Diagnosis and treatment of Bartholinitis

The greater vestibular glands, also known as Bartholin glands, are glands located on both sides of the vaginal opening behind the vestibular bulbs. They are about the size of soybeans. Each gland has a thin gland duct that flows into the common gland duct. The common gland duct opens in the vestibule of the vagina, which is equivalent to the junction of the middle and lower thirds of the labia minora. Careful observation will reveal a small opening.

The vaginal opening is easily contaminated and infected. In case of vulvovaginitis, the Bartholin's glands may also become inflamed and even form abscesses. If the opening of the Bartholin's gland duct is blocked, the secretions may accumulate and form cysts, and secondary infection of the cysts may also become abscesses.

1. Diagnosis

Bartholin's gland inflammation usually occurs during the childbearing years, and rarely occurs in infants and young children and after menopause. This indicates that this disease is also related to sexual activity. Sexual hygiene is a factor that cannot be ignored. The pathogens are mostly staphylococci, streptococci, Escherichia coli, enterococci, etc. Gonorrhea is also a common pathogen. Gonorrhea infection has shown a clear upward trend in recent years.

In the acute infection stage, local symptoms include redness, swelling, heat, and pain, and systemic symptoms are sometimes not obvious. Local inflammation can cause difficulty in defecation, pain during sexual intercourse, etc. If the inflammation progresses, an abscess may occur. At this time, there may be a swelling in the middle and lower parts of the labia majora, with aggravated pain, a foreign body sensation, or throbbing pain, and walking is also restricted, or there is fever. Examination can reveal red, swollen, and hard lumps in the middle and lower parts of the labia majora, as big as pigeon eggs or chicken eggs, with tenderness, often unilateral, and edema of the surface skin and mucous membranes. The abscess is fully formed and can be palpated and fluctuated. The ipsilateral inguinal lymph nodes may be enlarged or tender, and the white blood cell count may occasionally increase.

The diagnosis of vestibular gland inflammation or vestibular gland abscess should not be difficult, but sometimes the doctor cannot know its location very accurately. Due to the pain and the mass occupying the vaginal opening, endoscopic examination is often impossible. Finger palpation can be used to determine the location and nature, and to distinguish whether an abscess has formed or whether it is complete, because this is related to treatment.

2. Processing

Bartholinitis is the initial acute stage of Bartholin's gland inflammation. Patients should stay in bed, pay attention to local cleanliness of the vulva, and avoid sexual intercourse. Cold compresses and physical therapy are often effective and can quickly subside the inflammation. Antibiotics should also be given at the same time.