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Bartholinitis

Bartholinitis is inflammation of the Bartholin glands. These are structures found at the level of the vestibule of the vagina and are part of the female reproductive system. These glands are important for lubrication of the vagina but are also prone to blockage and infection.


Presentation

Bartholinitis involves inflamed Bartholin cysts and Bartholin abscesses. Both are common gynecological complaints, although abscesses occur more frequently than cysts [1]. Bartholin cysts are formed when the gland ducts are blocked, leading to swelling that is typically painless. Obstruction of the ducts is often precipitated by inflammation or trauma. Pain and dyspareunia may be experienced with an increased size of the cysts [2] [3].

Abscesses may arise as a complication of cyst infection or may occur spontaneously without prior pathology. The former differ from cysts in presentation, as they always cause pain. Typically patients may complain of vulval pain, which is amplified by certain daily activities such as walking. Some may also report the presence of a discharge associated with the cessation of pain. This is indicative of spontaneous rupture.

Physical examination of the vulva may reveal a unilateral labial swelling. In the case of an abscess, the mass is tender, and the surrounding tissue may also be inflamed and edematous. Some patients present with fever, although this is not common. Cysts may either be painful or painless. Ruptured abscesses may still be draining pus, which would be observed as a purulent discharge. Ruptured cyst discharges are non-purulent.

Bartholin abscesses can be caused by numerous pathogens, however, the most commonly cultured organisms are bacteria, of which the most common is the Escherichia coli species. The choice of antibiotics used depends on bacterial culture [4].

Overeating
  • Sometimes the abscesses spontaneously open, but the autopsy does not mean that the bartholinitis is over. Symptoms become less painful, but do not disappear at all. Often at this stage the disease passes into a chronic stage.[acikgunluk.net]
  • Bartholin's cysts are most likely to occur in women of child-bearing age although when they occur in women over 40, sometimes the doctor will recommend a biopsy just to be sure there are no cancer cells present, even though cancer of the Bartholin's gland[diki.pl]
  • Is there any over the counter remedies I can use OneHowTo Editor 24/07/2018 Hi Elizabeth, The only advice we could or should is to visit a doctor.[health.onehowto.com]
  • Get control over your healthcare and the treatment you need – without lengthy waiting lists.[aviva.co.uk]
  • Fluid may build up over many years before an abscess occurs. Often the abscess appears quickly over several days. The area will become very hot and swollen. Activity that puts pressure on the vulva , and walking and sitting, may cause severe pain.[nlm.nih.gov]
Heart Disease
  • It covers key issues ranging from osteoporosis to breast cancer and other cancers, domestic violence, sexually transmitted diseases, occupational hazards, eating disorders, heart disease and other chronic illnesses, substance abuse, and societal and behavioral[books.google.com]
Ulcer
  • When suppuration and the appearance of fluctuations revealed opening of the abscess, the introduction into the cavity of the emptied ulcer turunda with hypertonic sodium chloride solution.[iliveok.com]
Dyspareunia
  • Pain and dyspareunia may be experienced with an increased size of the cysts. Abscesses may arise as a complication of cyst infection or may occur spontaneously without prior pathology.[symptoma.com]
  • Symptoms of large cysts include vulvar irritation, dyspareunia, pain during walking, and vulvar asymmetry. Bartholin gland cysts may form abscesses, which are painful and usually red. Diagnosis is by physical examination.[merckmanuals.com]
  • Most Bartholin's cysts do not cause any symptoms, although some may cause pain during walking, sitting, or sexual intercourse (dyspareunia). They are usually between 1 and 4 cm, and are located just medial to the labia minora.[en.wikipedia.org]
  • Complications such as hematoma, dyspareunia and infection may occur [ 3 ].[doi.org]
  • Approximately 5 to 15 percent of Bartholin's duct cysts recur after marsupialization. 18 Complications associated with the procedure include dyspareunia, hematoma, and infection. 1 EXCISION Although Bartholin's gland abscesses may rupture and drain spontaneously[aafp.org]

Workup

In addition to a physical (pelvic) examination, pus cultures should be ordered to determine the causative organism. This will guide the treatment. Any vaginal discharges noted should also be cultured. In older women, a biopsy may sometimes be carried out. Screening tests for sexually transmitted diseases (STDs) are not routine but can be carried out in some cases.

Imaging techniques that can be used in the investigation are high definition ultrasonography, computed tomography (CT) scanning, and magnetic resonance imaging (MRI) [5] [6] [7].

Treatment

  • Once we've approved your claim, you'll get the private treatment you need. 3 And we’ll pay for treatment After you've been treated, send us your invoices.[aviva.co.uk]
  • Such a treatment also requires coordination with the doctor.[tip10.info]
  • Treatment Because treatment should designate your attending doctor, here we consider the treatment of bartholinitis in the home.[medicalj-center.info]
  • Treatment of a bartholinitis Treatment of a bartholinitis has to be carried out in a hospital under constant control of specialists.[en.medicalmed.de]
  • Treatment of the bartholinite In the initial stage of acute bartholinitis, with the goal of arresting the inflammatory process, conservative treatment is prescribed (bed regimen, antibiotics or sulfonamides, an ice pack, painkillers).[iliveok.com]

Prognosis

  • Review of the literature regarding etiology, clinical and pathological diagnosis, prognosis and treatment identified 18 journal articles and 6 books.[doi.org]
  • However, if the diagnosis of cancer is delayed, the prognosis can be poor. Pathology Obstruction of the distal Bartholin's duct may result in the retention of secretions, with resultant dilation of the duct and formation of a cyst.[aafp.org]

Etiology

  • Etiology of Bartholinitis Bacterial infection with Neisseria gonorrhoeae, Chlamydia trachomatis, E. coli or Staphylococcus aureus. Signs and Symptoms of Bartholinitis Unilateral enlargement of the vulva with redness, pain and fever .[urology-textbook.com]
  • Review of the literature regarding etiology, clinical and pathological diagnosis, prognosis and treatment identified 18 journal articles and 6 books.[doi.org]
  • Etiology Bartholinitis is inflammation of bartholin gland on both sides of the lower 1/3 of the labia majora. Its diameter is about 0.5-1.Ocm. The duct length is 1.5-2.Ocm. The gland's opening near the hymen is located inside the labia minora.[americandragon.com]
  • Etiology is frequently polymicrobial, with Bacteroides spp. and Escherichia More Details coli being the predominant organisms while Chlamydia trachomatis has also been implicated as a cause of bartholinitis. [3] , [4] We report here a case of Bartholins[ijpmonline.org]
  • Histogenesis and the etiological role of human papillomavirus. Am J Pathol 1993;142: 925-933. Peled N, David Y, Yagupsky P: Bartholin's gland abscess caused by Brucella melitensis. J Clin Microbiol 2004;42:917-918.[doi.org]

Epidemiology

  • Epidemiology Bartholin's duct cysts, the most common cystic growths in the vulva, 4 , 5 occur in the labia majora. 6 Two percent of women develop a Bartholin's duct cyst or gland abscess at some time in life. 6 Abscesses are almost three times more common[aafp.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Cysts are common complications of the Bartholin's gland, affecting the ductal region due to outlet blockage [ 2 ]. When the Bartholin's gland duct orifice becomes obstructed, the glands produce a build-up of mucus.[doi.org]

Prevention

  • Inflammatory edema may clog the duct cancer, preventing the release of purulent secretions, which, lingering in the channel, stretches it, forming a cyst (false abscess).[eurodoctor.ucoz.com]
  • Both complications usually arise when there is an obstruction of the gland exit orifice that prevents adequate drainage of their fluids.[tabletsmanual.com]
  • Prevention The most important rule in the prevention of bartholinitis – is the observance of rules of personal hygiene. To do this, after sleeping and before and also after each bowel movement to wash the perineum and genitals with warm water.[medicalj-center.info]
  • When doing your business, always wipe from front to back to prevent germs moving from the anus to the vagina. Use condoms during all sexual activity to protect against sexually transmitted diseases.[health.onehowto.com]
  • After an extract from a hospital for prevention and prevention of emergence of symptoms of a bartholinitis on the other hand the woman needs to follow rules of personal hygiene strictly.[en.medicalmed.de]

References

Article

  1. Omole F, Simmons BJ, Hacker Y. Management of Bartholin's duct cyst and gland abscess. Am Fam Physician. 2003;68(1):135-140.
  2. Lee MY, Dalpiaz A, Schwamb R, Miao Y, Waltzer W, Khan A. Clinical Pathology of Bartholin's Glands: A Review of the Literature. Curr Urol. 2015;8(1):22-25.
  3. Boujenah J, Le SNV, Benbara A, Bricou A, Murtada R, Carbillon L. Bartholin gland abscess during pregnancy: Report on 40 patients. Eur J Obstet Gynecol Reprod Biol. 2017;212:65-68.
  4. Kessous R, Aricha-Tamir B, Sheizaf B, Steiner N, Moran-Gilad J, Weintraub AY. Clinical and microbiological characteristics of Bartholin gland abscesses. Obstet Gynecol. 2013;122(4):794-799.
  5. Berger MB, Betschart C, Khandwala N, Delancey JO, Haefner HK. Incidental bartholin gland cysts identified on pelvic magnetic resonance imaging. Obstet Gynecol. 2012;120(4):798-802.
  6. Kozawa E, Irisawa M, Heshiki A, Kimura F, Shimizu Y. MR findings of a giant Bartholin's duct cyst. Magn Reson Med Sci. 2008;7(2):101-103.
  7. Eppel W, Frigo P, Worda C, Bettelheim D. Ultrasound imaging of Bartholin's cysts. Gynecol Obstet Invest. 2000;49(3):179-182.

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Last updated: 2018-06-22 12:06