- What is Bartholinitis?
- Why bartholinitis occurs: the main reasons
- Bartholinitis: symptoms
- Bartholinitis: How is the diagnosis made?
- Treatment of bartholinitis
- Is bartholinitis the cause of infertility?
- What is dangerous bartolinitis in pregnancy?
- Bartholinitis: prevention
Bartholinic paired glands are the largest of all glands of external female genital organs. They produce a viscous secret, the function of which is to maintain the optimum moisture level in the vagina. In the presence of certain conditions and factors, bartholin glands (or one of them) can become inflamed - as a result, a serious enough disease, fraught with complications, arises.
What is Bartholinitis?
Bartholinitis is a disease characterized by the development of the inflammatory process in the Bartholin gland. Most often, pathology is one-sided - that is, only one of the twin glands suffers.
At the first stage of the disease there are various violations of the patency of the excretory duct of the gland, as a result it is gradually clogged, the outflow of secretion ceases, and the secretions begin to accumulate directly in the gland. As the mucus accumulates, the thickening of the labia begins to feel. The clogged vessel becomes an ideal site for the development of infection, which eventually passes over to the gland itself - and the disease bartolinite arises.
Bartholinite, depending on the nature of the course, manifests itself in the following forms:
- Acute bartholinitis;
- Chronic bartholinitis;
- A false abscess (primary or secondary - when a previously formed cyst is inflamed);
- A true abscess.
Why bartholinitis occurs: the main reasons
"Culprits" of the onset of the disease are such bacteria as staphylococci, E. coli, Trichomonas, streptococci, Candida, etc. Most often, bartolinite begins as a result of getting into the Bartholin gland pathogens as a result of infection of a person with sexually transmitted diseases: chlamydia , gonorrhea , trichomoniasis.
There are a number of factors that significantly increase the risk of bartolinite:
- Violation of the rules of personal hygiene.
- All sorts of local micro-traumas (excellent entrance gates for infection): scratching, rubbing, intertrigo.
- The presence in the body of chronic foci of neglected infection (pyelonephritis, caries ) - in this case, the pathogens fall into the Bartholin gland with a current of lymph or blood.
- In some cases - surgery affecting the genitourinary sphere, if the sanitary norms are not observed during their conduct or when the prescribed rules are violated during the post-operation period.
- Frequent change of sexual partners, greatly increasing the risk of contracting diseases that are sexually transmitted.
- Wearing too tight underwear - as a result, the normal outflow of secret is broken, so it stagnates, thus creating ideal conditions for the development of infection.
- The general decrease in immunity, avitaminosis, hypothermia - all this weakens the defenses of the body, as a result of infectious agents, without encountering significant obstacles on the way, easily fall into both the outflow of the gland duct and the gland itself.
The very first symptom of bartholinitis in the vast majority of cases is the inflammation of the excretory duct of the gland located at the vestibule in the vagina. The symptom is manifested through the reddening of the opening of this duct and the appearance of minor purulent-mucous discharge. At the same time, the skin of the labia minor next to the opening of the duct is softened somewhat and, when probed, an increase in the inferior duct of the bartholin gland is found. This is a stage that precedes Bartholinitis, the disease itself occurs when the duct is blocked, thickens and accumulates mucus, and as a result, the inflammatory process passes directly to the gland.
Symptoms of acute bartholinitis:
- Redness around the exit site of the excretory duct of the gland - while the patient does not feel well.
- The palpation of the enlargement of the excretory duct of the gland - while pressing from it a small amount of pus is released.
Inflammatory secret, continuing to accumulate in the lobules of the gland due to obstruction of the duct, soon leads to the occurrence of a false abscess. This condition manifests itself through the following symptoms:
- Suddenly there was a strong pain in the area of that large labia, where the abscess developed - it is so pronounced that the patient experiences real pain when walking, sitting and stepping off a chair.
- Raise body temperature to 39 degrees.
- Weakness, chills, weakness.
Among the local signs of a false abscess are the following:
- The swelling of the large labia on the side of the appearance of the pathology - sometimes its dimensions are so large that it completely blocks the entrance to the vagina.
- Redness of the skin above the swelling while maintaining its mobility.
- Painful sensations when probing the affected large labia.
If suddenly there is softening of the swelling, this is a sign of the development of a true abscess with the formation of a purulent capsule in the Bartholin gland cavity.
Among the common symptoms of the true abscess of the Bartholin gland, the following manifestations are common:
- Deterioration of the general condition of the patient, characterized by a rise in temperature to 40 degrees and an increase in the intensity of symptoms of intoxication (weakness, headache, chills, dizziness).
- Increased pain in the labia majora, from which the pathology was formed: the pain becomes pulsating and permanent.
- The increase in leukocytes and ESR, revealed by the results of laboratory blood tests.
Local signs of the appearance of a true abscess are:
- Pronounced edema of the labia majora, the volumes of which can be quite significant;
- Bright red color of the skin above the swelling - while it is still;
- Sharp painful sensations at palpation of a swelling;
- In some cases, an increase in inguinal lymph nodes is observed.
Sometimes the abscess is opened by itself, after which the patient's state of health improves immediately: the temperature normalizes, the edema subsides, and pain disappears. However, one should not place too high hopes for self-healing, and at the first signs of bartholinitis seek qualified medical help.
As for chronic bartholinitis, this disease is characterized by a prolonged course, accompanied by periods of exacerbation and subsidence. Relapses usually cause such factors as menstruation, hypothermia, etc. And at this point, the symptoms of chronic bartholinitis repeat the symptoms of acute bartholinitis. The most common result of untreated chronic bartholinitis is the appearance of the cyst of the large gland of the vagina vestibule.
Bartholinitis: How is the diagnosis made?
The definition of bartholinitis does not cause any difficulties for the gynecologist. To make an accurate diagnosis, you may need to perform the following procedures:
- Questioning the patient with details of her complaints and finding out an anamnesis;
- Examination on the armchair, during which the color and size of the gland and tumor are assessed, and the presence or presence of cysts is confirmed or refuted;
- Analyzes for the detection of sexually transmitted diseases and AIDS - all this may be the cause of bartholinitis, without the elimination of which it is impossible to fully treat it;
- Smear on bioflora - is done the same way with the purpose of revealing the "inmates" of pathology;
- A common blood test - the level of leukocytes and ESR is detected;
- General urine analysis - to identify the risk of infection in the urinary system;
- Bacterial culture - for growing the pathogen in a favorable environment and its subsequent identification with the purpose of prescribing the most effective treatment.
Treatment of bartholinitis
Treatment of bartholinite depending on the characteristics of each specific case can be carried out by the following methods and their combinations.
- Local treatment. This method involves rest, cold (application for 40 minutes to the inflamed place of a tissue-wrapped bladder with ice), as well as the use of special ointments and compresses.
- Physiotherapy treatment. It is possible to start the procedure only after the onset of improvements in the patient's condition (usually the third day after the onset of the disease), accompanied by a decrease in the intensity of signs of general intoxication - chills, nausea, headache, high temperature, etc. The method in particular involves the use of magnetotherapy, laser and UHF.
- Antibiotics. The cause of bartholinitis is always an infection - so antibiotics can not be avoided. Of course, it must be drugs to which the pathogen is sensitive. However, the identification of "culprits" through bacteriological inoculation can take a long time, and it is advisable to start treatment as early as possible. Therefore, most often at the first stage the doctor prescribes antibiotics of a wide spectrum of action. In addition, often additionally prescribed painkillers and anti-inflammatory drugs.
- Surgical intervention. In some cases, you can not do without an operation. However, surgical intervention can not be limited to simply opening a cyst or abscess. The fact is that the tissues on which the pathology is formed have the property of rapidly sticking together after dissection, as a result of which the duct again becomes clogged. Therefore, there are two options for performing a surgical procedure:
- Complete removal of the gland (extirpation);
- Formation of an artificial duct of the bartholin gland (marsupialization).
Is bartholinitis the cause of infertility?
Many are concerned about the question of whether bartholinitis can cause infertility. In itself, the disease is not an obstacle to the conception. But the regular pathological process in the vagina causing regular inflammation of the bartholin gland is often the true cause of the inability to become pregnant.
What is dangerous bartolinitis in pregnancy?
Bartholinitis and its causes during pregnancy always have an adverse effect on the development of the fetus. And the protective mechanisms provided by nature, unfortunately, can not prevent the transmission of infection to the fetus by hematogenous way - that is, through the blood.
If the cause of bartolinite is Trichomonas or Gonococcus, the effect on the fetus of these infections can cause disruptions in the development of various organs and fetal systems.
If a woman becomes ill with bartholinitis during the period from conception and on the twenty-second week of pregnancy, the probability of spontaneous miscarriage or fetal death is high. In cases when the future mother is diagnosed with this disease on the last terms, the risk of premature birth significantly increases, as well as the infection of the child during the passage of the birth canal - the eyes, the umbilical ring, the lungs are affected.
Naturally, like any disease, bartholinitis is easier to prevent than to treat for a long time. And the most important simple preventive measures are acquired by the time a woman carries a child. All these recommendations may well become a way of life - none of them require special efforts for their implementation. So, the prevention of bartolinite includes the following activities:
- Observance of the rules of hygiene of external genital organs - is of fundamental importance;
- Use of contraceptives during casual sexual relations or having a single sexual partner;
- Timely treatment of foci of chronic infection: urethritis, colpitis, caries, pyelonephritis, etc .;
- Annual preventive visit to the gynecologist even in the absence of complaints;
- Avoiding wearing tight underwear, especially synthetic;
- General strengthening of immunity: full sleep, proper nutrition, sufficiently active way of life, avoidance of hypothermia, etc.