What is Bartholinite?
Bartholinitis is an inflammatory disease, during which the large gland vestibular gland is affected.
Causes of Bartholinitis
Most often, the pathology is caused by such pathogens as streptococci, staphylococci, E. coli, Proteus. More rarely, gonococci, trichomonads, and other pathogens act as pathogens.
Symptoms of Bartholinitis
Defeat with Bartholinitis can be located in different parts of the gland, this to some extent affects the specificity of the manifestations of the disease. The duct of the gland may be affected, leading its contents to the outside, in which case the disease will be called canaliculitis, or directly the gland itself (Bartholinitis itself). Canaliculitis is often caused by bacteria that trigger the development of gonorrhea.
It is characteristic that in this case the patient does not experience any unpleasant or painful sensations in the affected area. When visiting a doctor, complaints are most often absent, which in some cases is the cause of late diagnosis and a later start of treatment of the disease. The first symptom of the disease is the appearance of a red-colored roller around the opening whereby the iron opens on the surface of the mucous membrane. If you press on it, then droplets of pus are emitted from the lumen of the duct. They are the material that is taken from the patient for research under a microscope and for sowing on nutrient media in order to identify pathogens. In other cases, blockage of the lumen of the gland with droplets of thick pus, rejected by the cells of the surface layer of the mucous membrane, microorganisms can occur. At the same time, the outflow of the contents is sharply disturbed, the so-called pseudoabssess of the gland arises, that is, the gland itself turns into a large cavity filled with pus. When this occurs, there is largely a violation of the general well-being of the patient. There are complaints of weakness, fatigue, increased body temperature, disturbed sleep, appetite. In the area of the external genital organs, the patient experiences constant discomfort. At the border of the middle and upper thirds of the labia majora, a zone of significant edema and redness of the mucous membrane appears. When feeling this place develop very strong pain. The tissues surrounding the pathological focus become hot to the touch, edematous.
Signs of the disease in this case are immediately visible: in the region of the vestibule of the vagina there is a noticeable protrusion, sometimes of rather large size. It sticks out the outer or inner surface of the labia majora of the corresponding side, adjacent to the labia minora, almost completely blocking the entrance to the vagina. At the same time, in the area of the inner surface of the labia, a bright red spot is seen around the gland duct opening to the mucous membrane.
Especially strong pains are noted by patients during walking.
With the penetration of pathogenic microorganisms into the walls of the gland, as well as into the surrounding tissues, the picture of the disease becomes much harder, and a true abscess of the large gland of the vestibule of the vagina develops. The general well-being of a sick woman is very much worse. Significantly increased body temperature, chills appear, very intense headaches, sharp, sharp pain in the external genital organs, which occur not only during movement and walking, but also when the patient is at rest. When examining the affected area in the region of the vestibule of the vagina, you can see a protrusion, in appearance resembling a tumor. If the cavity of the gland contains a large amount of purulent masses, then the so-called symptom of fluctuation can be determined: when pushing towards the pathological formation, a wave movement is felt inside. Bartholin gland abscess can exist indefinitely, sometimes it spontaneously opens. The pus contained in it is excreted. At the same time, the patient’s condition improves significantly: the body temperature decreases, the general state of health rises, and pain almost completely disappears. But such an improvement is only imaginary, since soon the disease develops anew.
The most simple therapy for canaliculitis, since this form of the disease is the most superficial, the pathogens do not have time to penetrate to a considerable depth. Antibiotics or other antibacterial agents are prescribed to such patients. It should always be before the appointment of such drug therapy to take the patient’s material for research to clarify the type of microorganism causing the pathological process, as well as its sensitivity to antibacterial drugs. This allows for the most effective treatment of the disease.
Also a very good effect can be obtained by taking warm baths with the addition of a solution of potassium permanganate, applying to the place of the source of inflammation of the bladder with ice. This procedure is performed for 1 h 3-4 times a day, taking breaks between sessions for 30 minutes. Applications of various ointments can be applied, but only until the above-described symptom of fluctuation appears in the affected area. Symptomatic therapy in the form of anti-inflammatory, painkillers, vitamin preparations, etc. is also widely used. On the 3-4th day of illness, when the patient’s condition is somewhat normalized, you can begin to use physiotherapy, such as ultraviolet radiation and UHF.
With the appearance of signs of a large vaginal gland pseudoabscess, the treatment should only be operative. Pre-produce intravenous analgesia using various solutions. At the beginning of the operation, the touch determines the place where the most pronounced sign of fluctuation is. Then it is in this area that the dissection of the duct of the gland is made. The mucous membrane of the gland turns inside out and is stitched to the mucous membrane of the vulva. This surgical intervention was called Marsupalization.
If, after the treatment, the disease develops again and again, new abscesses and cysts appear, then the large vesicle gland is surgically completely removed.
With pseudo-and true abscess glands of gonorrheal origin, along with surgery, the appointment of appropriate antibacterial drugs. Their dosages are selected individually for each patient by the attending physician.