Bartholinitis
Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
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Doctors refer to the bacterial inflammation of the duct of one of the two Bartholin glands as Bartholinitis. These sex glands are located next to the entrance to the vagina. Very often the inflammation arises as a result of a Bartholin's cyst (Bartholin's cyst). Conversely, bartholinitis can also be the cause of such a cyst. Read more about the causes, symptoms and treatment of Bartholinitis here!
Bartholinitis: description
In Bartholinitis, the duct of one of the two Bartholin's glands (glandulae vestibulares majores) is inflamed - the gland itself is rarely affected.
The Bartholin glands are pea-sized sex glands next to the entrance to the vagina. During sexual intercourse, they secrete a clear, bright secretion that moisturizes the vaginal vestibule and thus reduces the friction when penetrating the penis. The ducts of the two glands open outwards on the inside of the labia minora.
Bartholinitis is the most common cause of pubic swelling. It can occur in adult women of any age, but it is particularly common in younger and sexually active women.
Bartholinitis: symptoms
Bartholinitis causes swelling (usually one-sided) in the lower third of one of the small and large labia. This swelling can reach the size of a chicken egg or even a tennis ball and is very painful. Many patients also complain of pain when sitting or walking. The affected area of the mucous membrane is reddened. Sometimes a fever also occurs.
Bartholinitis: causes and risk factors
Bartholinitis can be caused by a variety of bacteria, including those that occur naturally in or on the human body. These include, for example, Escherichia coli (in the intestine) and Staphylococcus aureus (on the skin, in the nose, etc.). Occasionally, pathogenic bacteria are the triggers of bartholinitis, such as certain pathogens of sexually transmitted diseases: chlamydia and gonococci (Neisseria gonorrhoeae; pathogen of gonorrhea = gonorrhea).
In most cases, Bartholinitis develops from a Bartholin's cyst. The affected Bartholin's gland is swollen due to a build-up of the glandular secretion, but initially not inflamed. Bacteria can multiply well in the blocked secretion, which then leads to inflammation.
Bartholinitis develops more rarely directly through infection with pathogenic bacteria that have penetrated from the vaginal vestibule into the duct of a Bartholin gland.
Bartholinitis: examinations and diagnosis
If there is swelling in the pubic area, you should consult your gynecologist. He can find out whether - as is very often the case - the cause is bartholinitis. First, the doctor will ask you in detail about your symptoms and medical history (anamnesis). Possible questions are:
- What ailments do you suffer from?
- When did you notice the swelling?
- Have you ever had such a swelling or proven bartholinitis?
The doctor will then examine the swelling. He works cautiously because the swelling in bartholinitis is very painful. The assessment and examination, together with the anamnesis, are usually sufficient to make a clear diagnosis of Bartholinitis.
If the inflammation is suspected to be caused by gonococci, the doctor will likely take a swab of the vagina and urethra to have a laboratory test for these germs.
Bartholinitis: treatment
Bartholinitis rarely heals on its own. It should therefore be treated.
Bartholinitis: Conservative Treatment
In the early stages, bartholinitis is generally treated conservatively. Anti-inflammatory and analgesic measures are used, for example in the form of ointments. You can also treat mild bartholinitis yourself with hip baths or compresses that contain anti-inflammatory additives. Sometimes heat (such as red light radiation) is also helpful: it causes the focus of inflammation to become isolated from healthy tissue.
Treatment with antibiotics is particularly indicated if the bartholinitis was triggered by gonococci - the causative agent of the sexually transmitted disease gonorrhea (gonorrhea).
Bartholinitis: Operative Treatment
Surgical treatment is necessary in the case of Bartholinitis in the advanced stage, i.e. when the inflammation has led to the formation of an accumulation of pus (empyema, abscess) or a cyst (see also below: Course of the disease and prognosis). To do this, the doctor cuts open the duct and sutures the duct walls to the edges of the skin. This keeps the gland duct open and the contents can flow away unhindered. This procedure is called marsupialization and is performed under general anesthesia.
If the bartholinitis keeps coming back despite treatment, the entire gland is usually removed (extirpation).
Bartholinitis: disease course and prognosis
The inflammation-related swelling of the tissue can obstruct the duct of the affected Bartholin's gland. The secretion still produced by the gland can then no longer flow away. Pus can form and accumulate in the obstruction of the duct. Doctors then speak of an empyema. In rarer cases, the surrounding tissue is melted with a purulent substance.So a new cavity is formed in which the pus collects. Then there is a Bartholin abscess.
With recurring Bartholinitis, a Bartholin's cyst (Bartholin's cyst) can develop as the final condition.
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