Inflammation of the Bartholin gland: causes, symptoms. Methods for the treatment of inflammation of the Bartholin's gland. Bartholinitis. Treatment at home Inflammation of the gonads in women

Inflammatory diseases of the external female genital organs are very common. Bartholin's paired glands are the largest of all the glands in this area. In the presence of certain conditions and factors, they can become inflamed - as a result, a rather serious disease occurs, fraught with complications.

What is bartholinitis

Bartholinitis is an inflammation of the large (Bartholin) gland located in the vestibule of the vagina. It has a very narrow excretory duct, which completely closes in case of untimely treatment, which creates an obstacle to the release of its secret and is a prerequisite for suppuration. The purulent process extends to the tissue near the inflamed gland, which leads to the formation of a true abscess - a cavity filled with pus.

With bartholinitis, the gland increases in size, the mucous membrane above it turns red

Sometimes there is a false abscess of the Bartholin gland, which develops a second time in the area of ​​​​its cyst. Bartholin gland cysts are smooth-walled cavities filled with sterile glandular fluid. They occur when the duct of the glands is blocked. In case of infection of the contents of such a cavity, a false abscess is formed.

Bartholinitis occurs only in women, since men do not have Bartholin glands.

Disease classification

Bartholinitis can be classified as follows:

• according to the prevalence of the process:
  • unilateral;
  • bilateral;
• according to the nature of the course of the disease:
  • spicy;
  • subacute;
  • chronic, recurrent.

Bartholinitis most often has a unilateral localization and an acute course. But in the presence of a constant provoking factor, bartholinitis can acquire a chronic, relapsing course, that is, constantly return. Subacute disease is called in case of mild symptoms of inflammation (pain, redness, swelling, fever), which is often associated with the characteristics of the woman's immune system.

Reasons for the development of pathology

The cause of inflammatory changes in the Bartholin gland is infection of its lumen with pyogenic microorganisms (Staphylococcus aureus, Escherichia coli, Proteus, enterococci, etc.).

For the development of inflammation in the gland, there are a number of predisposing factors:

• neglect of genital hygiene, especially after childbirth, abortion, during menstruation;
• tight underwear, causing friction of the skin of the external genitalia and mechanical compression of the ducts of the Bartholin glands;
• irregular change of daily and sanitary pads.

Diabetes mellitus is a factor provoking the development of pustular diseases, including bartholinitis, as well as the vagina (). Therefore, in diabetes, bartholinitis and thrush are often combined. With their recurrent course, it is recommended to check the blood sugar level.

Bartholinitis is more likely to affect women of childbearing age, since the listed provoking factors are typical for this period.

Symptoms of bartholinitis

Inflammation of the Bartholin's gland is accompanied by the following symptoms:

• pain in the perineum, increasing with movement, defecation, sitting;
• swelling in the area of ​​the labia;
• redness;
• the release of pus from the excretory duct of the gland when trying to squeeze it out;
• sometimes - an increase in the size of the inguinal lymph nodes and their soreness;
• low fever, chills, weakness, body aches.

When an abscess occurs, the condition worsens significantly:

• fever, weakness, sweating increase;
• pain in the perineal area increases and becomes pulsating;
• the area of ​​edema and redness increases;
• in the area of ​​the vestibule of the vagina, a small, round, extremely painful formation appears, softened to the touch.

If you find the above symptoms, you should immediately consult a gynecologist.

Diagnostics

Diagnosis of bartholinitis includes a consultation with a gynecologist, who will suspect the pathology according to characteristic complaints, as well as when examining the external genitalia in the gynecological chair.

Additionally, with bartholinitis, the following studies are prescribed:

• general blood test - it is expected to increase the number of leukocytes and, which is a sign of an inflammatory process;
• examination of a vaginal smear under a microscope is a method that allows you to quickly determine the causative agent of the disease, but it is not always accurate, therefore it is used only for preliminary diagnosis;
• sowing the contents of the gland on a nutrient medium with determining the sensitivity of bacteria to antibiotics is a laborious, but the most accurate method for determining the causative agent of the disease and its sensitivity to antibiotics, which is very important due to the increase in the number of cases of bacterial infections that are resistant to the most commonly used antibacterial drugs (Amoxiclav , Ceftriaxone, etc.).

The result of sowing is usually known no earlier than 3 days after the sampling of the material.

With the formation of an abscess, the gynecologist, when examining the external genital organs, will see a rounded formation and a pronounced edema that extends to the large and small labia.

Unlike an abscess, a Bartholin gland cyst has an elastic consistency to the touch and is absolutely painless. The skin in the projection of the cyst is not changed in any way, the general well-being of the patient is not disturbed.

Sometimes cysts of the Bartholin glands reach large sizes, which leads to discomfort in the genital area, worsens the quality of intimate life.

Treatment Methods

Methods of treatment depend on the severity of the inflammatory process:

• In the absence of an abscess, therapy is carried out on an outpatient basis with the help of medications.
• With the formation of an abscess, urgent hospitalization and an autopsy are indicated.
• The cyst of the gland of the vagina, causing discomfort, is subject to prompt removal in a planned manner.
• With the asymptomatic existence of a cyst, there is no need for surgical correction.

With bartholinitis, local and general methods of therapy are used. At the time of treatment, it is necessary to abandon intimate life.

Local therapy

Locally prescribed:

With early treatment at the very beginning of the disease, physiotherapy can be locally prescribed:

• UHF - a physiotherapeutic method of treatment that uses electromagnetic fields of ultra-high frequency, a kind of heat treatment that, with the help of special equipment, penetrates into human tissues and organs;
• ultraphonophoresis on the projection area of ​​the inflamed gland is a method based on the combined action of ultrasound in combination with medicinal substances.

Physiotherapy has the following effects:

• improves blood circulation in the area of ​​inflammation;
• increases the number of immune system cells that destroy pathogenic microbes;
• relieves swelling;
• stimulates the rapid resorption of the infiltrate;
• prevents festering.

Recipes for the preparation of antiseptic decoctions, infusions, solutions for compresses and baths

Instead of pharmacy antiseptics, you can use herbal preparations (decoctions of chamomile, sage, etc.) for lotions and baths, saline solution for setting compresses.

Preparation of sage decoction:

1. Take 2 tablespoons of dry sage leaves, place them in an enamel bowl.
2. Pour 200 ml of hot water.
3. Put in a water bath, keep for 15 minutes.
4. Strain the resulting broth, squeeze the leaves through gauze.
5. Bring the volume of the broth to 200 ml by adding clean boiled water.
6. Cool to room temperature and use 2 times a day as a lotion.

Chamomile decoction is prepared in the same way. The ingredients are taken in the same proportions.

Preparation of infusion from nettle leaves, blackberries and yarrow flowers:

1. Take 1 tablespoon of the listed herbs.
2. Pour the mixture of leaves with 700 ml of boiling water.
3. Insist for 1.5 hours, then strain the cooled infusion.
4. Ready infusion is used for lotions on the external genitalia twice a day.

In addition to lotions, baths based on medicinal herbs are used. To prepare a bath with a pronounced anti-inflammatory effect, you will need:

1. Take 1 tablespoon of eucalyptus leaves, chamomile flowers and dried oak bark.
2. Pour the leaves with 1 liter of water.
3. Boil the mixture for 10 minutes.
4. The resulting broth should cool to room temperature, after which it must be filtered.
5. Immerse the external genitalia in the resulting broth for 15-20 minutes 1-2 times a day.

Instead of decoctions and infusions, baths with potassium permanganate can be used. To do this, you need to collect water (preferably boiled) in a basin and add a few crystals of potassium permanganate (the solution is prepared by eye). In a basin with a solution, it is necessary to immerse the external genitalia for 10-15 minutes. Potassium permanganate is a strong antiseptic that effectively fights the causative agent of the disease. The resulting solution should have a pale pink hue. The bright pink solution is too concentrated. Its use can lead to chemical burns of the mucosa.

Saline compress:

1. Take 3 tablespoons of table salt with a slide (90 grams).
2. Pour them into 1 liter of warm boiled water.
3. Stir until completely dissolved (a solution with a salt concentration of 10% is obtained).
4. Apply multi-layer gauze dressings with saline solution to the swollen labia, changing them as they dry.
5. Before changing bandages, rinse the genitals with clean boiled water.
6. Never cover the compress with airtight materials (oilcloth, cellophane).

Hypertonic salt solution attracts water from soft tissues, thereby reducing their swelling and severity of pain. In addition, a high concentration of salt contributes to the death of harmful microorganisms in the area of ​​​​inflammation.

Self-staging warm compresses on the area of ​​​​the inflamed gland can lead to the spread of infection.

With a recurrent course of inflammation, immunomodulatory therapy (candles Genferon, Viferon for insertion into the vagina) can be prescribed. These drugs are designed to increase local immunity of the external genital organs and to improve the overall resistance of the body to infections. Immunomodulators should be used during remission (after elimination of inflammation).

Serious medical studies confirming the effectiveness of immunomodulators have not been conducted, so many doctors do not recommend the use of these drugs, considering them useless.

Methods of systemic exposure

Common treatments include:

• antibiotic therapy;
• taking non-steroidal anti-inflammatory drugs (NSAIDs).

Bartholinitis is a bacterial disease, the causative agent of which is fought by antibiotics. Their appointment is necessary when the pathology is accompanied by an increase in body temperature. Antibiotics of various groups (for example, Amoxiclav, Ceftriaxone, Levofloxacin, Metronidazole, Clarithromycin, etc.) can be administered orally or by injection (intramuscularly or intravenously). After the analysis is ready, which determines the sensitivity of bacteria, the replacement of drugs is carried out if necessary.

You can not neglect antibiotics for bartholinitis and try to cure it yourself only with folk remedies (baths, lotions, saline). This can lead to the formation of an abscess.

With high fever (temperature over 38.5 ° C), as well as to relieve pain, NSAIDs are prescribed (Nurofen, Ketonal, etc.).

Treatment of an abscess of the gland of the vagina

When an abscess is formed, hospitalization in a gynecological hospital and opening of the abscess is required:

After surgery, antibiotic therapy is indicated. Inpatient therapy takes about 7 days. Then the woman is discharged for home treatment. Within 4-5 weeks you can not sit, you must refrain from sexual activity. Recovery after surgery is usually uneventful.

With a correctly made incision, the skin and mucous membranes near the vagina heal without pronounced scars and there is no further discomfort during sexual intercourse.

Sometimes, with untimely treatment, the opening of the abscess occurs spontaneously. Usually, after this, the severity of the pain syndrome decreases, and overall well-being improves. In case of spontaneous opening of an abscess, in order to avoid possible complications, hospitalization is required, which provides for professional wound care and antibiotic therapy. Therefore, you must immediately consult a doctor.

Video: how to treat inflammation of the Bartholin glands

Forecast

With timely treatment to the doctor, the prognosis is favorable. A decrease in the severity of the symptoms of the disease occurs after 1-3 days from the start of treatment. If you violate the rules of intimate hygiene or wearing tight underwear, bartholinitis often returns.

Possible Complications

If the woman was not helped at the beginning of the disease, an abscess is formed. There is a possibility that the formed abscess of the Bartholin gland will open on its own. But a less favorable development is also possible. Purulent inflammation can move to neighboring tissues, spread deep into the pelvis, cause sepsis.

The opening of an abscess, even in a medical institution, is sometimes accompanied by the development of complications. Possible consequences of surgery:

• the formation of a fistula - a non-healing passage leading deep into the gland, from which pus is often released;
• divergence of sutures, which is possible with poor-quality technique of their application or with poor treatment of the wound;
• the formation of a cyst of the gonad, which is possible with the complete closure of the lumen of the gland;
• recurrence of an abscess, spread of infection to surrounding tissues, development of sepsis with ineffective antibiotics, poor wound care, or a pronounced decrease in immunity.

All these complications are more likely to develop with a belated request for medical help and inadequate treatment. It is especially dangerous to delay the treatment of bartholinitis during pregnancy, as this can lead to the development of an ascending infection, infection of the membranes and the fetus.

Prevention

The basis for the prevention of inflammation of the vaginal gland is the proper implementation of genital hygiene. To prevent a recurrence of the disease, it is necessary:

• daily change of underwear;
• wear underwear made from natural fabrics;
• avoid wearing tight underwear;
• change tampons and pads regularly;
• wash regularly, following the correct technique.

Many women in the implementation of hygiene measures in the vulva make mistakes:

• Rinse the external genitalia from back to front (thereby bringing microbes from the rectum to the genital mucosa). The jet of water should wash the genitals strictly from front to back.
• Rinse with water and soap not only the external genitalia, but also the mucous membrane of the entrance to the vagina. The mucous membrane inside the vagina is very sensitive to any means, even special ones intended for intimate hygiene. With regular washing, the vaginal mucosa dries out, its beneficial microflora, which protects the genitals from infections, dies.

The Bartholin gland is located in the region of the labia majora, or rather, in the subcutaneous fat.

Its functions: maintaining optimal moisture in the vagina through the development of a special secret, without which discomfort may occur during intercourse, pain in the perineum.

Bartholinitis is, as the name implies, an inflammatory process that occurs in the Bartholin gland. Harmful microorganisms affect not only the excretory duct of the Bartholin gland, but also itself.

The reasons

Why do women develop bartholinitis, and what is it? The causative agent of bartholinitis is Escherichia coli, staphylococci, streptococci, chlamydia, gonococci, Trichomonas. Often the cause of the development of the disease is a mixed infection - a combination of several pathogenic microbes.

The most common causes of bartholinitis are the presence of pathogenic bacteria in vaginal discharge. That is why inflammation is considered a secondary disease: it is almost always the result of a primary infection. In order to eliminate the causes of bartholinitis, it is first necessary to eliminate the source of infection that causes painful symptoms: bartholinitis causes very serious discomfort to a woman.

Often the cause of the appearance of bartholinitis lies in the uncleanliness of a woman. If you do not follow the rules of personal hygiene, you can easily bring an infection into the excretory duct of the gland, the source of which can lie not only in the vagina, but also in the urethra or intestines.

If left untreated, a painful abscess forms. After a while, it may open spontaneously. Purulent contents flow out. The condition of a woman suffering from bartholinitis is improving, but this does not mean that a doctor can not be visited. The disease can become chronic.

Classification

According to the course of bartholinitis, acute and chronic forms are distinguished. Acute bartholinitis manifests itself in the form of:

• false abscess (primary - canaliculitis and secondary - with inflammation of a previously formed cyst).
• true abscess.

Symptoms of bartholinitis in women

When bartholinitis occurs, the main symptoms are manifested in the form of reddening of the labia and the area of ​​​​the Bartholin gland, dense neoplasms appear. On palpation, you can detect its enlarged duct, pressure on the gland causes pain. Inflammation of the gland may be accompanied by the formation of a purulent sac.

In acute bartholinitis, there is usually a false abscess and acute pain, which makes it difficult to walk, the temperature reaches 39 ° C. Over time, the abscess breaks through (or it is opened in the hospital). If you open this abscess at home on your own, then there is a high risk that not all of the pus will be extracted. In this case, the symptoms of bartholinitis soften, but do not disappear completely - this is how the chronic form of the disease begins.

Often, bartholinitis occurs simultaneously with sexual diseases, so the symptoms of these infections are also present - burning, discharge, red spots, etc.)

Chronic form

The main signs of chronic bartholinitis include:

• weak aching pains on the side affected by the disease;
• pain during sexual intercourse;
• discomfort in the area of ​​​​the external genital organs during movement;
• swelling of the inflamed labia;
• neoplasm on the labia majora on the affected side;
• the appearance of a cyst of a large gland outside the vagina, which can open on its own after 4-5 days.

Symptoms of chronic bartholinitis are almost the same, except that the pain is not so acute and the temperature does not always rise. They usually occur during menstruation, with hypothermia, weak immunity, seasonal exacerbations are possible.

Bartholinitis: photo

What bartholinitis looks like, a photo of clinical manifestations is presented below.

Diagnostics

To figure out how to treat bartholinitis, it is necessary not only to diagnose a symptom, but also to determine the cause of its development. Therefore, when identifying signs of bartholinitis, a woman is assigned the following tests:

• smear from the vagina;
• bacteriological culture of material taken from the secretions (to select the appropriate antibiotic);
• study of pus taken during the breakthrough of an abscess;
• diagnosis of genital infections (, etc.).

Treatment of bartholinitis

Modern gynecology has a whole list of effective methods of treating bartholinitis, both conservative and surgical. The choice of therapy depends on the stage of inflammation. If severe forms of acute bartholinitis are detected, the treatment of a woman is carried out in stationary conditions. In mild forms of bartholinitis, treatment can be carried out at home.

Conservative therapy of acute bartholinitis is aimed at stopping the pain syndrome, eliminating the symptoms of intoxication and preventing the development of a true abscess of the gland. For this purpose, local and general therapy is prescribed.

Use tools such as:

1. , they relieve pain (Baralgin, Ibuprofen).
2. 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, identifying the "culprits" through bacteriological culture can take a long time, and it is desirable to start treatment as early as possible. Therefore, most often at the first stage, the doctor prescribes broad-spectrum antibiotics. In addition, painkillers and anti-inflammatory drugs are often additionally prescribed.
3. Lotions with 8-10% salt solution for 30-40 minutes. 3-6 times a day;
4. Irrigation with disinfectant solutions (Chlorhexidine, Miramistin), herbal decoctions (oak bark, calendula, chamomile, etc.);
5. Ointments (Vishnevsky, Levomekol) - the maximum therapeutic effect is achieved by their combination (one in the morning, the other in the evening);
6. Physiotherapy (magnetic therapy, UHF) - it is advisable to carry out for 3-4 days.
7. In some cases, you can not 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 quickly stick together after dissection, as a result of which the duct becomes clogged again. Therefore, there are two options for performing a surgical operation: the formation of an artificial duct of the Bartholin gland or the complete removal of the gland.

It should be noted that chronic bartholinitis requires a long and complex treatment. This is due to the fact that the dense capsule of the large gland of the vestibule of the vagina prevents the penetration of drugs to the focus of inflammation.

Prevention

Naturally, like any disease, bartholinitis is easier to prevent than to treat for a long time. So, the prevention of bartholinitis includes the following activities:

• observe the rules of personal hygiene;
• exclude casual sex, use barrier methods of contraception (condoms) during sexual intercourse;
• avoid hypothermia;
• avoid swimming in polluted waters;
• refuse to wear tight underwear and clothing;
• regularly visit a gynecologist (2 times a year).

Severe discomfort in the “intimate place”, temperature and general weakness are all signs of batrolinitis, an inflammatory process in the vagina. This pathology can cause serious complications in a woman, so it is necessary to treat bartholinitis as soon as unpleasant symptoms appear.

Why does the disease occur

Between the bases of the labia at the entrance to the vagina, inside the tissues is the Bartholin gland. This is a paired organ, the ducts of which are located on the inner surface of the small lips. The Bartholin gland provides moisture to the entrance to the vagina, secreting mucous viscous secrets, which provides lubrication of the genital organs during the period of sexual arousal.

During the inflammatory process, the parenchyma of the Bartholin glands and the fiber around it "melt" and small capsules with purulent contents are formed. This inflammatory process is called bartholinitis (see photo).

Important! The cause of bartholinitis is the entry of the infectious agent into the area of ​​the labia.

Various pathogens can cause bartholinitis:

• Sexually transmitted microorganisms - gonococci, trichomonas, chlamydia.
• Non-specific microorganisms -, Escherichia coli,.
• Fungal pathogens - Candida fungi.

Most often, when diagnosing a disease, not one, but several infectious pathogens are detected at once, i.e. bartholinitis occurs under the influence of a massive attack of microorganisms.

It should be noted that not all women who have had a sexually transmitted disease may develop bartholinitis. For the occurrence of the inflammatory process, a combination of several provoking factors is required.

What provokes bartholinitis in women:

• Weakening due to chronic stress, prolonged antibiotic treatment, hypothermia, beriberi.
• Chronic diseases that spread the infection through the bloodstream (, caries, chronic).
• Microtraumas in the area of ​​the labia and the vestibule of the vagina (for example, combing or depilation).
• Non-compliance with personal hygiene (especially during menstruation).
• Gynecological interventions (for example, abortion) or urinary tract surgery performed in violation of the rules of antisepsis.
• Promiscuous sex life without the use of barrier contraceptives.
• Inflammatory processes in the vaginal area and in the urinary system, when the infection can easily penetrate the Bartholin gland (vaginitis,).
• Wearing tight and narrow underwear - the excretory duct of the gland is squeezed, because of which the secret is concentrated in the cavity, and the infection begins to spread).

Infection with pathogenic microorganisms most often occurs sexually, less often through the bloodstream or lymph in the presence of infection in other organs and systems.

Manifestations and signs of bartholinitis

Clinical manifestations of the disease depend largely on the degree and stage of bartholinitis. Depending on the degree of course, the pathology is divided into acute and recurrent (chronic) bartholinitis.

Acute bartholinitis manifests itself as a true or false abscess of the Bartholin gland. With a true abscess, inflammation develops in the gland and its surrounding tissues, with a false one (canaliculitis), inflammatory processes occur mainly in the external duct of the gland.

Chronic bartholinitis occurs if the acute process remains untreated, and the abscess opens spontaneously. Due to the constant recurrence of chronic bartholinitis, a cyst of the Bartholin gland may occur.

Symptoms of bartholinitis depending on the type of disease

Important! You can not independently open pustular formations on the Bartholin gland. This will only lead to the spread of the lesion to neighboring tissues and the transition of the disease to a more dangerous stage.

The chronic course of bartholinitis is very dangerous, because. can go into a cyst, inside which inflammatory exudate accumulates. If the cyst is small, a woman may not be aware of its presence for many years. If the cyst is large, or if the cyst begins to become inflamed, the woman experiences severe pain, fever to high levels, severe weakness and chills. These are indicators for the urgent hospitalization of a woman and the appointment of treatment in a hospital.

How to cure bartholinitis

The decision on how to treat bartholinitis, the attending physician applies in each case individually, depending on the stage of the disease. Both conservative and surgical measures for the treatment of bartholinitis can be used, and therapeutic measures can be carried out both in stationary and at home.

Treatment of the initial stage (canaliculitis)

The canaliculitis stage is most often treated on an outpatient basis. The patient is prescribed bed rest, restriction of physical activity.

Main activities:

• Warm baths based on a decoction of chamomile or with the addition of potassium permanganate or saline.
• Treatment with antivaginal antiseptics, suppositories and applications with solutions, Chlorhexidine. Such procedures have a strong antiseptic effect, improve blood circulation, reduce edema, drawing out purulent fluid from the source of inflammation.
• Application of ointments: Levomekol, Ichthyol ointment, ointment. The use of ointments improves tissue microcirculation, helps the resorption of pustular formations.
• Taking antibiotics for manifestations of general symptoms of inflammation: Tinidazole,.

Additionally, vitamins are prescribed to maintain the general condition of the body.

False abscess treatment

Basically, therapeutic measures are carried out at home, but in the case of an acute inflammatory process with signs of general intoxication, therapy should be carried out in a hospital.

Main activities:

• Antibacterial therapy with the use of broad-spectrum drugs.
• The use of anti-inflammatory drugs: Nimesulide, Ibuprofen, Paracetomol.
• Treatment of the labia with antiseptic preparations.
• Ointments and Levomekol - apply in turn (change of funds every 12 hours).

Important! Warm sitz baths for Bartholin gland abscess are contraindicated.

Surgical intervention at this stage of bartholinitis is rarely used.

Treatment of a true abscess

Treatment is carried out in stationary conditions with the use of surgical intervention.

Stages of treatment:

• Opening of the focus (place of abscess), in which pus is drained.
• The wound surface is treated with hydrogen peroxide, after which a drainage tube is installed in the cavity of the gland to remove the remnants of pus. After a few days, the tube is removed.
• To speed up the healing process, antibiotic treatment (Azithromycin, Cefuroxime, Amoxiclav, Tsiprolet) and local therapeutic measures (baths, lotions, compresses) are prescribed.

Surgery for an abscess is a rather complicated procedure and the recovery process after it can take from 10 days to two months.

Treatment of chronic bartholinitis

Since chronic bartholinitis occurs with alternating periods of exacerbation and subsidence of symptoms, the treatment of pathology will be associated with the elimination of clinical symptoms and the removal of inflammatory processes.

Therapeutic measures are carried out similarly to the acute phase of bartholinitis - local and symptomatic therapeutic measures and antibiotics are used. After feeling better, physiotherapy is prescribed: infrared laser, UHF, magnetic therapy.

Additionally, vitamins are prescribed and the use of anti-inflammatory baths with solutions of potassium permanganate, decoctions of oak bark or chamomile.

During the period of "decay" of the disease, surgical intervention is performed. It is carried out in two ways:

• Marsupalization is a surgical option more preferable for bartholinitis, in which an artificial channel is formed in the cavity to remove the accumulated secret to the outside. The rehabilitation period after this procedure passes without complications, the patients recover fairly quickly.
• Estirpation. With unsuccessful marsupialization and constantly recurring relapses, an operation is performed to remove the Bartholin gland (see photo). During the operation, the inner surface of the labia is opened and the gland is scraped out with a scalpel. Such surgery is prescribed less frequently, because. usually associated with severe blood loss and a violation of the subsequent process of moisturizing the tissues of the vagina.

After the operation, antibiotics, anti-inflammatory drugs and physiotherapy procedures are prescribed.

Treatment of bartholinitis in pregnant women

If the disease occurs between the conception of a child and the 22nd week of pregnancy, then the fetus is most likely also infected, and this can lead to.

Acute bartholinitis during pregnancy is treated with standard therapeutic measures: baths, applications, anti-inflammatory and antiseptic drugs.

In a chronic process, surgical intervention is postponed until the postpartum period.

Consequences of bartholinitis

Bartholinitis in the initial stages is treated quite quickly and effectively. Late treatment can lead to complications:

• Chronic form of the disease and the formation of cysts;
• The appearance of fistulas;
• Inflammatory processes in the genitourinary system and, as a result, infertility;
• The formation of sepsis.

The prognosis of bartholinitis in the bulk is favorable if you seek medical help in a timely manner and follow all the recommendations of a specialist. Compliance with the rules of personal hygiene, timely sanitation of the vaginal area in case of inflammatory processes and an annual examination will help to avoid the occurrence of bartholinitis and all the discomfort associated with it.

Bartholinitis is an inflammatory process of the Bartholin gland located in the vestibule of the vagina. Its function is aimed at moisturizing the genitals. The disease occurs when one of the ducts is blocked by pathogens of infectious diseases. Its appearance does not depend on age, but is most often characteristic of the interval between 20 and 35 years.

What is bartholinitis

The Bartholin gland is a paired organ located at the base of the labia majora. At the moment of sexual arousal glands produce mucus necessary to reduce the likelihood of injury to the vagina during intimacy. Normally, the size of the organ is 1.5 cm. The penetration of bacteria into the gland leads to its blockage. An inflammatory process develops, accompanied by a number of unpleasant symptoms. In medicine, this phenomenon is called bartholinitis.

Deviations in the functioning of the Bartholin's gland leads to vaginal dryness. On this basis, there is discomfort during intercourse. Over time, the body increases in size, which brings inconvenience to the woman. Most often, with bartholinitis, one of the glands becomes inflamed. When infected with gonorrhea, the pathological process covers both parts.

Kinds

The disease is classified depending on the type and location of the focus of inflammation. The disease can occur in chronic and acute forms. The second type of bartholinitis is accompanied true or false abscess. In each individual case, there will be a certain symptomatology.

Spicy

With this form of the disease, the signs of the inflammatory process become pronounced. In the affected area an abscess develops, which over time can open on its own. This type of disease is characterized not only by local reactions, but also general deterioration in well-being. Acute bartholinitis may be recurrent or cystic.

Abscess

An inflammatory process in the area of ​​the duct or gland tissues leads to an abscess. It is characterized accumulation of purulent masses, which leads to swelling and redness of mucous surfaces. In some cases protrusion of the gland, which causes overlapping of the vestibule of the vagina. The danger of an abscess lies not only in the deterioration of health, but also in the likelihood of the infection spreading to other organs.

recurrent

An abscess characterized by periodic relapses is a manifestation of the chronic form of the disease. Exacerbation of symptoms is noted during menstruation, in the event of a secondary infection or a decrease in immune defense. The characteristic signs of a recurrent abscess include:

• subfebrile body temperature;
• slight intensity of pain;
• the presence of a seal in the region of the gland;
• development of edema during an exacerbation of the disease.

with cyst formation

If the chronic form of bartholinitis is not treated, the gland develops cystic tumor which is usually small in size. Sometimes a woman is not even aware of her presence. In the cavity of the cyst there is an inflammatory exudate formed as a result of a violation of the outflow of fluid. The neoplasm is located on the border between the middle and lower thirds of the labia. The intensity of pain depends on the size of the cyst. Discomfort is aggravated by sexual intercourse, while walking and as a result of rubbing clothing.

The reasons

Can provoke the development of the disease pathogenic microorganisms. The likelihood of their reproduction increases with a decrease in immunity. The main causative agents of the inflammatory process are coli, trichomonads, klebsiella, streptococci and gonococci. Factors that increase the risk of developing bartholinitis include:

• sexually transmitted diseases;
• wearing underwear made of synthetic materials;
• lack of nutrients;
• violation of hygiene rules;
• exacerbation of chronic infections during pregnancy;
• local microtrauma;
• inflammatory processes in the body;
• hypothermia;
• complications after operations and endoscopic studies.

Most often, bartholinitis develops against the background of existing inflammation with cystitis, vulvitis or vulvovaginitis. In rare cases, infection is primary. Women who have undergone childbirth or surgery are most prone to pathology. Lifestyle is also of great importance, since it forms the immunity of a woman.

signs

The severity of symptoms depends on the type of inflammation and the degree of damage to the Bartholin's gland.

The initial stages of the pathology can proceed imperceptibly for a woman. In this case, a small seal appears in the area of ​​​​the vestibule of the vagina, which does not cause significant discomfort. Painful sensations may be completely absent. The acute form of the disease is characterized by the following symptoms:

• increased pain in a sitting position or while walking;
• a significant increase in body temperature;
• decrease in working capacity;
• the formation of a mobile swelling at the entrance to the vagina;
• redness of the skin;
• suppuration;
• sensation of heat in the affected area;
• throbbing pain and feeling of fullness in the perineum.

Bartholinitis during pregnancy

Exists high risk of developing the disease in women in position. Immune protection during this period weakens, chronic diseases are activated, and the risk of infections increases. If the causative agents of the disease have entered the body for up to 12 weeks, they pose a particular danger to the embryo. In the first trimester, the child is not protected from external factors. Penetrating into the amniotic fluid, infection can provoke developmental pathologies or abortion.

Complications

In the absence of timely measures to eliminate the inflammatory process, negative manifestations are noted. One of them is considered a cyst. It is formed when the disease becomes chronic. Fistula is another unpleasant consequence of pathology. It is the result of the outflow of purulent masses from the focus of inflammation. The disease is difficult to treat conservatively. Most often, it is removed surgically. Other possible consequences of bartholinitis include:

• adnexitis;
• vulvitis;
• cystitis;
• colpitis.

Diagnostic methods

Most often the diagnosis is made upon visual inspection vaginal vestibule. With the help of laboratory research the causative agent of the disease is determined, since treatment is primarily aimed at eliminating it. Diagnostic measures include:

• bacterial culture;
• PCR diagnostics;
• smear to determine the degree of purity of microflora;
• study of inflammatory exudate.

Treatment of bartholinitis

Before conducting drug therapy, it is important to determine the sensitivity to antibiotics, which will improve the effectiveness of treatment. If the drugs do not bring the desired effect, an operation is performed. Medical therapy based on the provision of antipyretic, antibacterial and anti-inflammatory effects. It aims to achieve the following goals:

• prevention of intoxication of the body;
• elimination of painful sensations;
• prevention of abscess development;
• prevention of cystic formations.

Antibiotics

The use of such drugs in the treatment of bartholinitis is mandatory, since the disease has an infectious nature of origin. On average, the duration of the course of therapy is 7-10 days. If bartholinitis is caused by sexually transmitted diseases, then both partners are treated. The most effective drugs include:

• Ofloxacin;
• Azithromycin;
• Amoxiclav.

Operation

Surgical intervention is necessary to open a purulent formation. The patient goes to the hospital, having previously passed a series of tests. The operation is carried out in the event that in the area of ​​​​the glands formed cyst, fistula, or purulent abscess. Local anesthesia is not used. The operation is done under general anesthesia. There are two possible methods of surgical intervention:

1. Extirpation practiced in the absence of favorable forecasts.
2. Marsupialization implies the artificial formation of a channel for the outflow of fluid into the vaginal cavity.

ethnoscience

The use of medicinal plants is agreed with a specialist. Most often, this method is needed as an adjunct to drug therapy. Herbal recipes are used for topical use in the format lotions, baths and compresses. It is first necessary to exclude the possibility of developing an allergic reaction.

Anti-inflammatory decoctions

The main function of traditional methods of treatment is to eliminate the infection. Infusions with an antiphlogistic effect daily treat the surface of the vagina with a cotton swab or medical bandage. The procedure is carried out once a day. Decoctions of chamomile, St. John's wort, oak bark and yarrow help relieve inflammation.

Antiseptic infusions

There are a number of agents that have a disinfecting effect on the body. They can be used orally or topically. To make an infusion, the herbal mixture is poured with water and left for several hours. The following recipes help to cope with bartholinitis:

1. Valerian root, Icelandic moss, immortelle flowers and pine shoots mix, taking 20 g of each ingredient. The mixture is poured with 400 ml of water. Take the medicine should be 50 ml after a meal.
2. Three spoons fall asleep in 50 ml of liquid dry immortelle and insist under the lid. The resulting decoction is rubbed on the affected areas.
3. Knotweed and nettle in a volume of 100 g is mixed with 50 g of pikulnik and 40 g of horsetail. After insisting and straining, the medicine is taken in a third of a glass for seven days.

Regenerative remedies

They help speed up the healing process of the skin and are used in the recovery period. Plants are crushed to the state of gruel, which is applied to the damaged area for several hours. The following plants have a pronounced regenerative effect:

• sweet clover;
• kalanchoe;
• St. John's wort;
• Japanese Sophora;
• aloe;
• plantain.

Restorative

Means aimed at strengthening the immune system contain a large amount of vitamins. Replenishment of their stock allows the body to recover faster. Responsible for the functioning of the immune system vitamins A, C, E and PP. They are present in large numbers in meadow clover, red rowan and chokeberry.

At home

Therapeutic measures at home are carried out at an early stage of the disease or during remission in the chronic course of the disease. Such therapy is aimed at reducing inflammation and relieving symptoms. In some cases, it contributes to the rapid opening of the abscess. The list of home treatments includes lotions, strengthening tinctures, compresses and baths.

Trays

This is a convenient and relaxing way to treat the disease. The procedure is carried out in a large basin with high sides. The water temperature should be as comfortable as possible (about 33-37 degrees). It is maintained by adding hot liquid throughout the procedure. Herbal infusions or antiseptic solutions are added to the bath. The most successful components are:

• decoctions of eucalyptus, chamomile and oak bark;
• tincture of calendula;
• potassium permanganate solution.

Compresses

They are used to draw pus out of the problem area. Perfect for making medicinal ointments. They are applied in a thick layer on clean gauze and applied to the abscess area. From above, it is advisable to wear thick underwear, after covering the gauze with plastic wrap. Within two hours it is recommended to be in a horizontal position. Then the compress is removed, and the genitals are thoroughly washed with water. For this method of treatment, the following types of drugs are used:

• Vishnevsky ointment;
• Levomekol;
• Ichthyol ointment.

Lotions

Lotions from medicinal solutions help relieve swelling and stop the inflammatory process. Most often they are used after opening a purulent focus. Used as a base Chlorhexidine, hypertonic saline, or Miramistin. A gauze pad moistened with one of the products is applied to the problem area for 15 minutes. Up to three procedures are shown per day.

Strengthening tinctures

Help boost immunity during recovery herbal alcohol products. They have a minimum number of contraindications and side effects. Infusions can be prepared independently or purchased at a pharmacy. They are taken before meals in half a teaspoon. The general course of treatment is 25 days. The most effective are:

• rosehip and ginseng tinctures;
• alcohol extract of echinacea.

Prevention

Preventive measures allow you to protect yourself from infectious diseases, which will reduce the risk of bartholinitis. It is necessary to pay attention to restoration of immunity. The stronger it is, the less likely it is to develop an inflammatory process. The set of preventive measures includes the following:

• timely adoption of measures to eliminate infectious diseases;
• the use of means of protection against unwanted pregnancy;
• compliance with hygiene standards;
• ensuring proper sleep;
• proper nutrition.

Use of contraception

One of the reasons for the development of bartholinitis are infectious diseases. Barrier Methods protection can reduce the risk of their occurrence. The most effective way to protect is condom use. The uterine spiral and contraceptive sponges do not save from ingestion of infectious agents. They also have antimicrobial activity suppositories and gels for vaginal administration.

Timely treatment of foci of infection

Any inflammatory process in the body is capable of provoking bartholinitis. If you immediately take measures to eliminate the disease, you can avoid complications. Even caries can cause inflammation in the vulva. This is due to the fact that pathogenic organisms tend to move through the lymph.

Compliance with the rules of personal hygiene

Regular procedures for cleansing the surface of the genital organs do not allow bacteria to multiply. Women who do not monitor the cleanliness of the intimate area are the most vulnerable to infectious diseases. Compliance with hygiene standards reduces the risk of developing gynecological diseases. These include the following:

1. It is not recommended to use hand soap to clean intimate areas. It is advisable to use specialized tools.
2. When washing the genitals, you can not use washcloths and sponges. They can damage the mucous surface.
3. Hygiene procedures must be carried out twice a day.
4. Particular attention is paid to the choice of underwear. It should be comfortable and of good quality.
5. When washing the genitals, pay attention to the temperature of the water. Hypothermia provokes the development of unwanted diseases.
6. It is strictly forbidden to use other people's personal hygiene items.

Balanced diet

The state of the immune system depends on the quality of the diet. Food should be enriched with carbohydrates, proteins and fats. Eating fruits and vegetables will ensure the intake of vitamins in the body. A large content of calcium is present in dairy products. The protein responsible for muscle growth is found in beef, chicken, eggs, and legumes. Fish is rich in healthy fats, phosphorus, iodine, selenium and magnesium.

Full sleep

Disturbances in the work of the immune system appear against the background of physical overwork. It often develops as a result of lack of sleep. A person becomes more distracted and vulnerable to various pathologies. The likelihood of exacerbation of chronic ailments increases. The minimum duration of sleep should be at least eight hours. It is recommended to ventilate the room and go to bed at the same time.

Regular visits to the gynecologist

Most of the female diseases at the initial stage are asymptomatic. In order to diagnose them in time, one should pass preventive examinations at the gynecologist at least twice a year. It is especially important to follow this rule for women who have had an abortion, diagnostic surgery, or infectious diseases. At the gynecologist's appointment a smear is taken for microflora and a visual assessment of the genital organs is performed. If necessary, the woman is sent for additional examination.

women of childbearing age experience bartholinitis

Doctors call bartholinitis inflammation of the Bartholin glands. These glands are located in women in the labia majora, one on each side (see photo). Their purpose is to provide moisture to the entrance to the vagina before sexual intercourse. For this, the gland produces a viscous liquid, which is excreted on the eve of the vagina through the ducts. This occurs with sexual arousal or simply with mechanical stimulation of the glands.

Both glands can become inflamed, or only on one side - the latter happens more often. The disease can either cause no problems at all and go away on its own, or lead to serious complications.

Up to 2% of women of childbearing age experience bartholinitis.

Causes of bartholinitis

An indispensable participant in the inflammation of the Bartholin gland is various microorganisms. It can be both various representatives of sexual infections, and ordinary inhabitants of a person. At the same time, even peaceful microbes that find themselves in an unusual environment turn from our allies into dangerous aggressors. For example, E. coli is an indispensable inhabitant of the intestine, which is involved in the process of digestion, getting into the genital tract, often causing inflammation.

The main causes that provoke bartholinitis in women:

• sexual intercourse without a condom;
• violation of the hygiene of the intimate area
• severely reduced immunity.

Previously, it was believed that bartholinitis in women is caused mainly by gonococci. In the 60-70s of the last century, this really was the case, which was proved by the studies of those years. However, current research shows different results. In the modern structure of pathogens in more than half of the cases, polymicrobial associations are to blame - groups of microbes that live in a kind of bundle. Often, among the causative agents of the disease, there are inhabitants of the oral cavity and respiratory tract that enter the glands during oral sex.

As for genital infections, the proportion of gonococcal bartholinitis is decreasing, but the number of diseases associated with chlamydia is growing. In general, bartholinitis in women in our time is caused by a wide variety of bacteria and fungi.

Less often, the infection enters the gland through the blood and lymphatic vessels from foci of chronic infection, which at first glance seem safe and can be found throughout the body: dental caries or chronic tonsillitis. But in this case, bartholinitis will develop only in a woman who has other diseases associated with reduced immunity and immunodeficiency. In this case, additional provoking factors may be:

• microtrauma of the intimate area - for example, as a result of deep depilation,
• gynecological interventions, if the rules of antiseptics were not followed carefully enough,
• squeezing the duct of the gland with too narrow tight linen,

How does bartholinitis proceed and what will happen if it is not treated

Usually, inflammation begins in the duct, and then spreads to the gland itself. If the infection has entered the gland with blood, then the process immediately begins in the tissues of the gland.

If only the duct is inflamed without the gland itself, this condition is called canaliculitis. It is characterized by slight redness. If you press on the duct, a small drop of viscous liquid is released, and sometimes a burning sensation is felt. At this stage, spontaneous recovery may occur.

If this did not happen and the woman did not start treatment with antibacterial drugs, then due to edema, the inflamed duct closes completely. Grease cannot escape. Stagnation, it turns into pus. If pus cannot leave the gland for a long time and accumulates, the outer shell of the gland (parenchyma) and the subcutaneous fat next to it melt, and capsules with clear edges are formed in this place, filled with purulent contents. This is how an abscess of the Bartholin's gland develops.

Without treatment, the abscess breaks through, and pus comes out either outside or into the subcutaneous tissue. The last option is the most dangerous - from the subcutaneous tissue, pus quickly spreads throughout the pelvis, and sepsis develops.

Lack of treatment in the acute period can turn bartholinitis into a chronic form with periodic exacerbations. At first, it seems to the woman that the disease has receded. But sluggish inflammation provokes a gradual blockage of the duct, as a result of which the secret cannot leave the gland - a cyst appears, which gradually grows. The content of the cyst against the background of a chronic infection often suppurates, and the cyst turns into an abscess. And then, without treatment, either an attack of acute bartholinitis will resolve in the same way as the first time, or in one of the relapses the condition will lead to sepsis - the likelihood of this is small, but still not excluded.

Another scenario is also possible. A cyst forms in an initially healthy woman for no apparent reason. Such a cyst can also become infected, although this happens much less frequently.

How to recognize bartholinitis

In the acute stage of the disease, a woman feels pain in the genital area while walking and having sex. At the entrance to the vagina there are mucous and purulent discharge. The general condition does not suffer much. Perhaps a slight increase in temperature in the range of 37-37.5 degrees. The doctor, examining such a patient, will notice redness in the place where the duct opens.

If bartholinitis has developed so much that an abscess has appeared, it makes itself felt by a deterioration in the general condition. Body temperature rises to 38-40 degrees. Symptoms of intoxication develop: headache, weakness, chills. The parameters of the general blood test also change: leukocytes and the erythrocyte sedimentation rate increase. Pain in the perineum becomes very severe and a pronounced edema develops on the side of the lesion, which is visible to the naked eye. The size of the edema can reach 7 cm. In the area of ​​​​the abscess, a dense formation can be determined, sharply painful to the touch. The skin over the affected area is bright red or bluish in color.

The same formation, sometimes of considerable size, can be a manifestation of a much more harmless cyst without pus, but in this case the general condition of the woman does not suffer.

Important: under no circumstances should an abscess be opened on its own! If this is done at home, then indeed the first time you can notice the relief of symptoms. But it will not be possible to thoroughly clean out all the pus at home, the inflammatory process will not stop, and after the wound has healed, the problem will inevitably turn into a chronic form with constant relapses. In addition, the infection can get into the blood, and then blood poisoning will occur.

To make a correct diagnosis, the gynecologist does not require additional tests. A routine gynecological examination makes it easy to determine the condition. Laboratory diagnostics is needed, but its task is to clarify the pathogen after opening the abscess and to exclude genital infections. After all, if initially the problem was caused by gonococci or chlamydia that got into the gland, then these infections should be treated independently and in the first place.

To identify the pathogen, you need:

• microscopic examination of pus obtained from an abscess
• bacteriological culture of vaginal discharge (smear on flora)
• if there is a possibility of a sexual infection: a study PCR for gonorrhea, chlamydia and trichomoniasis

But to start treatment, you should not wait for the results of the tests. Infectious and inflammatory lesions of the Bartholin glands require urgent treatment in all variants of the course.

In no case should you open an abscess on your own! It will not work to clean out all the pus at home, the inflammation will not stop, and the problem will become chronic with constant relapses. The infection can get into the blood, and then there will be an infection

Treatment of bartholinitis and its complications

For the treatment of acute bartholinitis and exacerbation of chronic, a woman needs antibiotic therapy, which can be taken at home as prescribed by a doctor. The doctor prescribes broad-spectrum antibiotics by mouth.

Bartholinitis can be a serious problem for a woman, and it is best to try to avoid this disease. Proper hygiene of the intimate area, treatment of foci of chronic infection and diseases of the genitourinary tract, as well as intelligibility and accuracy during sexual intercourse are quite reliable preventive measures.

If, however, this happened, it is important to remember that the sooner a woman sees a doctor and begins treatment, the more likely she is to recover and avoid complications.