Bartholinitis (cyst or abscess of the Bartholin gland)

What is it about ?

Bartholin’s glands are 2 glands located in the wall of the vagina, rather towards the back. They measure about 1 cm and produce secretions that lubricate the entrance to the vagina. The small duct through which these secretions flow measures about 2 cm and opens on the inner side of the rear part of the labia minora. When this duct is blocked, secretions build up in the gland, creating a cyst that can become infected with bacteria and form an abscess. This inflammation is called bartholinitis.

What is its frequency?

About 2% of women experience Bartholin gland disease at one time or another.

How to recognize it?

• a cyst may be present without causing symptoms. A small lump is palpable in the wall of the vagina. If the cyst gets bigger, it can cause pain during sex.
• A cyst can become infected and form a very painful abscess, which causes discomfort when you sit down and when you walk. You may also have a fever.
• A mild infection of the Bartholin gland is accompanied by a small discharge of pus from the canal to the interior of the vagina.

How is the diagnosis made?

• The doctor almost always makes the diagnosis on the occasion of a simple gynecological examination. He sends a sample of pus or vaginal secretion to the laboratory.
• In order to exclude a STI (sexually transmitted infection)such as gonorrhea or Chlamydia infection, your doctor may also perform a test.
• If in doubt, a ultrasound is carried out.
• If symptoms persist despite treatment, a biopsy is programmed: a small piece of tissue is taken and sent to the laboratory for analysis.

What can your doctor do?

Cyst

• a cyst that does not cause any disturbance does not necessarily have to be treated.
• If he’s embarrassing, the cyst is treated by ‘marsupialization’ i.e. that the cyst is open and the walls are folded up and attached to the mucous membranes. It is also possible to insert a catheter. The advantage of these techniques is that they preserve the gland. The gland will only be removed after other treatments have failed.

Abscess

• In the presence of a abscess, a small incision is made under local anesthesia in the wall of the vagina. The pus can then drain out. Sometimes the doctor prescribes antibiotics.
• In case of’nascent abscess, we can try to be satisfied with an antibiotic therapy. But a little intervention is required in most cases.

Between 5 and 15% of women develop a new abscess or cyst after the incision.

An alternative treatment is to insert a small catheter under local anesthesia. This will allow the pus to drain. A balloon will then be inflated in the abscess cavity. The catheter should remain in place for 3 weeks.

Want to know more?

• What are STIs? (video) – LoveAttitude
• Ultrasound here Where to find on this page of Cliniques St Luc UCL

Source

Foreign clinical practice guidelines’ Bartholinitis; Bartholin’s gland abscess and cyst (2000), updated on 08.10.2017 and adapted to the Belgian context on 05.29.2019 – ebpracticenet