Formation of cysts within the scope of a bartholinitis

Introduction

On the outer female genital, one finds the Bartholin glands (Glandulae vestibulares majores), which are also called large atrial glands. They are approximately the size of beans and are located below the large labia. The ducts of the glands are approximately 2 cm long and end in a small space between the labia minora (vestibulum vaginae). The secretion produced by the Bartholin glands is released into the skin of the vagina and is used for moisturization. The secretion is produced during arousal to moisten the vagina.

Cause

The Bartholin glands and their excretory ducts are located near the urethra, vagina and anus. Therefore, the ducts can easily be colonized by bacteria that migrate from the other areas. The bacterial colonisation leads to the development of an inflammation of the excretory duct (Bartholinitis).

These are mostly bacteria: Staphylococci, Escherichia coli, Streptococci, but also Gonocococci. The Bartholin gland itself is not affected by Bartholinitis. Inflammation can promote the formation of a cyst or even pus accumulation in this area.

The inflammatory processes lead to a swelling of the tissue surrounding the inflammation. The excretory duct is thus closed by the swollen tissue and a cyst can form. An accumulation of pus in the course of an inflammation can also obstruct the excretory ducts.

In both cases, the secreted secretion can no longer flow off and therefore accumulates in the excretory duct. However, the excretory duct can also become obstructed or blocked independently of an infection, for example by adhesions in the excretory ducts. The secretion that has formed can then no longer drain off, a cyst forms, inside which the accumulated secretion of the gland collects.

In most cases, the cyst is only formed on one side, but rarely on both sides. However, if the cyst is not infectious, an inflammation of the cyst can occur secondarily. The accumulated secretion in the cyst provides a good breeding ground for bacteria, which can multiply there and eventually lead to inflammation of the excretory duct. This can even lead to the formation of an accumulation of pus and an abscess.

Symptoms

The accumulated secretion initially causes a painless, visible swelling in the area of the labia. Whether the cyst causes pain depends on its size and whether the cyst is infected. Large and especially infected cysts, i.e. Bartholinitis cysts, are usually painful, although the pain can be so severe that even walking can be difficult.

Small cysts, on the other hand, are usually painless and hardly disturbing. As the secretion accumulates further and further in the excretory duct, the cyst gradually increases in size and thus slowly leads to impairment due to the increase in size. and swelling in the vaginal entrance