Bartholinitis or Bartholin's cyst

Content

Introduction

Bartholin's cyst appears as a soft and smooth swelling located to the right or left of the entrance to the vagina, at the point where the excretory duct of the two Bartholin glands is located. Usually, the swelling does not cause pain but if the cyst grows in size, and / or its contents become infected, it can turn from a cyst into an abscess (collection of purulent fluid often caused by bacterial infection). In this case, pain appears, the surrounding area appears red, tense and swollen, and sometimes fever may also appear.

The two Bartolinian glands are positioned to the right and left of the vaginal entrance at the lower part of the labia majora. They have the function of producing and secreting a liquid that helps lubricate the vagina. (excretory duct) becomes blocked, the fluid accumulates inside the gland causing the formation of the cyst.

In about one in 50 women, during reproductive age, a Bartholin's cyst develops. It is a rare condition in girls and in women after menopause. Very often the cyst does not become infected and a simple home remedy is enough to solve the problem (see below) .In case of infection, however, you should contact your doctor to decide how to solve the problem.

Symptoms

In most cases the cyst is very small and can go completely unnoticed as it resorbs spontaneously. In the rare cases where it tends to increase in volume and turn into an abscess, disorders (symptoms) may appear, including:

  • discomfort or pain when walking or sitting
  • pain during sexual intercourse
  • fever

Usually, the swelling varies in size between a nut and a walnut and occurs only on one side of the vaginal opening. It is advisable to consult your doctor if the cyst is painful or if it does not improve with home treatments such as frequent compresses with warm water. and salt. This remedy has the objective of making the cyst open and empty spontaneously. In women over the age of 40, when a neoformation appears on the genitals, it is always recommended to contact your doctor because, although rarely, it may not be a Bartholin's cyst but the sign of a different and more serious problem.

Causes

The formation of Bartholin's cyst is the consequence of the obstruction of the duct that carries the fluid secretion from the inside of the gland to the entrance of the vagina. The occlusion of the excretory duct causes the liquid to accumulate inside the gland causing the formation of the cyst which can sometimes become infected with bacteria such as Escherichia Coli or with microorganisms from sexually transmitted infections such as, for example, Chlamydia or gonorrhea (caused by the bacterium Neisseria gonorrhoeae).

Diagnosis

The referring physician for Bartholin's cyst is the gynecology specialist. After performing the examination, the gynecologist evaluates whether to take a small amount (sample) of vaginal or cervical secretions to check for any sexually transmitted infections.In women over the age of 40, if they deem it necessary because they suspect that it is not a Bartholin's cyst but of lesions of another nature, they can take a piece of tissue (biopsy) to be analyzed in the laboratory.

Therapy

If the cyst does not cause disturbances, no drug or surgical treatment is necessary. Only if it increases excessively in size or becomes infected and becomes painful, therapies should be performed which, in the opinion of the doctor, may include:

  • compresses with warm water and salt several times a day, to be carried out for three or four days in the hope that the wall of the cyst opens spontaneously, letting out the infected liquid present inside them
  • antibiotics, to be taken in case of abscess on prescription. They are rarely able to solve the problem and do not rule out the need for surgical incision
  • surgical drainageThis is done using local anesthesia in most cases. The doctor makes a small incision in the cyst to drain the infected fluid. Then he inserts a small drain (for example, hemmed gauze) to keep the incision open and allow the complete release of the contents before re-epithelialization (wound closure) of the cyst
  • marsupialization, a surgical procedure lasting about 15 minutes performed under local anesthesia. It offers the best results by preventing the cyst from returning. After having incised the wall, the doctor applies stitches to maintain a permanent opening of the excretory duct of the gland and prevent possible recurrence. Again, a drain is inserted and the stitches are removed after two weeks to prevent the incision from closing. spontaneously
  • excision of the Bartholin's gland, carried out only in cases where other treatments have failed and Bartholinitis has manifested itself several times.It is a complex procedure that lasts about an hour and requires general anesthesia and hospitalization. In addition to the risk of bleeding and possible infections, the removal of the gland can leave scars and deprives the woman of the vaginal lubrication guaranteed by the Bartholin gland.

To facilitate good wound healing and avoid infectious complications, after the surgery it is suggested to avoid sexual intercourse for a month, the use of vaginal tampons and perfumed soaps.

Prevention

There is no way to avoid the development of a Bartholin's cyst, however good intimate hygiene and the use of condoms in sexual intercourse, to avoid sexually transmitted infections, can help prevent infection of the cyst and its transformation into an abscess. .

Bibliography

NHS. Bartholin "s cyst (English)

Mayo Clinic. Bartholin "s cyst (English)

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