BARTHOLINITIS

Bartholinitis: description

In Bartholinitis, the 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 gonads near the entrance to the vagina. During sexual intercourse, she clears a clear, light secretion, which moistens the vaginal vestibule and thus reduces the friction when penetrating the penis. The ducts of the two glands open on the inside of the labia minora outwards.

Bartholinitis is the most common cause of pubic swelling. It can occur in adult women of all ages, but it develops especially in younger and sexually active women.

Bartholinitis: symptoms

Bartholinitis causes a (usually one-sided) swelling in the lower third of one of the small and large labia. This swelling can reach the size of a hen’s egg or even tennis ball and is very painful. Even when sitting or walking, many patients complain of pain. The affected mucosal area is red. Sometimes fever also occurs.

Bartholinitis: causes and risk factors

Bartholinitis can be caused by a variety of bacteria, including those naturally occurring 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 morbid (pathogenic) bacteria are the triggers of Bartholinitis, such as certain pathogens of venereal diseases: chlamydia and gonococci (Neisseria gonorrhoeae, exciters of gonorrhea = gonorrhea).

In most cases Bartholinitis develops on the basis of a Bartholin cyst. The affected Bartholin gland is swollen by a jam of the glandular secretion, but initially not inflamed. In the blocked secretions bacteria can multiply well, which then leads to an inflammation.

More rarely, Bartholinitis develops directly by infection with pathogenic bacteria, which have penetrated from the vaginal vestibule into the duct of a Bartholin gland.

Bartholinitis: examinations and diagnosis

If you have swelling in the pubic area you should consult your gynecologist. He can find out whether – as is often the case – a Bartholinitis behind it. First, the doctor will ask you in detail about your symptoms and the history of the disease (anamnesis). Possible questions are:

• Which symptoms do you suffer from?
• When did you notice the swelling?
• Have you ever had such a swelling or a proven Bartholinitis?

Subsequently, the doctor will examine the swelling. He is careful, because the swelling in a Bartholinitis is very painful. The examination and examination, together with the anamnesis, are usually sufficient to clearly diagnose Bartholinitis.

If there is a suspicion that the infection is caused by gonococci, the doctor will probably make a smear from the area of ​​the vagina and urethra to have it examined in the laboratory for these germs.

Bartholinitis: treatment

Bartholinitis rarely heals on its own. It should therefore be treated.

Bartholinitis: Conservative treatment

Bartholinitis is generally treated conservatively in the early stages. Anti-inflammatory and analgesic measures are used, for example in the form of ointments. Even with sitz baths or envelopes that contain anti-inflammatory additives, you can treat yourself for mild Bartholinitis. Sometimes heat (such as red-light irradiation) is helpful: it causes the focus of inflammation to be isolated from healthy tissue.

Treatment with antibiotics is particularly indicated when the bartholinitis by gonococcal – the causative agent of the sexually transmitted gonorrhea (gonorrhea) – was triggered.

Bartholinitis: surgical treatment

Surgical treatment is necessary in advanced stage bartholinitis, ie when the inflammation has led to the formation of a collection of pus (empyema, abscess) or a cyst (see also below: disease course and prognosis). To do this, the doctor cuts the excretory duct and sutures the side walls with the skin edges. So the gland duct is kept open, and the contents can flow away unhindered. This procedure is called Marsupialization and performed under general anesthesia.

If the Bartholinitis despite treatment always returns, usually the entire gland is removed (extirpation).

Bartholinitis: disease course and prognosis

Due to the inflammation-induced swelling of the tissue, the excretory duct of the affected Bartholin gland can be relocated. The secretion produced by the gland can then no longer drain away. It can form pus and accumulate in the misplaced excretory duct. Physicians then speak of an empyema. In rarer cases it comes to purulent melting of the surrounding tissue. Thus, a new cavity is formed in which the pus accumulates. Then there is a Bartholin abscess.

With recurring BARTHOLINITIS may end up as a Bartholin cyst (Bartholin cyst).