Bartholin glands inflammation. Bartholinitis. Causes, symptoms and treatment. Manifestations by stage

Bartholinitis is an acute infectious inflammatory disease of the large Bartholin gland with subsequent involvement of nearby tissues with the formation of a capsule filled with pus.

The disease affects one of the glands; bilateral inflammation is rare.

Let's figure out what kind of disease this is, how to get rid of bartholinitis, how to treat inflammation of the Bartholin gland using medications at home, and whether it is possible to do without surgery.

general information

Bartholin's glands are located in the labia majora and produce a mucous, protein-rich secretion. The secretion of the Bartholin glands maintains constant moisture in the vagina.

During sexual arousal, secretion is activated, a large amount of mucus facilitates the penetration of the male genital organ into the vagina.

The secretion of the Bartholin gland also plays an important role during childbirth: it helps to stretch the vagina and serves as a natural lubrication of the birth canal.

With insufficient secretion, the vagina dries out, this is manifested by itching and burning in the perineum, sexual intercourse becomes unpleasant and painful.

After menopause, the activity of the Bartholin glands decreases against the background of a natural decrease in estrogen levels.

The ICD-10 code for bartholinitis is N75.

Causes

What causes bartholinitis? The disease develops when pathogens penetrate the gland. Most often, the inflammatory process is caused by gonococci, sometimes by.

Against the background of weakened immunity, the disease can develop due to damage to the organ by representatives of the so-called pyogenic microflora ( Escherichia coli, streptococci and staphylococci). There are cases of viral and fungal infection.

The presence of a potential pathogen in the body does not mean inevitable inflammation; pathology can develop in the presence of additional provoking factors:

• immunodeficiency states;
• microtraumas in the genital area;
• careless attitude towards intimate hygiene;
• promiscuity;
• the presence of chronic inflammatory processes;
• inflammatory processes in the vagina or urethra;
• second phase of the menstrual cycle and menstruation;
• intrauterine manipulations in violation of aseptic requirements;
• tight underwear.

Inflammation of the Bartholin glands - bartholinitis in women; its causes, symptoms and treatment are discussed in this video:

Forms and signs of the disease

According to the characteristics of the course of bartholinitis may be acute or chronic.

In an acute inflammatory process, the disease occurs with the formation of a false or true abscess. The chronic process is prone to frequent relapses.

With a false abscess, pus accumulates inside the gland; with true bartholinitis, the tissue adjacent to the organ is involved in the purulent inflammatory process.

The chronic form of the pathology develops in the absence or insufficiency of treatment of the acute process or relief of the condition after spontaneous opening of the abscess. Over time, a Bartholin gland cyst forms.

Bartholin gland cyst:

Acute canaliculitis

At the first stage of the disease, the inflammatory process affects the gland duct, canaliculitis develops. Swelling and redness of the skin forms above the site of inflammation.

Often, women mistake the first manifestations of bartholinitis for the resemblance of a white eel and squeeze it out. A few drops of pus are released from the duct of the affected gland.

Over time, the pus thickens, clogs the duct and accumulates in the gland itself, forming a false abscess. The affected gland greatly increases in size, the labia protrudes towards the vestibule and blocks the entrance to the vagina.

Redness and swelling are visible above the compacted focus of inflammation, the skin above it is easily displaced. Symptoms of intoxication are mild, a slight increase in temperature is possible.

An inflamed gland causes pain to a woman When walking and during sexual intercourse, a burning sensation is felt in the perineal area. With rest, the pain subsides.

True abscess

Penetration of pathogens into glandular tissue leads to its melting. Subcutaneous tissue is involved in the inflammatory process.

The labia are very swollen, soreness and redness spread to both sides. Directly above the lesion is noted local increase in temperature, the skin does not move.

The pain is constant, very strong, throbbing. The patient cannot walk due to pain. The general body temperature is increased, chills, weakness and other manifestations of intoxication are possible.

Attempts to squeeze out an abscess can lead to sepsis; with a true abscess of any location, qualified medical care is required.

Chronic course of the disease

With insufficient treatment or its absence (which happens after spontaneous opening of an abscess), the disease becomes chronic.

Manifestations of inflammation subside, the affected gland becomes denser, pain subsides. The disease periodically worsens.

With a long course of chronic inflammation, a cyst forms inside the affected gland - a painless tumor-like neoplasm filled with fluid.

Sex, pregnancy and childbirth with inflammation

Inflammatory processes in the Bartholin gland do not affect the ability to conceive and do not always affect the course of pregnancy.

In the acute stage of the disease, intimate contacts are very difficult or completely impossible, since any touch to the affected labia causes excruciating pain.

Chronic bartholinitis causes less trouble and is not considered by patients as a serious obstacle to sexual life. Discomfort during sexual intercourse is perceived as tolerable.

If acute bartholinitis develops in pregnant women, it requires immediate treatment, as there is a risk of infection of the fetus.

Identified Bartholin gland cysts during pregnancy cannot be treated; surgical intervention is postponed until the baby is born.

Which doctor should I contact?

The symptoms of many female diseases are very similar. Any unpleasant sensations in the genital area, especially persistent ones - a reason to be vigilant and consult a gynecologist.

Self-medication for purulent inflammation in the intimate area is unacceptable. Bartholinitis does not go away spontaneously; on the contrary, purulent inflammation progresses rapidly.

Many patients ignore the pain until it becomes unbearable, and almost never call an ambulance.

Possible complications and consequences

Why is bartholinitis dangerous? Without timely treatment, suppuration in the vestibule of the vagina can lead to the spread of infection to other organs of the reproductive system.

There is a risk of spontaneous opening of the abscess inside with the subsequent spread of purulent inflammation to other tissues and organs, up to sepsis.

When the abscess opens, relief comes out, but the disease without treatment becomes chronic, sometimes a fistula forms at the site of the abscess breakthrough.

Acute bartholinitis can pose a danger to the fetus during pregnancy. Possible intrauterine infection before the 22nd week of pregnancy can provoke a miscarriage.

When the disease develops in the third trimester of pregnancy, the risk of premature birth increases. During childbirth, an infectious agent can enter the baby's eyes or lungs, and the umbilical wound is also at risk of infection.

The chronic, asymptomatic form of the disease is also far from harmless. Any chronic inflammatory process is a time bomb. Under certain circumstances, it can lead to complications from any physiological system.

Diagnostics

An experienced gynecologist recognizes patients with acute bartholinitis by their specific gentle gait.

On examination, redness is detected, swelling of the skin over the affected gland and an ovoid painful formation in the vestibule of the vagina.

The Bartholin gland cyst is painless on palpation, the affected organ is slightly enlarged in size and hardened.

To confirm the diagnosis, laboratory research:

• microflora smear;
• bacterial culture to determine the sensitivity of the pathogen to antibiotics;
• bacteriological examination of pus discharged from the affected gland;
• PCR to determine the nature of the pathogen.

Conducted blood tests for HIV and syphilis.

How to treat at home and in hospital

Is it possible to cure bartholinitis without surgery forever? Depending on the stage at which the pathology is detected, treatment can be conservative or surgical.

Conservative therapy

The earlier the pathology is detected, the faster, easier and more effective the treatment.

If the patient is diagnosed with bartholinitis at the initial stage, hospitalization is not necessary; treatment can be carried out at home, following the doctor’s instructions.

How to cure bartholinitis forever? To relieve pain, it is recommended to apply an ice pack to the affected area, but some gynecologists object to this practice.

For bartholinitis a course of antibiotic treatment is prescribed for 7-10 days, additionally - drugs of the imidazole group. Metronidazole is good for inflammation.

Local treatment is carried out, Vishnevsky ointment, Levomekol or Ichthyol ointment is applied to the site of the lesion.

These drugs improve blood microcirculation: the abscess either resolves or matures.

Folk remedies

Operations

In practice, treatment of patients with early stages of bartholinitis is relatively rare.

The imaginary frivolity of the reason for contacting, false shame, attempts at self-medication result in a waste of time. They come to the appointment when the pain becomes unbearable - at the stage of abscess formation.

False and true abscesses are subject to surgical treatment. How is the operation to remove bartholinitis performed? The lesion is opened, the cavity is cleaned of pus with disinfectants, then drainage is installed to drain the pus.

On day 5-6, the drainage is removed. The abscess cavity is washed daily, and tampons with Levomekol or Vishnevsky ointment are inserted into it. In parallel, a course of antibiotic treatment is prescribed.

Treatment of Bartholin gland cyst

If the disease is detected at the cyst stage, two treatment options are possible: Marsupialization of the cyst or extirpation of the affected gland.

Marsupialization means opening the cyst and surgically forming a new excretory duct. After opening the bartholinitis, the surgeon sutures the edges of the capsule to the skin and fixes the drainage in the hole.

The formation of a new duct occurs within 2 months after surgery. Such operations are carried out without exacerbation.

The indication for extirpation (removal) of the affected organ is an exacerbation of the inflammatory process.

When treating any form of the disease, multivitamins are prescribed, after eliminating acute symptoms - a course of physiotherapy.

Forecast

If you consult a doctor in a timely manner, the disease can be completely cured. Sometimes the help of other specialized specialists (immunologist) may be required.

Prevention

Among the key measures to prevent purulent processes in the genitals are: regular visits to the gynecologist for timely detection and treatment of diseases that increase the risk of developing bartholinitis.

At the slightest suspicion of a disease of the reproductive system, you should consult a doctor.

The risk of infection is significantly reduced by maintaining hygiene, using barrier contraceptives and a monogamous lifestyle.

An important condition for maintaining women’s and general health is strengthening the immune system.

To do this, you need to adhere to the principles of a healthy lifestyle: normalize sleep, work and rest, organize proper nutritious nutrition, ideally, completely abandon bad habits, change physical activity.

Bartholinitis is a potentially dangerous but treatable disease. The main thing is to be responsible and attentive to your health.

The Bartholin gland is located in the area of ​​the labia majora, or more precisely, in the subcutaneous fat.

Its functions: maintaining optimal humidity in the vagina through the production of a special secretion, without which discomfort may occur during sexual intercourse and pain in the perineum.

Bartholinitis is, as the name implies, an inflammatory process that occurs in the Bartholin gland. Harmful microorganisms affect not only the excretory duct of the Bartholin gland, but also the gland itself.

Causes

Why do women experience bartholinitis, and what is it? The causative agent of bartholinitis is Escherichia coli, staphylococci, streptococci, chlamydia, gonococci, trichomonas. Often the cause of the development of the disease is a mixed infection - a combination of several pathogenic microbes.

The most common causes of bartholinitis are the presence of pathogenic bacteria in vaginal discharge. This is why inflammation is considered a secondary disease: it almost always results from a primary infection. In order to eliminate the causes of bartholinitis, it is necessary to first eliminate the source of infection, which causes painful symptoms: bartholinitis causes very serious discomfort to a woman.

Often the reason for the appearance of bartholinitis lies in the uncleanliness of a woman. If you do not follow the rules of personal hygiene, you can easily introduce an infection into the excretory duct of the gland, the source of which can lie not only in the vagina, but also in the urethra or intestines.

If left untreated, a painful abscess will form. After some time, it may spontaneously open. The purulent contents flow out. The condition of a woman suffering from bartholinitis is improving, but this does not mean that there is no need to visit a doctor. The disease can become chronic.

Classification

According to the course of bartholinitis, acute and chronic forms are distinguished. Acute bartholinitis manifests itself as:

• false abscess (primary - canaliculitis and secondary - with inflammation of a previously formed cyst).
• true abscess.

Symptoms of bartholinitis in women

When bartholinitis occurs, the main symptoms manifest themselves in the form of redness of the labia and the Bartholin gland area, and dense neoplasms appear. Upon palpation, you can detect its enlarged duct; pressing on the gland causes pain. Inflammation of the gland may be accompanied by the formation of a purulent sac.

In acute bartholinitis, a false abscess and acute pain usually appear, making it difficult to walk, and the temperature reaches 39°C. Over time, the abscess breaks out (or it is opened in the hospital). If you open this abscess at home yourself, there is a high risk that not all of the pus will be extracted. In this case, the symptoms of bartholinitis soften, but do not disappear completely - this is how the chronic form of the disease begins.

Bartholinitis often occurs simultaneously with sexually transmitted diseases, so the symptoms of these infections are also present - burning, discharge, red spots, etc.)

Chronic form

The main signs of chronic bartholinitis include:

• mild aching pain on the side affected by the disease;
• painful sensations during sexual intercourse;
• discomfort in the area of ​​the external genitalia when moving;
• swelling of the inflamed labia;
• neoplasm on the labia majora on the affected side;
• the appearance of a large gland cyst outside the vagina, which can open on its own after 4-5 days.

The symptoms of chronic bartholinitis are almost the same, except that the pain is not so acute and the temperature does not always rise. They usually occur during menstruation, hypothermia, weak immunity, and seasonal exacerbations are possible.

Bartholinitis: photo

What bartholinitis looks like, photos of clinical manifestations are presented below.

Diagnostics

To figure out how to treat bartholinitis, it is necessary not only to diagnose the symptom, but also to determine the cause of its development. Therefore, when signs of bartholinitis are detected, a woman is prescribed the following tests:

• vaginal smear;
• bacteriological culture of material taken from secretions (to select a suitable antibiotic);
• examination of pus taken from an abscess rupture;
• diagnosing sexually transmitted infections (, etc.).

Treatment of bartholinitis

Modern gynecology has a whole list of effective methods for treating bartholinitis, both conservative and surgical. The chosen treatment tactics depends on the stage of inflammation. If severe forms of acute bartholinitis are detected, the woman is treated in a hospital setting. For mild forms of bartholinitis, treatment can be carried out at home.

Conservative therapy for acute bartholinitis is aimed at relieving pain, eliminating symptoms of intoxication and preventing the development of a true gland abscess. For this purpose, local and general therapy is prescribed.

The following means are used:

1. , they relieve pain (Baralgin, Ibuprofen).
2. Antibiotics. The cause of bartholinitis is always an infection - therefore, antibiotics cannot be avoided. Of course, these must be drugs to which the pathogen is sensitive. However, identifying the “culprits” through bacteriological culture can take a long time, and it is advisable to start treatment as early as possible. Therefore, most often at the first stage, the doctor prescribes broad-spectrum antibiotics. In addition, painkillers and anti-inflammatory drugs are often additionally prescribed.
3. Lotions with 8-10% salt solution for 30-40 minutes. 3-6 times a day;
4. Irrigation with disinfectant solutions (Chlorhexidine, Miramistin), herbal decoctions (oak bark, calendula, chamomile, etc.);
5. Ointments (Vishnevsky, Levomekol) - the maximum therapeutic effect is achieved by their combination (one in the morning, another in the evening);
6. Physiotherapy (magnetic therapy, UHF) - it is advisable to carry out on the 3-4th day.
7. In some cases, surgery cannot be avoided. However, surgery cannot be limited to simply opening a cyst or abscess. The fact is that the tissues on which the pathology is formed tend to quickly stick together after dissection, as a result of which the duct becomes clogged again. Therefore, there are two options for performing a surgical operation: the formation of an artificial duct of the Bartholin gland or complete removal of the gland.

It should be noted that chronic bartholinitis requires long-term and complex treatment. This is due to the fact that the dense capsule of the large gland of the vaginal vestibule prevents the penetration of medications to the site of inflammation.

Prevention

Naturally, like any disease, bartholinitis is easier to prevent than to treat for a long time. So, prevention of bartholinitis includes the following measures:

• observe the rules of personal hygiene;
• exclude casual sex, use barrier methods of contraception (condoms) during sexual intercourse;
• avoid hypothermia;
• avoid swimming in polluted waters;
• refuse to wear tight underwear and clothing;
• Visit a gynecologist regularly (2 times a year).

is a disease of the female genital area, which is characterized by inflammation of the large gland of the vestibule of the vagina (Bartholin's gland).

This is a paired organ located deep in the subcutaneous fat at the base of the labia majora. The main function of the Bartholin glands is the production of a viscous secretion, which is released during sexual intercourse through the excretory ducts of the glands and lubricates the entrance to the vagina.

Bartholinitis is most often caused by the following infections: gonococcus, staphylococcus, E. coli, Trichomonas, etc. Penetration of infection through the excretory duct of the gland leads to its clogging and the resulting formation of a cyst (false abscess).

Bartholinitis can be acute or chronic. The disease becomes chronic if treatment was insufficient or not carried out at all: frequent relapses are characteristic, which lead to the accumulation of secretions in the cavity of the gland, which leads to a Bartholin gland cyst.

Symptoms of bartholinitis

Bartholinitis can occur for a long time without any manifestations. The first sign of the disease is a small red lump near the outlet of the gland. When pressing on the roller, purulent masses can be released, but if there is too much pus, the outlet becomes blocked.

Bartholinitis is manifested by the following symptoms:

• pain in the external genitalia;
• increased temperature (sometimes up to 40C);
• weakness and malaise;
• decreased performance.

When a false abscess forms, canaliculitis occurs - inflammation of the excretory duct of the gland.

Bartholinitis causes swelling, hyperemia (redness) and tenderness of the Bartholin gland. The skin over the abscess is mobile. Sometimes the protrusion of the gland can partially block the entrance to the vagina. Pain occurs when moving and walking.

Bartholinitis can also cause a true abscess when infectious pathogens penetrate directly into the tissue of the Bartholin gland. In this case, the parenchymal tissue of the gland undergoes transformation, and the skin over the source of inflammation becomes motionless.

Bartholinitis with a true abscess causes the following symptoms:

• severe swelling of the labia;
• constant acute pain in the perineum (usually one-sided);
• enlarged inguinal lymph nodes.

A true abscess causes high temperature and the formation of an extensive abscess inside the gland, which is easily palpated. Spontaneous opening does not cause emptying of the capsule, and after some time repeated suppuration may occur. A true abscess should be opened in a clinical setting.

Treatment of bartholinitis

The main principles of treatment for bartholinitis are antibacterial therapy and pain relief. If a Bartholin gland cyst or abscess develops, surgical treatment is often necessary. During the entire treatment period, the woman is advised to abstain from sexual activity.

Antibacterial therapy for bartholinitis involves taking antibiotics and local treatment of the skin in the area of ​​inflammation with disinfectant solutions. The choice of antibiotic is made by the attending physician based on the data of the tests performed.

Skin treatment is usually carried out with a Betadine solution, but it is possible to use another weak (non-burning skin) disinfectant solution (for example, a weak solution of potassium permanganate).

In case of abscess of the Bartholin gland, surgery to remove the abscess and the gland itself is indicated. In addition, antibacterial therapy is prescribed simultaneously with the operation.

Such operations for bartholinitis are necessarily carried out under general anesthesia. As a rule, they do not take much time. A pleasant factor is that the consequences for the patient who has undergone such an operation are minimally painful.

Treatment of chronic bartholinitis

Chronic bartholinitis is treated in several stages:

Surgical treatment is combined with antibacterial therapy.

Treatment of acute bartholinitis with folk remedies is not recommended, since in the absence of antibacterial therapy, bartholinitis turns into an abscess of the Bartholin gland.

Treatment of bartholinitis with herbs can only be effective if it is combined with drug treatment (taking antibiotics). As a rule, warm 20-minute baths with chamomile, oak bark, and eucalyptus are used for this purpose.

Antibacterial drugs

Azithromycin

• Azitrox;
• Sumamed.

Amoxicillin

• Amine;
• Ospamox.

Doxycycline

• Doxibene;
• Doxinate;
• Medomycin;
• Unidox Solutab.

Clarithromycin

• Klacid;
• Clubax.

Clindamycin

• Dalatsin;
• Klimitsin;
• Klindafer;
• Clinda-fer;
• Clindacin;
• Klinoxin.

Co-trimoxazole

• Biseptol;
• Groseptol;
• Septrin.

Ofloxacin:

• Ofloxin;
• Oflocid;
• Tarivid.

Ciprofloxacin

• Aquacipro;
• Arflox;
• Afenoxin;
• Ifi-cipro;
• Quintor;
• Quipro;
• Liproquin;
• Medociprin;
• Microflox;
• Proxacin;
• Procipro;
• Recipro;
• Tseprova;
• Qi-plox;
• Tsiprinol.

Operation

Treatment of bartholinitis and its symptoms is usually a long process, including a preparatory stage, during which the patient needs to take medications to relieve the exacerbation of the disease, and subsequent surgical intervention, during which the following will be performed:

• a skin incision in the area of ​​inflammation;
• cleansing the gland, then removing the cyst;
• restoration of blood vessels of the circulatory system;
• suturing the edges of the incision.

Treatment of bartholinitis at home

Folk remedies for treating bartholinitis at home should be agreed with your doctor.

Causes of bartholinitis

Factors that predispose to the development of bartholinitis can be varied. Microorganisms that penetrate the tissue of the large gland located in the vestibule of the vagina, under certain conditions, are the main causes of the disease.

Bartholinitis develops when microorganisms penetrate the gland tissue through the excretory duct, which opens on the inner surface of the labia minora in the vestibule of the vagina.

In most cases, microbes that cause infection enter the gland from the vagina or urethra in the presence of diseases such as colpitis and urethritis. Rarely, the cause of the disease is infection through the blood.

The pathogens include the following microbes:

• staphylococci;
• streptococci;
• coli;
• gonococci;
• chlamydia;
• Trichomonas.

The most severe course of the disease develops due to the gonorrheal pathogen.

There are other risk factors for developing bartholinitis:

• hypothermia of the body;
• venereal diseases;
• avitaminosis;
• sexual intercourse during menstrual bleeding;
• promiscuous sexual intercourse;
• stress;
• neglect of personal hygiene rules;
• weakened immune system;
• complications after abortion and other uterine surgical interventions.

Classification of bartholinitis

According to the clinical course, there is the following classification of bartholinitis:

• spicy;
• chronic;
• false abscess;
• true abscess.

Diagnosis of bartholinitis

If you independently discover symptoms of bartholinitis, you need to contact them in a timely manner to establish an accurate diagnosis and timely treatment.

To diagnose bartholinitis, a gynecologist will conduct a standard examination of a woman’s internal and external genitalia. Discharges from the Bartholin gland duct will be sent for microbiological laboratory testing to accurately identify the causative agents of the disease. When a purulent abscess is opened, its contents will also be sent for culture.

The results of laboratory tests will allow us to exclude the presence of such severe infections as symptoms of HIV and syphilis, and to prescribe the correct drug treatment to a woman with bartholinitis.

Prevention of bartholinitis

The main key to successful treatment of bartholinitis is the destruction of the causative agent of the disease. To do this, you need to re-take tests after treatment and follow all the recommendations of your doctor. Do not neglect preventive examinations by a gynecologist.

If basic rules of personal hygiene are not followed, bartholinitis can recur repeatedly, which sooner or later will lead to the formation of a fistula (a through hole between the tissues).

Ignoring the inflammatory process will lead to a chain reaction - the inflammation will spread to neighboring tissues and go deep into the body. If the infection enters the blood, sepsis may even develop.

Questions and answers on the topic "Bartholinitis"

Question:Hello. Last year, bartholinitis developed for the first time. It hurt for about 2 weeks, until there were tears in my eyes. It opened on its own. The relapse occurred after half a year, then once a month at the slightest hypothermia. Sometimes it was opened on its own, in 2-3 days, sometimes I managed to get it to the hospital in time for the opening. I visited 4 doctors at the local gynecology department, all unanimously repeating that it is necessary to boost the immune system, but they do not give directions for tests that provoke the disease; they prescribed a one-time antibiotic + terzhisstan after it. The canal is thoroughly cleaned every time. This time, bartholinitis opened up on its own, in just 2 days, at a time when I had a sore throat (the temperature was about 39-40). But it did not heal; as I understand it, a fistula formed. In general, there is a discharge from it, a pungent odor, and green in color. Last Monday I squeezed everything out, treated it with peroxide, and put a tampon with Vishnevsky ointment overnight. It didn’t bother me for a week, but after that I had heavy discharge again. What tests should be taken and is it possible to take them without a referral, because our doctors do not give one.

Answer: Hello! Apparently, you have formed a Bartholin gland cyst, which periodically suppurates. This cannot be treated conservatively. Outside of exacerbation, it is necessary to remove the cyst. There are several ways. Your doctor will make the decision. Donate blood for GTT, antibodies to STIs, PCR for common infections. Preliminary treatment is carried out to prevent relapses and complications. Usually, this is vaginal sanitation (Terzhinan, Macmiror), immunocorrectors (Viferon) and probiotics (Bifiform, Acipol). After surgery, FTL is effective.

Question:Hello. I’m 23 years old, the question is this: Bartholinitis has swollen for the second time, I came to the hospital, they prescribed injections for pregnant women, after 2.5 days they cut it out, since I could almost no longer walk, they performed an operation under general anesthesia lasting 5 minutes, and for pregnant women Can I have anesthesia at 13 weeks? Will it affect the child? After the operation I just lay in the hospital without appointments for 3 days, is it normal not to even treat me with anything? They installed a drainage, but no one even comes and asks how my condition is, today I’ll go to the doctor myself so that she can look at me and maybe they’ll let me go home since there’s no point in lying on my own.

Answer: Hello! I believe that you should forward these questions to your attending physician or the head of the department.

Question:Hello. At the initial stage of development of bartholinitis, I took measures (levomekol ointment), the pain and inflammation went away, but the seal remained. This, as I understand it, is a Bartholin gland cyst. Why is it dangerous and can it go away on its own? Maybe there is some kind of remedy, please tell me.

Answer: Hello! This is dangerous due to relapse and suppuration. You need to see a gynecologist and start treatment.

Bartholin's gland is a small paired formation located in the thickness of the labia majora. It got its name from the surname of the anatomist who discovered it, Caspor Bartolini, who published his works in the 17th century. The gland duct opens in the vestibule of the vagina, not far from the labia minora. She secretes a liquid secretion that lubricates the genitals and facilitates sliding during coitus. Bartholinitis is an inflammatory disease of the gland, often becoming chronic with the formation of a cyst. Most often, the disease is of an infectious nature and is associated with STD pathogens.

Mechanism of disease development

The Bartholin gland belongs to the exocrine glands, that is, it secretes its secretion out through the excretory duct. Functionally, it can be divided into:

• Producing part- has the shape of a pea, the inside is lined with secretory epithelium, which produces a liquid secretion. This is where fluid accumulates before it is released.
• Outflow tract- a thin tube 1.5-2 cm long, opening between the labia minora and the entrance to the vagina. Through it, the secretion is released onto the surface of the mucous membrane.

The duct of the Bartholin gland is relatively wide and various microorganisms easily penetrate through it. With a decrease in local immune defense or general resistance of the body, even opportunistic microflora that populate the skin and rectum can cause inflammation - bartholinitis.

The main causes of the disease are:

• Streptococci;
• Staphylococcus;
• Escherichia coli;
• Proteus;
• Klebsiella.

Nonspecific microflora can penetrate into the gland not only through the duct from the outside, but also through the blood or lymph flow from internal foci of chronic infection (tonsillitis, carious cavities, inflammatory diseases of the internal genital organs). In this case, bartholinitis is secondary and recurrent in nature if the underlying cause of the disease is not cured.

Among the causative agents of STDs, damage to the Bartholin gland is caused by:

Microorganisms attach to the surface of the epithelium, penetrate deep into it, where they multiply intensively and release toxic metabolic products. Under their influence, epithelial cells die, an inflammatory reaction develops: a rush of blood to the site of the lesion, swelling, and the release of leukocytes into the tissue. Due to swelling of the walls, the gland duct narrows or becomes completely impassable, its secretion accumulates inside, stretching the capsule - a cyst is formed. The purulent process inside it leads to the formation of an abscess - a limited cavity filled with pus. In the latter case, the gland is filled with dead leukocytes, microorganisms and remnants of epithelial cells. Partial breakdown products are absorbed into the blood with manifestations of a systemic reaction: body temperature rises, general health worsens.

Without treatment, the perineal tissue surrounding the gland sometimes undergoes purulent melting. As a result of this development of the disease, rough, disfiguring scars are formed at the site of inflammation, which interfere with sexual activity. In some cases, the abscess opens out, but complete emptying rarely occurs and the remaining pus causes new exacerbations of bartholinitis. The inflammatory process in the gland duct often leads to the formation of a cyst, which gradually increases in size and blocks the entrance to the vagina.

Clinical picture

Symptoms of bartholinitis are expressed to varying degrees, depending on the intensity of the inflammatory process. They appear acutely, often after hypothermia, menstruation, childbirth, abortion or unprotected sexual intercourse. First, a woman feels tingling, pain, heat, heaviness in the labia, which intensifies with movement and makes sexual intercourse painful or impossible. Along with this, general health worsens: body temperature rises to 38 degrees C, appetite disappears, headaches, and general weakness occur. Gradually, the pain in the perineum increases, becomes pulsating, the woman finds it difficult to walk and sit, and night sleep is disturbed.

Acute bartholinitis in most cases develops on one side. The labia majora at the site of the gland swells, increases in size, and its skin turns red. In the thickness of the lip, a painful lump ranging in size from one to several centimeters is felt - the gland itself. If the inflammatory process does not involve the surrounding tissues, then the skin above it is mobile and easily moves. When subcutaneous fat is involved, the epidermis becomes fused with it and loses its mobility. Often the inguinal lymph nodes react to inflammation; they increase in size and become visible in the form of round, dense formations under the skin. After some time from the formation of an abscess, it may burst outward with the flow of yellow-green pus.

After acute inflammation subsides, the disease enters the chronic stage. At first, the symptoms completely disappear and the woman feels healthy. This period of calm lasts from several months to several years, but any decrease in immune defense leads to an exacerbation of bartholinitis. Pain and swelling in the labia area, discomfort when walking, sitting, and sexual intercourse reappear. The temperature does not always rise and does not reach high values. As a rule, general health does not suffer.

Sometimes the inflammation is mild and occurs unnoticed by the woman or with minimal symptoms that are easy to miss. If, as a result of the disease, the patency of the gland duct is disrupted, then the gradual formation of a cyst begins. In the thickness of the labia majora, at its base, a subcutaneous volumetric formation of a round shape appears, painless to the touch, not fused with the surrounding tissues. It bulges outward, partially covering the entrance to the vagina. If both Bartholin glands are affected, the vestibule can be completely blocked, and sexual intercourse becomes painful due to the dryness of the external genitalia.

Diagnostics

The diagnosis of bartholinitis is made by a gynecologist after interviewing and examining the patient. Typically, diagnosis does not require additional research methods, but if another pathology with similar symptoms is suspected, the doctor prescribes:

• General blood analysis– an acute inflammatory process is manifested by an increase in the number of leukocytes, a shift in the leukocyte formula to the left, and an increase in ESR;
• General urine analysis– with bartholinitis, trace concentrations of protein may be detected;
• to pathogens of STIs – allows you to identify the possible causative agent of the disease;
• , separated from the Bartholin gland - the most accurate way to identify pathogenic microflora and its sensitivity to antibiotics.

Treatment

Treatment of bartholinitis is carried out on an outpatient basis or in a day hospital. Therapy must be combined with diet, protective regimen and sexual rest.

In the case of an STD, both partners must undergo antibiotic treatment to prevent recurrence of the disease.. During the period of acute inflammation, you should refrain from spicy, pickled foods, alcohol, and fatty foods. It is necessary to drink at least 2 liters of liquid per day - fruit drinks, compote, juice to quickly remove toxins from the blood and normalize well-being.

To treat bartholinitis use:

To speed up healing, physiotherapy methods are also used - exposure to ultra-high frequency current, magnetotherapy, and local electrophoresis. They become the main ones in the treatment of the chronic form of the disease, together with them they use general restorative procedures - ozone therapy, oxygen therapy, intravascular laser irradiation of the blood. Drugs are prescribed to activate the immune response - immunomodulators (Licopid, Thymalin). Sanitation of other foci of chronic infection is carried out and the intestinal microflora is normalized with the help of pre- and probiotics (Bifilac, Acipol, Linex).

Treatment at home is fraught with chronicity of the process, since there is no adequate antibacterial therapy. Bartholinitis often develops in conditions of immunodeficiency and the body is not able to cope with the causative agent of the disease. Do not squeeze pus out of an inflamed gland! The abscess capsule may break not outward, but into the tissues, in this case the purulent process spreads to the subcutaneous fatty tissue. Folk remedies are recommended to be used in addition to primary therapy: decoctions of chamomile, calendula, eucalyptus in the form of sitz baths relieve inflammation well and have an antibacterial effect.

Inflammation of the Bartholin glands during pregnancy, treat with topical medications whenever possible to minimize the risk to the fetus. Self-medication in this case is unacceptable, especially the independent use of antibiotics and antipyretics - this can lead to congenital malformations in the child.

Removal of formed Bartholin gland cysts and opening of abscesses is carried out surgically. The woman is hospitalized in the gynecological department for 5-6 days, the operation is performed under general anesthesia or epidural anesthesia. Local anesthesia is used only when removing a non-inflamed cyst. The doctor either eliminates the formation along with the gland, or forms a new excretory duct to replace the overgrown one. If an abscess is opened, it is completely cleaned of pus, washed with an antiseptic and partially sutured.

The earlier and more fully the treatment of bartholinitis is carried out, the lower the risk of chronicity and further surgical intervention. To prevent the disease, you should carefully observe personal hygiene, especially during menstruation, and use condoms during sexual intercourse.

Video: doctor about Bartholin gland cyst and bartholinitis

Video: inflammation of the Bartholin glands, “Live healthy!”

Bartholinitis in women is an inflammatory disease of the Bartholin gland, a paired organ located in the vestibule of the vagina in the lower part of the labia majora. Its size is 1 - 2.5 cm, and its main function is to secrete secretions through narrow ducts to moisturize and soften the mucous membrane during sexual intercourse. Symptoms and treatment of inflammation should be determined by a doctor after examination. According to the international classification of the ICD, pathology is assigned code N75.0 - N75.9 (disease of the Bartholin gland - cyst, abscess, unknown origin).

Development mechanism

With bartholinitis, the cause of the disease can be various pathogenic microflora: staphylococci, streptococci, E. coli, enterococci. Often the causative agent of the inflammatory process is the source of diseases that are sexually transmitted (gonococci, chlamydia, trichomonas, etc.). A similar lesion of the Bartholin gland occurs in women of reproductive age after the onset of menstruation. The disease does not occur in girls, since this organ is in an immature state and develops with changes in hormonal levels.

The Bartholin gland begins to function under the influence of strong sexual arousal. A thick, grayish secretion that is odorless is secreted into the vaginal lumen. The duct is considered the narrowest point of the organ. Therefore, when it is blocked as a result of a bacterial process, the secretion remains inside and begins to accumulate. This is how bartholinitis occurs.

The developing inflammatory reaction can affect not only the gland. Over time, it begins to spread to the tissue of the labia majora and lower vagina, sometimes the pathology affects a nearby lymph node. Bartholinitis is especially dangerous for pregnant women. In the first trimester, intrauterine infection of the fetus and subsequent miscarriage are possible, and in later stages there is a high risk of infection of the umbilical cord, organs of vision, hearing and breathing of the child during childbirth. The risk of infection increases if a purulent abscess of the gland has ruptured.

In most cases, bartholinitis is a one-sided process. Only with gonorrheal infection does bilateral damage occur. It is important to start treatment in a timely manner, since the disease tends to quickly become chronic. Constant relapses of symptoms of bartholinitis serve as an indication for surgical removal of the organ.

Etiological factors

The main causes of inflammation of the secretion glands are the penetration of bacterial microflora through the ducts into the organ. The risk of developing pathology increases if a woman is promiscuous. Unprotected sex increases the risk of contracting sexually transmitted diseases. Also causes of bartholinitis are:

• lack of intimate hygiene, especially during menstruation;
• touching the genitals with dirty hands or objects;
• infection during surgery or diagnostic procedures;
• wearing tight synthetic underwear;
• vulvovaginitis (infectious inflammation of the vagina and labia mucosa);
• urethritis.

The risk of bartholinitis increases when the immune system is impaired. A weakening of the body's defenses may be a consequence of long-term use of antibacterial drugs, cytostatics, and glucocorticoids. Immunity suffers from chronic diseases, hypothermia, and deficiency of vitamins and minerals in the diet. In this case, the infection can enter the gland through the bloodstream from other foci of bacterial inflammation.

Depending on the clinical picture, acute (with pronounced symptoms), subacute (with blurred manifestations), recurrent (returning from time to time) and chronic bartholinitis are distinguished. There is also a classification system for inflammation of the gland, based on the localization of the pathological process. If it affects the excretory duct, they speak of canaliculitis (or false abscess). The formation of a focus of inflammation inside the organ indicates right- or left-sided purulent bartholinitis (it is also called a true abscess). Sometimes cavities filled with exudate (cysts) form in the Bartholin gland.

Clinical picture

Symptoms of bartholinitis develop gradually. The inflammatory process begins in the duct, and then, if left untreated, spreads further. However, it is quite difficult to notice pathology at the initial stage. Redness occurs in the place where the excretory duct of the Bartholin gland is located, intensifying with secretion.

Women's diseases. Inflammation of the Bartholin glands

Bartholinitis: treatment at home

Bartholin gland cyst and bartholinitis

Bartholinitis symptoms

During sexual intercourse, itching and burning may be felt at the entrance to the vagina. When pressure is applied to the gland, purulent discharge appears. In subsequent stages of bartholinitis, the inflammatory process spreads deep into the organ with the formation of an abscess or cyst. This is accompanied by the following symptoms:

• pain in the lower genital area, aggravated by walking, defecation, exercise, sex, palpation;
• an increase in the size of the Bartholin gland, sometimes it looks like a chicken egg and blocks the entrance to the vagina (photos of inflammation can be found on the Internet);
• a sharp increase in temperature to 38 - 38.5°;
• the appearance of signs of general intoxication (weakness, feelings of weakness, decreased performance, drowsiness);
• inflammation of the inguinal lymph nodes;
• swelling of the labia majora and minora;
• possible concomitant signs of a sexually transmitted disease or vulvovaginitis (itching, burning, foul-smelling mucopurulent discharge from the vagina).

Symptoms of chronic bartholinitis are unexpressed. The temperature can be kept at a subfebrile level (lower than 37.5°), the gland can be felt like a small ball. Pain appears only with strong pressure. In some cases, the gland abscess ruptures on its own. When it bursts, the appearance of purulent discharge is noted, followed by sanguineous discharge mixed with blood. The condition improves sharply, signs of inflammation disappear, but immediate hospitalization is required to prevent the spread of bacterial infection and the development of sepsis. With bartholinitis this is a common complication.

Detection methods

What bartholinitis is can be seen during the first examination of a woman in a gynecological chair. The doctor notes redness in the area of ​​the gland duct and sharp pain when pressed. In severe cases of the inflammatory process, the organ is enlarged in size, which is visible to the naked eye. Further examination is aimed at identifying the cause of bartholinitis.

The gynecologist takes a smear from the vaginal mucosa and sends it for bacterial culture to determine sensitivity to antibacterial drugs. You should donate blood for analysis using the PCR method to identify pathogens of sexually transmitted infections. At the initial stage, when the gland duct is not clogged, diagnosis of bartholinitis is carried out by examining its purulent discharge.

The results obtained are sufficient to prescribe treatment. However, the doctor needs to make sure that the inflammation has not affected other organs of the woman’s reproductive system. In this case, in the process of diagnosing bartholinitis, an ultrasound is performed to assess the condition of the uterus, fallopian tubes and ovaries. After completing all the procedures, the gynecologist can determine the regimen for using medications in a hospital setting or on an outpatient basis.

Local therapy methods

Treatment of bartholinitis with vaginal suppositories and ointments ensures faster delivery of the active components of the drug to the gland than when taking tablets. The medications used have a wide spectrum of activity. They have anti-inflammatory, antiseptic and antimicrobial effects. The following remedies are prescribed:

• Medicine terzhinan. These suppositories for bartholinitis have an antibacterial and fungicidal effect due to the presence of antibiotics and nystatin in their composition. And prednisolone has an anti-inflammatory effect. The suppositories must be inserted deep into the vagina while lying down at night.
• Eplan has a wound-healing, antimicrobial and regenerating effect. The product is available in the form of a cream or solution. To resolve the abscess, you should smear the area of ​​the inflamed Bartholin gland several times a day.
• Vishnevsky ointment contains natural ingredients (tar, xeroform, castor oil, aerosil) and is used in the form of lotions. To do this, apply it to a small piece of gauze and apply it for 30 - 40 minutes. Ichthyol ointment is also used.
• Ichthyol ointment is an effective anti-inflammatory and antiseptic agent for the treatment of bartholinitis. The method of its application is the same as that of Vishnevsky’s liniment.
• Metrogyl (Metronidazole, Klion, Trichopolum) is available in the form of vaginal gel and suppositories. It acts against the causative agents of trichomoniasis and is used one suppository (or applicator with ointment) 1 – 2 times a day.
• Levomekol is active against gram-positive and gram-negative microorganisms. Ointment is also prescribed for bartholinitis in the form of applications.
• Hydrocortisone 1% ointment contains a glucocorticosteroid and is an effective remedy for fighting inflammation.
• In addition to hydrocortisone, hyoxyzone ointment contains the antibiotic oxytetracycline and has an antimicrobial effect.
• Miramistin solution is active against most pathogens of infectious diseases of the genital organs. To treat bartholinitis, lotions made from fabric soaked in medicine are used.

Such drugs are effective at the initial stage of the inflammatory process. After the formation of an abscess in the gland, they may not bring the desired result. They are also prescribed after rupture or surgical incision of the inflammation. This is necessary to prevent complications.

Use of antibacterial agents

In most cases, local therapy in the form of a bandage with Vishnevsky ointment or other creams may not be enough. For bartholinitis, the best treatment is antibiotics. Ideally, they should be prescribed after receiving the culture results. But in severe cases, when a woman’s temperature rises and the pain is too severe, drugs with a wide spectrum of activity are prescribed:

• Amoxiclav for bartholinitis affects strains of staphylococci, streptococci and other bacteria resistant to many antibiotics. Its “advantages” include the possibility of use during pregnancy (even in the first weeks) and when breastfeeding is practiced. You should drink it 625 mg three times a day (every 8 hours).
• Doxycycline is used to destroy resistant strains of staphylococci; it is also active against other representatives of pathogenic microflora. Prescribed 100–20 mg per day.
• Flemoxin Solutab contains amoxicillin and, like Amoxiclav, belongs to the group of penicillin antibiotics. The drug is available in the form of tablets, which can be taken whole or dissolved in water to form a suspension or syrup. The dosage for adult women is 500 – 750 mg twice a day.
• Azithromycin (Sumamed, Hemomycin, Azitrox) is a fairly strong antibiotic. For bartholinitis in women, special treatment is required if it is associated with sexually transmitted diseases (in particular, gonorrhea). This is where the drug Azithromycin comes to the rescue, but it is not advisable to use it during pregnancy and during breastfeeding. Prescribe 500 mg 1 time per day.
• Ofloxacin has a wide spectrum of activity. It is used to treat chlamydia or gonorrhea associated with inflammation of the gland. The dosage of the drug is from 400 to 1600 mg per day, divided into two doses.
• Ciprolet (Ciprofloxacin) is an antibiotic of the cephalosporin group, widely used to treat bartholinitis and other genital infections. Prescribe 500 mg twice a day.

It should be noted that for sexually transmitted diseases, men also need to take a course of antibiotics. If this is not done, when having sex, re-infection and relapse of inflammation of the Bartholin gland will occur. The duration of antibiotic use ranges from 5 days to 2 weeks. Depending on the severity of the process, it is possible to prescribe drugs in the form of injections in a hospital setting in the first 2 to 3 days.

Concomitant therapy

In addition to antibiotics, ointments and suppositories, nonsteroidal anti-inflammatory drugs (NSAIDs) help cure bartholinitis. They have a complex effect: antipyretic and analgesic. They can be used in the form of tablets or rectal suppositories. Doctors recommend medications such as Nimesulide (100–200 mg twice a day), Ketoprofen or Ketonal in the same dosage, Ibuprofen.

Immunostimulants are widely used in gynecology as part of the complex treatment of both acute and chronic bartholinitis. Patients with complaints of symptoms of inflammation of the Bartholin gland leave good reviews on numerous forums about Genferon rectal suppositories and Longidaza vaginal suppositories. In addition to stimulating the body's defenses, they relieve inflammation, have antimicrobial activity and accelerate tissue regeneration. They should be used once a day at night. When introducing the drug into the rectum, it is recommended to do an enema first.

Surgical methods

If conservative treatment of bartholinitis does not bring the expected effect, surgery is indicated to open a purulent abscess or cyst. Previously, such a manipulation was quite simple: the skin over the gland was cut, cleaned and washed with antiseptic solutions, and then the wound was sutured. However, this surgical technique for bartholinitis has a significant drawback. During the healing process, the gland duct may become overgrown, so the disease returns after a short period of time.

In some patients, bartholinitis was opened and the cyst was removed up to ten times. As a result, the woman was offered radical surgery, during which the gland was simply removed. On the one hand, this permanently eliminates such a female disease. On the other hand, it brings a certain discomfort.

In addition, the organ is connected to large venous vessels. Its resection is associated with the risk of complications and a long recovery period. Therefore, a surgical technique called marsupialization was developed. It is as follows:

• A small incision is made under local anesthesia;
• a catheter made of non-toxic material is installed into the gland duct; at its end there is a small ball, which is filled with air to prevent it from falling out;
• leave it in the vaginal cavity for 7 - 8 weeks, then remove it.

In this way, a new duct of the gland is formed, which will no longer close after it has been opened. A similar operation is also used to cure chronic bartholinitis. A video with a detailed description of the manipulation can be found on the Internet. The procedure itself does not last long, and the recovery period for patients takes from three days to a week. To prevent bacterial complications, a course of antibiotics is prescribed and the wound is sprinkled with streptocide.

Alternative medicine methods

Treatment of bartholinitis at home should be carried out only after consulting a doctor in parallel with the main, conservative therapy. To avoid surgery, you need to make applications from a bandage or gauze swab soaked in a hypertonic saline solution prepared at the rate of 3 tablespoons of salt per liter of water. Baths with a decoction of a mixture of chamomile flowers, calendula and oak bark, taken in equal proportions, a solution of potassium permanganate (5 g per 10 liters of water), and soda are also effective. To treat chronic bartholinitis and cyst resorption, compresses from undiluted aloe (or Kalanchoe) juice are used.

Many doctors recommend this recipe for lotions: 100 ml of furatsilin, 1 ml of dimexide and dexamethasone and 10 ml of dioxidine. All these drugs can be purchased at the pharmacy. Mix the components, then soak a tampon with the solution and insert it into the vagina, replacing it with a new one every 2.5 - 3 hours. One of the methods of treating bartholinitis with folk remedies is wiping the inflamed area after washing with a decoction of the following plants:

• calendula flowers, chamomile;
• celandine and string grass;
• nettle leaves.

Take the listed ingredients in equal quantities, and then pour 5 g of the mixture with a glass of boiling water. Treatment at home can also be carried out using tampons soaked in a mixture of propolis and honey. To relieve inflammation and remove the cyst, a compress of baked and mashed onion and scalded cabbage leaves with boiling water will help. Homeopathy can help avoid surgery for chronic inflammation. The doctor selects the necessary products, and the healing granules are sold in a specialized pharmacy.

St. John's wort ointment has a good effect in treating bartholinitis at home. A tablespoon of the plant should be ground in a coffee grinder or blender, then mixed with 5 g of natural beeswax and 20 g of any animal fat (hare, goose or badger). Melt in a water bath until a homogeneous consistency is obtained. Apply to the area of ​​inflammation with a gauze pad overnight.

Recently, hirudotherapy has been gaining popularity. For the procedure, medicinal leeches grown in a clean environment are used. For this pathology, they are placed on the perineal area and other reflex points. At the same time, they secrete about 30 biologically active substances that have anti-inflammatory, antimicrobial and immunostimulating effects.

How to prevent the development of the disease. Complications

Prevention of bartholinitis involves following the rules of intimate hygiene. It is recommended to wash your face twice a day, promptly change pads and tampons during menstruation, and use protective equipment when having sexual intercourse with an unfamiliar partner. Preference should be given to loose underwear made from natural materials. Timely detection and treatment of infections of the vagina and labia mucosa is of great importance.

If symptoms of bartholinitis appear, or you feel a lump or thickening at the entrance to the vagina when washing, you should not delay a visit to the gynecologist. During treatment, you need to stay in bed and abstain from sexual contact. The consequences of this pathology include the transition of the disease to a chronic form, the formation of fistulas, and the spread of infection further along the genitals (vulvitis, colpitis, adnexitis begins). If you do not follow the recommendations on how to properly treat bartholinitis, pathogenic flora enters the urethra, causing urethritis, cystitis and pyelonephritis.

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