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].
Entire Body System
- Inflammation
Bartholinitis Inflammation, sometimes with abscess formation, in one of the BARTHOLIN'S GLANDS. bartholinitis inflammation of the Bartholin glands. [medical-dictionary.thefreedictionary.com]
As for canaliculata, it is the first form, which is characterized by only a slight inflammation of the prostate. The disease starts with the appearance of small red spots, inflammation of the tissues. [medicalj-center.info]
Inflammation is produced when a small orifice that releases fluid to lubricate the vagina becomes obstructed. This fluid comes from the Bartholin’s glands. [thejoyofwellness.net]
Obstruction of the ducts is often precipitated by inflammation or trauma. Pain and dyspareunia may be experienced with an increased size of the cysts. [symptoma.com]
- Asymptomatic
An asymptomatic cyst may require no treatment, 2 but symptomatic Bartholin's duct cysts and gland abscesses require drainage. Unless spontaneous rupture occurs, an abscess rarely resolves on its own. [aafp.org]
It contains sterile mucus and is asymptomatic. Secondary infection of the cyst produces a Bartholin's abscess. The organisms usually cultured are staphylococci, streptococci, E. coli and on occasion, gonococci. The abscess is often tender. [web.archive.org]
Sitz baths for mild symptoms Surgery for more severe symptoms and for all cysts in women > 40 In women 40, asymptomatic cysts do not require treatment. Mild symptoms may resolve when sitz baths are used. [merckmanuals.com]
- Fever
[…] tumor surface, there may be: Edema surrounding the area A sense of volatility Development of an abscess mostly the size of an egg Often accompanied by inguinal lymph node swelling Severe cases : Fever Headache If not treated, abscesses may rupture on [americandragon.com]
Accompanied by chills, fever, dry mouth, pay less, painful urination, poor sleep soundly upset, red tongue, yellow greasy moss, pulse a few strings.. [acuherbxia.com]
A 33-year-old woman was admitted for a 3-day genital pain without fever and urinary functional signs. The abscess was incised and drained; A. aphrophilus was the only micro-organism that grew from the pus. [ncbi.nlm.nih.gov]
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. [symptoma.com]
Signs and Symptoms of Bartholinitis Unilateral enlargement of the vulva with redness, pain and fever. Therapy of Bartholinitis Antibiotics. A large empyema must be drained by incision. [urology-textbook.com]
- Falling
As for the ways of penetration of pathogens, they primarily fall into the duct from the urethra or the vagina for such violations as urethritis, colpitis. [tip10.info]
Learn simple steps 2 Jul 2018 Aches and pains Diet and exercise, avoiding falls and tips for a quick recovery. [aviva.co.uk]
This disease, widespread in gynecology, to which women of reproductive age are subject the peak of incidence falls on 20-30 years, the frequency of occurrence makes 15%. [medicine-for-you.com]
[…] incision is made; otherwise the cyst can collapse, and a false tract may be created. 16 The incision should be within the introitus external to the hymenal ring in the area of the duct orifice. 10, 16 If the incision is too large, the Word catheter will fall [aafp.org]
- Surgical Procedure
CONCLUSIONS: Bartholin gland infections and Bartholin cysts are uncommon occurrences after surgical procedures that have the potential to obstruct the Bartholin duct. [ncbi.nlm.nih.gov]
A surgical procedure known as marsupialization may be used or, if the problems persist, the entire gland may be removed. Removal is sometimes recommended in those older than 40 to ensure cancer is not present. [en.wikipedia.org]
procedure to drain the cyst, which is performed swiftly under local anaesthesia in the doctor's office. [health.onehowto.com]
As there are reports of septic shock arising as a complication of bartholinitis, it is advisable to include antimicrobial agents in addition to surgical procedures. 1. Zeger W, Holt K. Gynecologic infections. [ijpmonline.org]
Skin
- Erythema
Larger cysts and abscesses are found in the lower vestibular region and typically present with erythema and edema. Biopsy is an effective method for distinguishing between Bartholin's gland cysts and differential diagnosis. [ncbi.nlm.nih.gov]
[…] mass in the pudendum T: Purplish C: Slight yellow and greasy P: Thready Treatment Principle Activate the Blood Resolve Stasis Clear Damp-Heat Herb Formulas Points Clinical Manifestations Local inflammation with pus Deep-rooted, hard and painful boils Erythema [americandragon.com]
Cellulitis with localized erythema and tenderness may develop. Abscesses cause severe vulvar pain and sometimes fever; they are tender and typically erythematous. A vaginal discharge may be present. Sexually transmitted diseases may coexist. [merckmanuals.com]
Primary carcinoma of the Bartholin gland accounts for approximately 5% of vulvar carcinomas. [1, 2, 3, 4, 5] Patients typically have an exquisitely tender, fluctuant labial mass with surrounding erythema and edema. [emedicine.medscape.com]
Neurologic
- Irritability
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]
Urogenital
- 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]
The cyst is usually 1-3 cm in diameter and often asymptomatic, although larger cysts may be associated with pain and dyspareunia. [1, 2, 9, 10] Bartholin abscesses result from either primary gland infection or infected cyst. [emedicine.medscape.com]
- Urinary Retention
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. The cyst may become infected, and an abscess may develop in the gland. [aafp.org]
Cevik M, Savas M, Guldur ME, Boleken ME: Urinary retention as the presentation of Bartholin's duct cyst in a neonate. J Pediatr Adolesc Gynecol 2012;25:e65-67. [doi.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].
Microbiology
- Neisseria Gonorrhoeae
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]
gonorrhoeae, Streptococcus pneumoniae or other bacteria. bartholinitis Gynecology Inflammation of Bartholin's glands, which is usually bacterial bar·tho·lin·i·tis ( bahr'tō-lin-ī'tis ) Inflammation of a vulvovaginal (Bartholin) gland. [medical-dictionary.thefreedictionary.com]
Aerobes: particularly Escherichia coli Neisseria gonorrhoeae (may account for 10-15% of cases) Chlamydia trachomatis (much less frequent than gonorrhea ) Rare pathogens: include S. pneumonia, Haemophilus spp. -- To view the remaining sections of this [hopkinsguides.com]
A Bartholin's duct cyst does not necessarily have to be present before a gland abscess develops. 10 Bartholin's gland abscesses are polymicrobial ( Table 1 ). 4, 11, 12 Although Neisseria gonorrhoeae is the predominant aerobic isolate, anaerobes are the [aafp.org]
- Candida
Why bartholinitis occurs: the main reasons The culprits of the occurrence of the disease are bacteria such as staphylococcus, Escherichia coli, Trichomonas, streptococci, Candida, etc. [en.medicine-worlds.com]
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]
Fourteen women who had marsupialisation were traced and none had suffered a recurrence six months after treatment. Conclusions: The WC is a safe and effective treatment for a Bartholin's abscess. [doi.org]
Treatment of a bartholinitis Treatment of a bartholinitis has to be carried out in a hospital under constant control of specialists. [en.medicalmed.de]
Prognosis
Review of the literature regarding etiology, clinical and pathological diagnosis, prognosis and treatment identified 18 journal articles and 6 books. [doi.org]
Prognosis If abscesses are properly drained and reclosure is prevented, most abscesses have a good outcome. Recurrence rates are generally reported to be less than 20%. [emedicine.medscape.com]
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
Review of the literature regarding etiology, clinical and pathological diagnosis, prognosis and treatment identified 18 journal articles and 6 books. [doi.org]
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]
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, Pathology Department of the disease caused by damp heat evil dipping vulva, and even then Yun poisoned pus. [acuherbxia.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]
Epidemiology
Typically, this lesion presents as a gradually enlarging gland in an asymptomatic, postmenopausal woman. [3] Epidemiology Approximately 2% of women of reproductive age will experience swelling of one or both Bartholin glands. [11] Bartholin gland diseases [emedicine.medscape.com]
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]
Pathophysiology
Pathophysiology Bartholin glands are known to form cysts and abscesses in women of reproductive age. Cysts and abscesses are often clinically distinguishable. [emedicine.medscape.com]
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]
Bartholinitis: prevention Naturally, like any disease, Bartholinitis is easier to prevent than to treat for a long time. And simple preventive measures gain the most importance in the time of a woman bearing a child. [en.medicine-worlds.com]
Both complications usually arise when there is an obstruction of the gland exit orifice that prevents adequate drainage of their fluids. [tabletsmanual.com]
Bartholin gland is responsible for the production of a special viscous substance that prevents dryness in the vagina. [brulanta.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]
References
- Omole F, Simmons BJ, Hacker Y. Management of Bartholin's duct cyst and gland abscess. Am Fam Physician. 2003;68(1):135-140.
- 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.
- 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.
- 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.
- 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.
- 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.
- Eppel W, Frigo P, Worda C, Bettelheim D. Ultrasound imaging of Bartholin's cysts. Gynecol Obstet Invest. 2000;49(3):179-182.