Bartholinitis. Abscess and cyst of the Bartholin gland. Treatment

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Bartholin's glands are located in the lower part of the labia majora (one on each side). The task of these glands is to moisturize the vaginal epithelium. They are the ones who produce mucus, which is released during sexual arousal. Bartholinitis is a disease in which inflammation of the Bartholin glands occurs.

Bartholinitis is the most common disease in sexually active women aged 20-30 years. What are the causes and symptoms of inflammation of the Bartholin gland?

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

Causes of inflammation of the Bartholin gland

Typically, the cause of bartholinitis is a bacterial infection. Microorganisms enter the gland through the outlet of the gland duct, where they begin to multiply. As a result, inflammation, suppuration, swelling and blockage of the gland ducts occurs. The mucus in the ducts stagnates, which leads to the formation of a Bartholin gland cyst (accumulation of pus).

The most common cause of inflammation of the Bartholin gland is sexually transmitted diseases:

• gonorrhea
• trichomoniasis
• chlamydia

And:

• failure to comply with intimate hygiene rules (infection with staphylococci, streptococci, E. coli)
• development of inflammation due to candidiasis (thrush)

Factors that can stimulate bartholinitis in women include:

• hypothermia
• weakened immune system
• sexual intercourse during menstruation
• abortion and other uterine surgeries

Causes and mechanisms of the disease

Pathogenic bacteria begin to spread through microscopic breaks in the integrity of the skin, and also through the blood and lymphatic vessels. Direct penetration of pathogenic flora into the mouth of the sweat gland is possible. Subsequently, the process involves the sebaceous glands, hair follicles and subcutaneous tissue.

Provoking factors are non-compliance with personal hygiene rules and careless hair removal during depilation. Wearing uncomfortable synthetic underwear can contribute to the development of skin irritation or diaper rash. Excessive sweating promotes the proliferation of microflora and the development of the pathological process. Metabolic disorders - obesity. Diabetes mellitus and endocrinopathies also create a favorable environment for the development of inflammation. A decrease in immunity after a serious illness or during pregnancy can help reduce the barrier functions of the skin and facilitate the entry of pathogens into tissues.

What symptoms do you see a surgeon for:

• Presence of hernial protrusion
• Daggering pains in the abdomen
• Bloating
• Pain in the right hypochondrium
• Bitterness in the mouth
• Nausea
• Presence of neoplasms on the skin
• Swelling and redness of the skin
• Bone fractures and bruises
• Wounds of any location
• Vomit
• Enlarged and painful lymph nodes

Symptoms of bartholinitis

According to the stage of the disease, bartholinitis can be divided into types:

• spicy
• chronic
• recurrent

At the site of inflammation:

• canaliculitis - inflammation of the excretory duct of the gland
• Bartholin gland cyst

Bartholin's glands are normally the size of a pea. When the Bartholin gland is inflamed (usually occurring on one side), redness, swelling, or swelling is often observed at the base of the labia majora.

A characteristic symptom of bartholinitis is an unpleasant sensation when palpating the inflamed area in the vaginal area, as well as when walking, sitting, changing position, or sexual intercourse. When the inflammation process worsens, suppuration occurs in the gland and body temperature rises to 39 - 40 C, pain in the area of ​​inflammation becomes throbbing, weakness and headache appear. The inguinal lymph glands may also become enlarged.

In the chronic form of bartholinitis, the disease proceeds slowly, without pronounced symptoms. However, during exacerbations, the disease makes itself felt by acute pain in the vagina. As a result of the chronic form of bartholinitis, a Bartholin gland cyst can form.

Catheter placement – ​​Word

This is a modern method of surgical treatment for Bartholin’s gland cyst, especially in case of its recurrence.

Under local anesthesia, the cystic area is opened with a small incision of about 5 mm, the contents are removed and sent for bacteriological examination, the cyst cavity is washed and a Word catheter is installed in it (this is a silicone tube 55 mm long, 5 mm in diameter with a channel inside, blindly ending, with thinner walls at the end, due to which the tip can inflate into a ball, which has no analogues), inflating its rubber tip to 3 ml with a physiological solution of 0.9% sodium chloride, thereby fixing it in the cavity of the cyst. For better fixation and prevention of loss during the woman’s movements, it is recommended to apply 2-3 absorbable interrupted sutures along the contour of the catheter emerging from the cavity of the cyst. The second end of the catheter is inserted into the vagina. The catheter remains in the cyst cavity for 6 weeks. This is aimed at forming a channel for the passage of secretions, the walls of which do not grow together. The study shows that the Word catheter is an easy-to-use, low-cost outpatient procedure with acceptable short-term recurrences. Treatment costs are seven times lower than with marsupialization [7]. While the catheter is in the cyst cavity, the patient is advised to have sexual rest to avoid its loss. In a number of countries there is no such restriction, since studies have shown that the pain symptom caused by both the cyst itself and the procedure performed with the catheter in the cavity completely disappears over time (by day 6) [8]

As an alternative, a Voroda or a Jacobi ring (the catheter does not have a channel, it is harder, shaped like a ring) which is installed through 2 punctures in the mucous membrane and capsule of the cyst and the 2 ends are fastened to each other.

Cyst symptoms

Symptoms of a cyst vary in severity depending on its condition:

• in the absence of inflammation - periodic mild pain in the labia majora, discomfort when walking or palpating
• with inflammation of the cyst - pain in the external genital area, aggravated by physical activity, increased body temperature, weakness, severe swelling and redness at the site of cyst formation.

After inflammation, the cyst can spontaneously open with the release of purulent contents, which can positively affect the woman’s overall well-being.

However, it is important to remember that even in this case it is necessary to consult a gynecologist, since if the cyst is arbitrarily opened, complete cleansing of pus does not occur and surgical intervention is necessary. In addition, it is necessary to pay attention that squeezing out suppuration on your own is PROHIBITED, as it can lead to infection entering the blood and causing general infection (sepsis).

The lack of adequate treatment can lead to the formation of a non-healing fistula (unnatural opening), the spread of infection through the vaginal mucosa, and the spread of inflammation to the urethra. Also, when visiting a gynecologist, you can consult on questions that interest you, for example, painful PMS, as well as undergo the prevention of gynecological diseases, such as ectropion of the cervix.

Complications

The most common complication is the addition of a bacterial infection, resulting in the formation of an abscess. Other complications less common:

1. Vulvovaginitis, cervicitis, urethritis and other inflammatory diseases. This can happen when the infection spreads to nearby organs.
2. Formation of a fistula in the chronic course of the disease.
3. Septic complications.

Another fairly common phenomenon is the re-formation of a cyst.

The likelihood of relapse depends on the quality of treatment provided.

Treatment of bartholinitis

As in any area of ​​health, self-monitoring and timely consultation with a doctor in the early stages of inflammation are important. In this case, antibacterial therapy and pain relief are used. In the early stages of bartholinitis, “home methods” of treatment can be prescribed, including sitz baths or compresses with chamomile, oak bark, miramistin, chlorhexidine, Vishnevsky ointment and levomikol. Treatment is carried out only after consultation with a doctor and in accordance with his recommendations!!!

But when dealing with the acute stage of inflammation or a Bartholin gland cyst, a more categorical intervention is necessary, which boils down to opening the purulent focus, disinfection and removal of the contents. In this case, it is necessary to maintain bed rest, abstain from sexual relations and prevent hypothermia for a certain period of time.

In some cases, inflammation and suppuration may occur again after surgery. In this case, the extription method is used - removal of the Bartholin gland.

How to choose the right therapy

The only effective treatment method is surgery. The use of medications or folk remedies will not help get rid of the pathology. Surgical treatment is not indicated in all cases; the need for surgery is determined by two main factors:

• size of education;
• presence of complications.

Also, the operation can be performed at the request of the woman, due to a cosmetic defect.

Small size

Asymptomatic small cysts do not require surgical intervention. But they need to be monitored in order to begin timely treatment if necessary.

Before the operation, it is recommended to adhere to general rules that are aimed at preventing the development of complications:

1. Follow the rules of intimate hygiene.
2. Wear underwear made from natural materials.
3. Do not wear tight underwear or thongs.
4. Visit your gynecologist regularly and follow his recommendations.

These rules do not cure the disease, but significantly reduce the risk of cyst inflammation and abscess formation.

For large size

If the formation is large, elective surgery is indicated. There are two possible options for surgical intervention: marsupialization and enucleation.

1. Marsupialization is an operation aimed at restoring the patency of the excretory duct of the gland. The main advantage of such an operation is to preserve the function of the gland (most often the operation is performed on the Bartholin glands). The disadvantage of marsupialization is frequent relapses. The essence of the operation is the temporary installation of a silicone catheter, which ensures the patency of the excretory duct.
2. Husking is a more radical method of treatment. The tumor is removed along with the gland and duct. The operation is more traumatic than marsupialization, but does not lead to relapse of the disease.

For abscess

If an abscess forms, urgent surgical intervention is prescribed. The abscess is opened and drainage is installed.

Bartholinitis and pregnancy

Infections that a woman is infected with and that cause bartholinitis can negatively affect the course of pregnancy and the development of the child. Infected mother's blood, entering the child's body through the placenta, can lead to disturbances in the formation of the baby's organs. In the early stages of pregnancy, infection can cause fetal death.

Do not delay visiting your doctor if you have symptoms of inflammation of the Bartholin gland. You can diagnose bartholinitis in our clinic, and also receive qualified help, advice and recommendations by making an appointment with a gynecologist by phone. or the feedback form at the bottom of the page.

Watch yourself, appreciate yourself and be healthy!

Pathogenesis

The resulting inflammation of surrounding tissues occurs in 3 stages:

Stage 1 - Alteration the release of fluid during Stage 2 - Exudation and blood cells from the vessels into the tissue, edema occurs.

Stage 3 - Proliferation (or productive stage) does not occur, since damaging factors continue to operate and therefore the resulting swelling, thickening of the walls, narrowing of the lumen of the canal, thickening of the secretion, resulting in blockage of the duct), the secretion of the Bartholin gland being produced, accumulating, thickening, leads to the formation of a cystic cavity formation, gradually increasing in size. Local defenses fail due to concomitant diseases, decreased general immunity and the aggressiveness of the flora that causes inflammation. Reaching a size of 4 or more centimeters, squeezing the surrounding tissues, causes pain in a woman and can, turning into an inflammatory process, cause an abscess of the Bartholin gland [2] [3] [4]

The causes and mechanism of development of Bartholin’s gland abscess are described below in the “Complication” section.

Cost of treatment for Bartholin gland cyst: