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.
Bartholinitis involves inflamed Bartholin cysts and Bartholin abscesses. Both are common gynecological complaints, although abscesses occur more frequently than cysts . 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  .
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 .
Entire Body System
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]
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)   .
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