- What is bartholinitis?
- Why bartholinitis occurs: the main reasons
- Bartholinitis: Symptoms
- Bartholinitis: how is the diagnosis made?
- Bartholinitis treatment
- Is bartholinitis the cause of infertility?
- What is dangerous bartholinitis during pregnancy?
- Bartholinitis: prevention
Bartholin's paired glands are the largest of all the glands of the external female genital organs. They produce a viscous secret, whose function is to maintain an optimal level of moisture in the vagina. In the presence of certain conditions and factors, the Bartholin glands (or one of them) can become inflamed - as a result, a rather serious disease occurs that is fraught with complications.
What is bartholinitis?
Bartholinitis is a disease characterized by the development of the inflammatory process in the Bartholin gland. Most often, the pathology is one-sided - that is, only one of the paired glands suffers.
At the first stage of the disease, various violations of the patency of the ductal duct of the gland occur, as a result, it gradually becomes blocked, the secretion outflow stops, and the discharge begins to accumulate directly in the gland. With the accumulation of mucus seal in the thickness of the labia begins to feel. A closed vessel becomes an ideal platform for the development of infection, which eventually goes on to the gland itself, and this is how Bartholinitis occurs.
Bartholinite, depending on the nature of the flow, manifests itself in the following forms:
- acute bartholinitis;
- chronic bartholinitis;
- false abscess (primary or secondary - when a previously formed cyst suppuated);
- true abscess.
Why bartholinitis occurs: the main reasons
The culprits of the occurrence of the disease are bacteria such as staphylococcus, Escherichia coli, Trichomonas, streptococci, Candida, etc. Most often, Bartholinitis begins as a result of the entry of pathogens into the Bartholin gland as a result of human infection with sexually transmitted diseases: chlamydia , gonorrhea , trichomoniasis.
There are a number of factors that significantly increase the risk of Bartholinitis:
- Violation of personal hygiene.
- All sorts of local microtrauma (excellent entrance gate for infection): scratching, scuffing, diaper rash.
- The presence in the body of chronic foci of neglected infections (pyelonephritis, caries ) - in this case, the pathogens enter the Bartholin gland with a current of lymph or blood.
- In some cases, operations affecting the urogenital area, with non-compliance with sanitary standards during their implementation or in violation of the prescribed rules in the postoperative period.
- Frequent change of sexual partners, greatly increasing the risk of contracting diseases that are sexually transmitted.
- Wearing too tight linen - as a result, the normal outflow of secretion is disrupted, as a result of which it stagnates, thus creating ideal conditions for the development of infection.
- The general decrease in immunity, vitamin deficiency, hypothermia - all this weakens the body's defenses, as a result of infection pathogens, without encountering significant obstacles on the way, they easily get into both the excretory duct of the gland and the gland itself.
In the overwhelming majority of cases, the very first symptom of Bartholinitis is inflammation of the excretory duct of the gland located in the vestibule in the vagina. The symptom manifests itself through reddening of the opening of this duct and the appearance of insignificant purulent-mucous secretions. In this case, the skin of the labia minora next to the duct orifice softens somewhat, and when probing, an increase in the Bartholin gland duct is detected. This is the stage preceding Bartholinitis, the disease itself occurs when the duct is blocked, it thickens and accumulates mucus, and, as a result, the inflammatory process goes directly to the gland.
Symptoms of acute bartholinitis:
- Redness around the exit of the exit duct of the gland - while the patient's condition does not change.
- Feeling for an increase in the excretory duct of the gland - while pressing, a small amount of pus is released from it.
The inflammatory secret, continuing to accumulate in the lobes of the gland due to blockage of the duct, soon leads to a false abscess. This condition is already manifested through the following symptoms:
- Suddenly appeared severe pain in the area of the labia majora, where the abscess developed - it is so pronounced that the patient experiences real agony when walking, sitting and stool discharge.
- Increase in body temperature to 39 degrees.
- Weakness, chills, weakness.
Among the local signs of a false abscess are the following:
- The swelling of the labia majora on the side of the onset of pathology - sometimes its size is so large that it completely blocks the entrance to the vagina.
- Redness of the skin over swelling while maintaining its mobility.
- Painful sensations during palpation of the affected labia majora.
If a softening of the swelling is suddenly detected, this is a sign of the development of a true abscess with the formation of a purulent capsule in the cavity of the Bartholin gland.
Among the common symptoms of a true Bartholin gland abscess, the following are common:
- Deterioration of the patient’s general condition, characterized by a rise in temperature of up to 40 degrees and an increase in the intensity of intoxication symptoms (weakness, headache, chills, dizziness).
- Increased pain in the labia majora, from which the pathology was formed: the pain becomes pulsating and constant.
- Increased leukocytes and ESR, detected by the results of laboratory blood tests.
Local signs of a true abscess are:
- pronounced swelling of the labia majora, the volume of which can be very significant;
- bright red skin over the swelling - while it is motionless;
- sharp painful sensations during palpation of swelling;
- in some cases, an increase in the inguinal lymph nodes.
Sometimes an abscess is opened independently, after which the patient’s well-being immediately begins to improve: the temperature normalizes, the edema subsides, and the pain disappears. However, one should not put too high hopes on self-healing, and at the first signs of Bartholinitis, seek qualified medical assistance.
With regard to chronic Bartholinitis, then this disease is characterized by a long course, accompanied by periods of exacerbation and subsidence. Relapses are usually caused by factors such as menstruation, hypothermia, etc. And at this moment the symptoms of chronic Bartholinitis repeat the symptoms of acute Bartholinitis. The most frequent result of the untreated chronic Bartholinitis is the occurrence of a cyst of the large gland of the anterior vesicle.
Bartholinitis: how is the diagnosis made?
The definition of Bartholinitis does not cause any particular difficulties for the gynecologist. To make an accurate diagnosis, it may be necessary to carry out the following procedures:
- interviewing the patient with details of her complaints and clarifying the history;
- examination on the chair, during which the color and size of the gland and the tumor is evaluated, and the presence of cysts is either confirmed or refuted;
- tests for the detection of sexually transmitted diseases and AIDS - all this can be the causes of Bartholinitis, without eliminating which it is impossible to fully treat it;
- a smear on bioflora - is also done in order to identify the “conservatives” of pathology;
- complete blood count - revealed the level of leukocytes and ESR;
- urinalysis - to identify the risk of infection in the urinary system;
- Bacterial seeding - for growing the pathogen in a favorable environment and its subsequent identification in order to designate the most effective treatment.
Treatment of Bartholinitis, 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 area of a bubble wrapped with ice), as well as the use of special ointments and compresses.
- Physiotherapy treatment. Procedures can only be started after the onset of improvements in the patient's condition (as a rule, this is 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 fever, etc. The method in particular involves the use of magnetic therapy, laser and UHF.
- Antibiotics. The cause of Bartholinitis is always an infection - therefore, antibiotics are indispensable. Of course, these should be drugs to which the pathogen is sensitive. However, the identification of "culprits" by means of bacteriological seeding can take a long time, and it is desirable to begin treatment as soon as possible. Therefore, most often in the first stage, the doctor prescribes broad-spectrum antibiotics. In addition, analgesic and anti-inflammatory drugs are often additionally prescribed.
- Surgical intervention. In some cases, not to do without surgery. However, surgery cannot be limited to simply opening a cyst or abscess. The fact is that the tissues on which the pathology is formed tend to clump together quickly after dissection, as a result of which the duct is again clogged. Therefore, there are two options for surgery:
- complete removal of the gland (extirpation);
- formation of the artificial Bartholin gland duct (marsupialization).
Is bartholinitis the cause of infertility?
Many are worried about whether Bartholinitis can cause infertility. By itself, the disease is not an obstacle to conception. But the chronic pathological process in the vagina, which causes regular inflammation of the Bartholin gland, is often the true reason for not being able to become pregnant.
What is dangerous bartholinitis during 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, are not able to prevent the transmission of infection to the fetus by hematogenous means - that is, through blood.
If the cause of Bartholinitis is Trichomonas or gonococcus, the effect on the fetus of these infections can cause disturbances in the development of various organs and systems of the fetus.
If a woman becomes ill with Bartholinitis between conception and the twenty-second week of pregnancy, the probability of a miscarriage or death of the fetus is high. In cases where the future mother is diagnosed with this disease in the last periods, the risk of premature birth and infection of the child during the passage of the birth canal significantly increases - the eyes, umbilical ring, lungs are affected.
Naturally, like any disease, Bartholinitis is easier to prevent than to treat for a long time. And simple preventive measures gain the most importance in the time of a woman bearing 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 Bartholinitis includes the following activities:
- compliance with the rules of hygiene of the external genital organs - is of fundamental importance;
- the use of contraceptives during casual sex or the presence of a single sexual partner;
- timely treatment of foci of chronic infection: urethritis, colpitis, caries, pyelonephritis, etc .;
- annual preventive visits to the gynecologist, even in the absence of complaints;
- avoiding wearing tight underwear, especially synthetic;
- general strengthening of immunity: proper sleep, proper nutrition, an active enough lifestyle, avoidance of hypothermia, etc.