapy is prescribed.
Antibiotic therapy includes the appointment of antibiotics Tetracycline, Azithromycin, Ofloxacin, etc. and also special ointments and solutions for topical application. Antibiotic is chosen depending on the pathogen and the cause of bartholinitis. When taking antibiotics, it is also worthwhile to support the intestinal microflora with Linex, polyvitamins.
For local treatment of bartholinitis, the following agents can be used.
Acceptance of sedentary baths with the addition of a weak solution of potassium permanganate (slightly pink baths), as well as chamomile broth – take 15-20 minutes 2-3 times a week.
Treatment of the seal and surrounding areas with Betadine solution – rinsing or moist compress.
The use of ointments – Vishnevsky ointment, Ichthyol, phonophoresis with hydrocortisone ointment. The best option is to apply these three ointments in turn. Ointment is applied to cheesecloth or cotton swab, then this tampon is fixed. In order not to lose the tampon, it is better to lie when performing the procedure. Tampons apply twice a day – in the morning and in the evening, apply until complete recovery.
At the time of treatment, a woman should avoid sexual contact, physical activity. It requires proper nutrition – no acute and fatty foods.
Diagnosis of inflammation of the Bartholin glands is a minute affair, but the treatment is quite long, especially when forming a cyst or abscess. Bartholin glands are in dense connective tissue, which slows the action of antibiotics.
When the cyst is formed, the bartholin gland is excavated – a technically difficult operation, in which relapses often occur. But there is another option – the implementation of the marsupilization of the Bartholin gland. The essence of this operation is that the surgeon forms a new output channel for the normal functioning of the gland. Marsupilation is a simple operation, it is performed under local anesthesia.
If the disease is treated in a timely manner, then the probability of recovery is high. The most difficult is gonorrheal bartholinitis, which can lead to infertility.
Preventive measures to prevent this disease include the thorough hygiene of the genitals, avoidance of casual sexual intercourse, the use of a condom during sexual intercourse. It is also recommended to wear underwear made of natural fabric, to exclude synthetics from the wardrobe. And most importantly – in time to identify bartolinite and soon begin its treatment.