Diagnosis
A gynecological examination is necessary to diagnose pain in the labia and/or clitoris. In the run-up to the examination, the doctor will discuss the current symptoms. During the examination, the outer and inner vagina is examined and palpated and swabs are taken.
For the diagnosis of bartholinitis, a gaze diagnosis is usually sufficient, since the appearance is very clear. For other inflammations, the smear is used to detect the pathogen. In order to exclude benign and malignant changes, samples are taken from the respective region in order to detect a cell change. In case of vaginal dryness, a blood test is performed to detect a lack of estrogen. Vulvodynia is a diagnosis of exclusion if no gynaecological, neurological, dermatological and orthopaedic cause has been found.
TreatmentTherapy
The therapy of choice for bartholinitis is a so-called marsupialization. In this procedure, a small incision is made in the swelling, the edges of the Bartholin glands are turned outwards and sutured to the labia. If an abscess is present, the pus is drained and tested for pathogens if necessary.
In the case of inflammation in the vaginal area, the therapy depends on the pathogen in question.In herpes infections, antivirals such as Aciclovir are used locally or in severe cases in tablet form, fungal infections are treated with antifungal drugs such as Clotrimazole. For bacterial inflammations, antibiotics such as metronidazole in tablet or ointment form are used. If necessary, the sexual partner must also be treated if sexually transmitted diseases are involved.
Depending on the nature of the benign changes, corticosteroid creams can be used symptomatically. Warts are first treated with the antiviral drug Imiquimod and then removed with CO2 laser, cold therapy (cryotherapy) or a sling. For the treatment of malignant changes, the therapy depends on the stage of the In the case of preliminary stages, removal is carried out by laser or surgery.
In the case of carcinomas, these are cut out as far as possible and, depending on the location of the tumor, radio- or chemotherapy is used. In the case of vaginal dryness due to estrogen deficiency, creams, suppositories or gels that are applied locally are usually helpful. In more severe cases, for example during menopause, when further symptoms occur, hormone therapy with progestin estrogen preparations can be used.
