How to treat Bartholinitis

Overview of Bartholinitis: Bartholinitis is located at the lower part of the labia majora, one on each side, and the gland duct opens on the inner side of the lower part of the labia minora on both sides of the vaginal opening. Due to the characteristics of this anatomical part, when the vulva is contaminated during sexual intercourse, childbirth, and other situations, pathogens can easily invade the gland and form Bartholinitis. Let's introduce the treatment of Bartholinitis in detail.

Diagnosis of Bartholinitis: Based on the medical history, local appearance and digital examination, it is generally not difficult to diagnose. However, attention should also be paid to whether there are any abnormalities in the urethral opening and paraurethral glands. Due to severe pain, vaginal speculum examination is no longer possible. If it is not necessary, it can be temporarily suspended. Generally, secretions from the opening of the Bartholin gland, the urethral opening, and the paraurethral glands should be taken for smear examination of pathogens.

Clinical manifestations of Bartholinitis: local pain, redness and swelling in the acute phase, the pain is most severe when Bartholin gland abscess forms. Fever is common, chills are rare. Sometimes urination and defecation are difficult. Clinical examination can reveal a red, swollen, hard lump in the lower 1/3 of the labia majora, which is obviously tender. If it has developed into an abscess, it is mostly egg to apple sized, often unilateral. The skin on the surface of the lump is red, curved and thin, and the surrounding tissues are edematous. When the inflammation is severe, it can spread to the perineum and the contralateral vulva. Local tenderness is significant, with a sense of fluctuation, and the inguinal lymph nodes are often enlarged.

Treatment measures for Bartholinitis: In the acute phase, patients should stay in bed and rest, pay attention to local cleaning, apply local cold compresses, and apply antibiotics. If an abscess has formed, it should be incised and drained immediately. The incision should be made at the thinnest part of the skin. Generally, a half arc incision is made on the inner side of the labia majora to drain pus. After disinfecting the vulva, an 18-gauge needle can be used to pierce the abscess cavity from the mucosal side to suck out the pus. The needle remains in place and 200,000 to 400,000 units of penicillin saline are slowly injected. After removing the needle, press with gauze or cotton balls for several minutes to prevent the drug from leaking out, and add a vulvar pad and fix it with a menstrual belt. After this method of treatment, the inflammation can usually subside within 24 hours, and the pain can be relieved. If the effect is not significant, the incision and drainage method can be adopted again. Various methods for treating Bartholin's gland cysts can also be used for treatment.

The first step in the treatment of Bartholin's glanditis is rest: those with systemic symptoms should rest in bed. In addition, the vulva must be kept clean and hygienic.

The second step in the treatment of Bartholinitis: local hot compress, infrared or microwave therapy.

The third step in the treatment of vestibular glanditis: systemic use of antibiotics. Before obtaining the culture results, broad-spectrum antibiotics can be selected. If it has not yet become purulent, taking medicine will promote the gradual improvement and absorption of symptoms. When there are systemic symptoms, fever, and elevated white blood cells, intravenous antibiotics such as cypermethrin or penicillin 800,000 u intramuscular injection are often used, twice a day. Cephalosporins can also be used: the first-generation cephalosporins have a strong antibacterial effect on Gram-positive cocci, the second-generation cephalosporins have a broad antibacterial spectrum and enhanced effects on Gram-negative bacteria, the third-generation cephalosporins have an antibacterial spectrum superior to the second generation, and some drugs are effective against anaerobic bacteria. Metronidazole 0.2-0.4g/time, 3 times/day; quinolones such as norfloxacin, ciprofloxacin, levofloxacin (Lailixin), 0.2g/time, 2 times/day. Or choose according to drug sensitivity. In addition, local hot compresses or sitz baths can be used for heat-clearing and detoxifying Chinese medicines such as dandelion, Viola yedoensis, honeysuckle, and forsythia. Or use 1:5000 potassium permanganate water for a sitz bath or local hot compress and then apply antibacterial ointment.

The fourth step in the treatment of Bartholinitis: Those who have abscesses should immediately undergo incision and drainage and ostomy. This is because simple incision and drainage can only temporarily relieve symptoms, and cysts or repeated infections may still form after the incision is closed. When performing incision and drainage of abscesses, pay attention to making the incision large enough to prevent poor drainage of pus, resulting in fistula formation or repeated abscess attacks.