Brief overview
- Symptoms: Usually unilateral redness and swelling in the lower area of the labia or vaginal entrance, increasing protrusion of the labia, tenderness, pain when sitting and walking, restricted general condition
- Treatment: Sitz baths, painkillers, for abscesses that do not drain, surgical opening and insertion of a drain, antibiotic therapy for recurring Bartholin’s abscesses, no treatment for asymptomatic Bartholin’s cyst
- Causes and risk factors:Blockage of the excretory ducts of the Bartholin glands (e.g. as a result of birth injuries, episiotomy, other genital injuries), infection of the accumulated secretion with bacteria, infection of an existing Bartholin cyst, rarely: Consequence of an infection with sexually transmitted diseases (chlamydia, gonorrhea)
- Examination and diagnosis:The doctor recognizes bartholinitis on the basis of the symptoms and the typical appearance. Under certain circumstances, the pathogen is determined from the secretions of the inflamed gland and sexually transmitted diseases are excluded.
- Prevention: No specific prevention measures known, wear comfortable, not too tight-fitting pants, use condoms to protect against sexually transmitted diseases
Bartholinitis: Symptoms
Bartholinitis causes redness and swelling (usually on one side) in the lower third of one of the labia minora and labia majora. This swelling can reach the size of a hen’s egg or even a tennis ball and is very (pressure-)painful. Many patients also complain of pain when sitting or walking. Sexual intercourse is painful or not possible due to the pain. Sometimes a fever occurs and affected women feel weak and exhausted.
Bartholinitis: treatment
Bartholinitis rarely heals on its own. It is also not advisable to treat bartholinitis yourself. To ensure that the symptoms improve quickly, it is important that bartholinitis and bartholin abscesses are treated by a doctor.
Bartholinitis: conservative treatment
Treatment with antibiotics is particularly indicated if the bartholinitis was caused by gonococci – the pathogens that cause the sexually transmitted disease gonorrhea.
Bartholinitis: surgical treatment
Surgical treatment is necessary in advanced stages of bartholinitis, i.e. when the inflammation has led to an accumulation of pus (bartholin abscess) or a cyst that causes discomfort. As a rule, surgery is required for bartholinitis if the secretion or pus does not drain away. To enable drainage, the doctor cuts open the excretory duct. A catheter is inserted to ensure that the pus continues to drain. This procedure is performed under local anesthesia. In some cases, the doctor also performs a so-called marsupialization: This involves opening the excretory duct and suturing the duct walls to the edges of the skin. This keeps the duct open and the contents flow out unhindered. This procedure is performed under general anesthesia.
If bartholinitis recurs despite treatment, the entire gland is usually removed (extirpation).
Bartholinitis: causes and risk factors
In most cases, bartholinitis develops on the basis of a Bartholin’s cyst. The affected Bartholin’s gland is swollen due to a build-up of glandular secretions, but is not initially inflamed. Bacteria multiply well in the congested secretion, which then leads to inflammation.
More rarely, bartholinitis develops directly as a result of infection with pathogenic bacteria that have entered the excretory duct of a Bartholin gland from the vaginal vestibule.
Bartholinitis: Description
In Bartholinitis, the excretory duct of one of the two Bartholin glands (Glandulae vestibulares majores) is inflamed – the gland itself is rarely affected.
The Bartholin glands are pea-sized sex glands next to the vaginal entrance. During sexual intercourse, they secrete a clear, light-colored secretion that moistens the vaginal vestibule and thus reduces friction during penetration. The ducts of the two glands open outwards on the inside of the labia minora.
Bartholinitis is the most common cause of swelling in the pubic area. It occurs in adult women of all ages, but develops particularly in sexually active women between the ages of 20 and 29. Around two to three in 100 women develop bartholinitis at some point in their lives.
Bartholinitis: examination and diagnosis
- What symptoms are you suffering from?
- When did you notice the swelling?
- Have you ever had such swelling or proven bartholinitis before?
The doctor will then examine the swelling. He will do this carefully because the swelling caused by bartholinitis is very painful. The assessment and examination, together with the medical history, are usually sufficient to make a diagnosis of bartholinitis.
If there is a suspicion that the inflammation is caused by gonococci or chlamydia, the doctor will take a swab from the vaginal and urethral area to have it tested for these germs in the laboratory.
Bartholinitis: course of the disease and prognosis
If the tissue of the inflamed gland continues to swell, there is a risk that the excretory duct of the affected Bartholin gland will close. The secretion that continues to be produced by the gland then no longer flows out. If there are bacteria in the secretion, pus forms and collects in the blocked duct. Doctors then speak of empyema. In rarer cases, purulent melting of the surrounding tissue occurs: a new cavity forms in which the pus collects. The result is a Bartholin’s abscess.
Bartholinitis: Prevention
There is no specific measure to prevent bartholinitis. However, wearing comfortable, not too tight-fitting underwear and pants is beneficial for a healthy skin climate in the genital area. To prevent the inflammation of the Bartholin gland from worsening, it is advisable to consult a doctor as soon as possible if you suspect it. Appropriate treatment can also reduce the risk of recurrence of bartholinitis.
Pathogens from sexually transmitted diseases such as gonorrhea or chlamydia are less frequently involved in the development of bartholinitis. The use of condoms drastically reduces the risk of infection with sexually transmitted diseases. Regular check-ups at the gynaecologist also help to detect any undetected infections or diseases and treat them at an early stage.
