BARTHOLINITIS (1): WHAT IS IT?
Dr. Claude Allouche, Obstetrician-Gynecologist
Ahuza Clinic, Raanana, Israel
Contact: 058 726 02 64
Bartholinitis refers to an abscess of the Bartholin gland, typically caused by:
- A superinfection of a Bartholin's gland cyst due to the obstruction of its excretory duct.
- The ascent of germs from the vagina into the excretory duct of the gland.
Symptoms:
- A painful "lump" appears at the posterior part of one of the large labia, on one side only.
- Patients often experience throbbing pain, swelling, and sometimes fever.
- During a gynecological exam, the lump is several centimeters in diameter, tender, with redness in the surrounding skin. There may also be pus discharge and swollen lymph nodes in the groin.
Additional Tests:
- A bacteriological sample of the pus is taken to identify the responsible germ and adapt the antibiotic treatment accordingly.
- In cases of bilateral Bartholinitis, gonococcal infection is suspected.
Progression:
Without treatment, the abscess will grow in size and pain, eventually leading to fistulization (rupturing and draining to the skin).
BARTHOLINITIS (2): WHAT TREATMENT?
Treatment for Bartholinitis:
- Early stages: Antibiotics and painkillers may be prescribed.
- Severe or persistent cases: Surgical intervention is necessary.
Surgical Treatment:
- Drainage: A drainage incision is performed under general anesthesia once the abscess is fully developed. The abscess is drained, and its cavity is washed with antiseptic. A bacteriological sample is taken to identify the causative germ, possibly a sexually transmitted infection.
- Recurrence Prevention: To prevent the skin from closing too quickly and causing a recurrence, one of the following techniques is employed:
- Marsupialization: The incision is sutured to the skin edges, creating a permanent opening for drainage.
- Wicking: An antiseptic-soaked wick is inserted into the abscess cavity for 24-48 hours.
Gland Removal:
- In the acute phase, the Bartholin gland is typically left in place due to the risk of complications.
- Gland removal may be considered after the first recurrence, but it is performed after the infection has subsided when a residual cyst or nodule remains palpable.