Bartholinitis in women: features, symptoms and reliable treatment. Bartholinitis: symptoms and treatment at home

Girls who are concerned about problems in the lower abdomen may suffer from diseases of the Bartholin glands, and at the same time even be unaware of their existence. Therefore, it is extremely important to know what these glands are, what functions they perform and what diseases they can cause. In this article, we will take a closer look at the properties and functions of the Bartholin's gland.

bartholin glands- these are paired glands, up to one centimeter in size, which are located in the lower part of the labia majora approximately at the level of the inferior commissure (commissure is the junction of skin folds). The ducts of the glands pass through the tissues of the labia majora on the eve of the vagina, and are displayed on the inside of the labia minora.

Main function these glands - excretion secret having a viscous structure of a grayish color. This mucus promotes hydration mucous membrane vagina and the production of lubrication, which is important:

during sexual intercourse - facilitates the insertion of the penis into the vagina
during labor - favors stretching of the vaginal muscles

Quantity secretion secreted by these glands depends on such factors:

female hormonal background
emotional experiences
possible injuries

If the lubricant is released in insufficient quantities or stops completely, dryness, irritation or itching of the mucous membrane of the labia minora may appear. Usually, bartholin glands invisible and almost imperceptible.

However, when the flow channel clogged(due to infections, injuries, etc.) and the secreted fluid, due to the obstacle that has appeared, is not able to go outside, accumulating inside the gland become inflamed swell and become quite noticeable. At the same time, a woman may experience an uncomfortable state during intercourse and even when walking.

Treatment of Bartholin's glands

Violations in the work of the Bartholin glands often lead to the formation of cysts and inflammatory processes. cysts- formations in tissues that occur due to stagnation of the secret secreted by the gland due to blockage of the duct.

According to experts, small cysts that do not cause discomfort and are asymptomatic can be left untreated. If a woman experiences inconveniences of various properties, the doctor prescribes the necessary therapy.

Therapeutic therapy of the Bartholin glands is aimed at restoring their functions by forming a channel through which the secreted fluid flows out. Given the nature of the dysfunction of the Bartholin gland and the condition of the patient, the doctor prescribes certain treatments:

Local treatment(ointments, lotions) - is prescribed simultaneously with drug treatment.
Medication(antibiotics, sulfonamides, etc.) - both the initial stages of inflammation and the period after surgery are indications.

Opening the focus of inflammation- an incision is made through which the liquid is removed and then the cavity is washed. As a rule, with this method, the likelihood of re-formation of abscesses or cysts is high. The reason is the rather rapid adhesion of tissues, which at the same time close the duct.
ImplementationWord-catheter- after the opening procedure with the extraction of the contained fluid, the cavity is washed and a Word catheter is inserted. It is a silicone tube with a ball inflated at the tip. Thanks to this adaptation, the tissues do not stick together and are covered with epithelium. After 5 or 6 weeks, this device is removed. Indications are cysts more than 3 centimeters without an acute inflammatory process.
Laser vaporization- impact on the pathological tissue of cystic formation with a laser beam. The advantage of this method is the painlessness of the procedure and the absence of the need for hospitalization.
Marsupilization of the cyst- in the place of the greatest increase in the gland, an incision is made in the oval tissue, the liquid is removed. The edges of the cyst walls are sutured to the mucosa. This method allows you to save the Bartholin gland and its normal functioning.
Complete removal of the cyst- with this method, Bartholin's gland is removed. The indication is numerous relapses after the application of the methods of treatment described above.

Besides, traditional healers offer the following methods:

hirudotherapy(treatment with leeches)
compresses and baths using medicinal plants
ointments based on natural ingredients

Bartholin's glands: inflammation, causes

Often in women of any age there is inflammation Bartholin's glands, otherwise known as bartholinitis. Caused by the ailment of penetration infections in the gland. Main reasons doctors call this disease:

infection pathogenicmi microorganisms that have a sexual nature of distribution (gonorrhea, chlamydia, trichomoniasis, mycoplasmosis, etc.). It should be noted that not always the presence of these diseases can provoke inflammation of the Bartholin glands.
Revitalization conditionally pathogenic microflora at reduced immunity(Candida, Escherichia coli, Staphylococcus aureus, Streptococcus, Klebsiella, etc.).

Much increases the likelihood of inflammation and appearance bartholinitis availability of the following factors:

illegible intimate relationships and a fairly frequent change of partners - this increases the risk of infection genital infections.
not respected requirements personalhygiene – bacteria, which are located on the surface of the labia majora, can penetrate the vagina. In addition, the spread of infection often occurs through vaginal discharge. Therefore, a woman needs to change pads as often as possible, especially after each visit to the toilet.
microtrauma mucous membrane of the vagina, obtained with excessive combing or intimate contact with insufficient lubrication (in this case, the infection gets inside through small wounds).
Availability hemorrhoids or cracks anus.
Frequent wearing of too tight underwear.
Availability diabetes For bacteria, glucose is a beneficial nutrient medium.
chronic diseases stomach, kidneys or liver - the movement of the lymph can spread the infection in the body.
Immunodeficiency(congenital or arising as a result of colds, nervous tension, overwork, etc.) - with weakened protective functions of the body, the risk of infection increases.
Violation sanitary standards for surgical operations genitourinary system and in the subsequent postoperative period of rehabilitation.
hypothermia intimate organs.
stressful conditions that are permanent.

Process occurrence and further development of the disease bartholinitis in general can be described as follows:

infectious agents from the surface of the labia minora penetrate into the flow channel of the Bartholin gland.
They are active reproduction.
Duct becomes inflamed.
Further inflammation distributed by on iron, which increases in size and thickens.
Appears puffiness.
going on suppuration.
Arises abscess(false, true, secondary).

If you suspect bartholinitis be sure to contact to the doctor to to begin treatment, to prevent further spread of the infection. It's no secret that any disease is better warn, than to treat. To to avoid disease described disease, observe the following measures prevention:

get regular check-ups with a gynecologist
take care of hygiene
treat infections on time
avoid casual unprotected intimate contact
strengthen immunity

Inflammation of the Bartholin gland: treatment, photo

AT primary stages inflammation bartholin's gland woman can not feel no pain or other discomfort. She observes in herself only a certain seal tissue of a local type on the eve of the vagina. Then, with the penetration of the infection further into the organs, it appears pain.

In some cases, the inflammatory process may subside while maintaining seal gland or its duct. And over time, inflammation again flashes, spreading the infection further. Medical therapy, which the doctor prescribes, depends on the nature of the course of the inflammation process. In this case, the form is distinguished:

acute
chronic

Acute The form of the disease is characterized by states women:

An increase in temperature.
Weakness and intoxication of the body as a whole.
Redness and swelling of the focus of the inflammatory process.
The formation of a rounded seal in this place, with pressure on which the woman experiences pain.
On palpation of the gland, there is a feeling of the presence of fluid near it and its channel.

Experts describe the following types acute

Canaliculitis (false abscess)- inflammation of the excretory canal of the Bartholin gland. It is characterized by redness, or hyperemia of the skin. When pressing the region of the gland, a small amount of purulent discharge from the duct is possible. At the same time, due to a significant increase in volume, the canal can be palpated during palpation. The general condition of a woman can be quite normal, without a significant increase in temperature. Pain may appear with active movements.
Primary (true) abscess- through the flow channel, infectious microorganisms penetrate into the tissues of the Bartholin gland itself, and its further inflammation occurs. The gland significantly increases in size. The labia (small and large) are very swollen and redden. The body temperature of a woman can rise above 38 - 39 degrees. Pain or burning increases not only during movement, but also at rest.
Secondary abscess- suppuration of a cyst that formed earlier.

Often happens spontaneous opening of the abscess and the release of purulent discharge to the outside. However, even in this case, complete cleansing of pus not happening and intervention is required. surgeon for wound care.

Do not try to open the abscess yourself, as this can lead to the infection getting into the lymph. It is very dangerous!

At acute form of inflammation of the Bartholin's gland, a woman is sent to hospital where she is being treated. Acute form can go to chronic, in which periods of exacerbation of inflammatory processes alternate with periods of remission. The temperature is usually within the normal range. Pain is absent or insignificant. Relapses of the disease can be provoked by the following reasons:

hypothermia
intimate contact
infections
hormonal disruptions
nervous tension

If chronic bartholinitis is observed in a woman for a long time, a Bartholin gland cyst may form in her. Therapeutic treatment by a doctor is prescribed not only depending on the nature of the course of the disease, but without fail and after identifying the causes of infection. Diagnostics includes the following:

gynecological examination
donation of a vaginal smear
PCR for genital infections
bacteriological culture to detect sensitivity to antibiotics
examination of purulent secretions
in older women, pus is sent for biopsy

After research all indicators are assigned by a specialist treatment inflammation of the Bartholin's glands:

conservative
operational

During the period of treatment, it is necessary to refrain from intimate contact. In addition, it is very important to completely cure concomitant infections in order to avoid relapses. A conservative approach includes the appointment of medications:

Antibacterial(amoxiclav, azithromycin, ceftriaxone) of a wide spectrum of action aimed at various types of pathogens.
Painkillers(diclofenac , analgin, ketorolac) to alleviate the condition.
antipyretic(doloren, acetylsalicylic acid) at high body temperatures.
Fluoroquinols(ofloxacin, ciprofloxacin) - antimicrobial drugs, the action of which is directed to microorganisms resistant to antibiotics.
Immunoregulatory that increase the protective properties of the body and contribute to the restoration of the intestinal microflora and tissues at the cellular level.
Multivitamin complexes.

In addition, the methods local therapy:

Tampons with anti-inflammatory drugs (ichthyol liquid, levomekol, levosin).
Bandages and compresses with solutions of miramistin or chlorhexidine.
hot baths with the use of infusions of medicinal herbs or potassium permanganate.
Treatment with ultrasonic waves, ozocerite and others physiotherapy.

In cases abscesses or absence a positive result with drug treatment, resort to surgical an intervention that:

The focus of inflammation is revealed.
The purulent content is removed.
The wound is disinfected.
For the outflow of pus, a drainage tube is inserted, which is removed after a few days. In this case, it is very important to prevent premature fusion of tissues over the drainage hole, as this can cause the formation of cystic formations.
Antibacterial, antimicrobial therapy and physiotherapy procedures are prescribed.

It happens that such operation shown even in the chronic stage of bartholinitis. remember, that bartholinitis- this is serious a disease that, if left untreated, can lead to heavy consequences:

the formation of a non-healing hole (fistula) in the tissues
frequent relapses
spread of infection to the genitourinary system
sepsis
whole body intoxication syndrome (may occur in debilitated patients)

Inflammation of the Bartholin gland: treatment at home

At the initial stage of inflammation of the Bartholin gland, in the absence of an abscess, a woman can be treated at home. Its main goals are:

edema reduction
pain relief
extinguishing the inflammatory process
preventing the development of formations with purulent contents

You can use various folk ways. So , natural medicine offers the following healing recipes:

A mixture of honey, crushed aloe plant and red dry wine (in equal parts) put in a water bath and cook over low heat for about an hour. Strain and take three times a day before meals.
Mix chopped walnuts with honey, minced boiled garlic and dill seeds. Consume after meals 2-3 times a day.
Prepare a decoction of nettle, horsetail, Icelandic moss, immortelle (in equal parts) and boiling water (calculated as 1 liter of liquid per 4 tablespoons of a mixture of herbs). Boil for 7 - 10 minutes. Drink this infusion 15 minutes after drinking the honey-based mixtures described above.

Do anti-inflammatory daily baths based on such herbs:

chamomile
calendula
oak bark
Hypericum

For their cooking pour a tablespoon of dry plants with a glass of boiling water and keep in a water bath for about 5 minutes. Then dilute the strong infusion with warm water and take bath in a sitting position for about 20 minutes.

For the same purposes, you can use compresses:

Solution Based salt- 2 tsp dissolve coarse salts in a glass of hot water. Soak a soft cloth in this solution and apply to the inflamed area for half an hour 3-4 times a day.
based on rye of bread- Mix the crumbled bread with honey and a crushed clove of garlic. Apply a paste of this mixture to the affected area.
Based herbs- a tablespoon of yarrow flowers and black elderberry, blackberry leaves and nettles, pour a liter of boiling water and leave for 2 hours. Make lotions twice a day.

It should be noted that all of the above methods apply in complex with medical prescriptions prescribed by a doctor drugs, and do not act as an alternative treatment. So check with your doctor first.

When treated with antibiotics, the body needs a lot of liquids. For these purposes, drink healing herbal teas, insisted on:

wild rose
lime blossom
birch leaves
sage
oregano

If you feel a sharp pain and deterioration in well-being, then the application of ice frozen in a bag or a plastic container will greatly alleviate this condition. Take painkillers and then be sure to go to the hospital for help.

Removal of Bartholin's gland

Timely and correct treatment is the key to successful disposal of diseases of the Bartholin's gland. However, in some cases, its complete removal(extirpation) surgically:

in the absence of a positive result after marsupilization
with frequent relapses

The main and perhaps the only advantage this procedure is exception the possibility of manifestation relapses. However, full removal the gland has a number disadvantages:

The operation is usually performed under general anesthesia, which may be unfavorable for some patients.
During the operation, severe bleeding and the formation of large hematomas are possible, since the base of the gland is located near the accumulation of veins.
The presence of scars after suturing both inside and outside the genitals.
Subsequently, due to violations of the mucosal hydration, a woman may experience dryness during intimate contact.

Before carrying out the operation, a number of factors:

carry it out after the end of the patient's menstruation
in acute inflammation, medication is first prescribed

Process operations are as follows:

make an incision on the labia minora from the inside
separate the gland with a scalpel and remove it
put stitches on the wound (catgut)

rehabilitation period lasts over a week and includes:

taking antibiotics
compresses with antiseptic, antimicrobial and anti-inflammatory drugs
UHF procedures
magnetotherapy

Note that the removal of the gland does not affect on the childbearing woman's function. However extirpation is a last resort. Therefore, in order to to avoid operations, prevent exacerbation of the disease:

see a doctor promptly
strictly comply with his requirements during treatment

Video: Women's diseases: Bartholin gland cyst

If for some reason an infection enters the duct of the Bartholin gland, then bartholinitis. The gland becomes a dense capsule in which there is pus. The process is always one-sided. The disease develops when the infection directly enters the gland. Often this is a violation of hygiene or frequent hair removal. There are acute and chronic course of the disease. Depending on the process, bartholinitis treatment is prescribed at home or in a hospital.

Acute bartholinitis may look like a false or true abscess of the Bartholin gland. False is called canaliculitis - inflammation of the external duct of the gland, which closes and contains pus inside. A true abscess is characterized by the fact that not only the Bartholin gland becomes inflamed, but also the surrounding tissues.

The chronic process develops against the background of an untreated acute after the abscess has opened. Symptoms subside, but exacerbation comes from time to time. Untreated bartholinitis is dangerous because a true abscess develops, and subsequently the disease becomes chronic and the cyst of the Bartholin gland forms.

The main symptom of the disease is hyperemia and acute pain. On examination, an enlargement of the Bartholin gland and a thickening of its duct are seen. With the development of the process, the duct closes and inflammation occurs. At the same time, the temperature rises, general well-being worsens. You need to be very careful with the unauthorized opening of the abscess, because the leaked pus can cause inflammation of the external and internal genital organs.

The faster the patient turned to the doctor, the more chances to avoid surgical intervention. Depending on the stage of the disease, treatment of bartholinitis with folk remedies or with the help of drugs can be prescribed.

General principles for the treatment of bartholinitis

After a differential diagnosis is made, treatment is prescribed. Surgical intervention is resorted to only in the most severe form of the disease. The severity depends on the time when the patient asked for help. Usually, women do not delay a visit to the doctor for a long time, because the inflammation of the Bartholin's gland causes acute pain and discomfort when walking and sitting. If a woman has been diagnosed with acute bartholinitis, treatment at home is possible.

Mandatory conditions in the treatment of bartholinitis are bed rest, taking antibacterial drugs, local treatment with antiseptics and ointments based on antiseptics and antibiotics. A heating pad with ice on the site of inflammation relieves pain very well. It must be wrapped in a cloth and applied for 40 minutes with half-hour breaks.

In the chronic form of bartholinitis in remission, you can take non-hot baths with the addition of manganese so that the water is slightly pink. Doesn't take a bath. Sit for about twenty minutes. In order for inflammation not to come with renewed vigor, it is necessary to strictly comply with all conditions of personal hygiene and treat urethritis and cystitis in time.

Treatment of a true abscess

It is possible to cure a true abscess at home only at the initial stage of the disease, when the outflow from the Bartholin gland is preserved. The disease causes a number of accompanying symptoms, which also need to be paid attention to when prescribing treatment. First of all, it is fever and pain. Since bartholinitis is inflammation, it is worth adding anti-inflammatory drugs.

In order not to relieve symptoms individually, you can take drugs that will simultaneously relieve pain, fever and inflammation. For example, Naproxen, Nimesil, Brufen . If the pain is very severe, you can add analgesics Dexalgin or Depiofen .

A prerequisite is the use of antibacterial drugs. When prescribing an antibiotic, it is necessary to proceed from the results of the analysis of secretions from the duct of the Bartholin gland. Because the cause of the development of inflammation can be different microorganisms. The main pathogens are trichomonas, gonococcus, chlamydia and non-specific anaerobic flora in violation of the hygiene of the genital organs. Appoint Trichopolum, Tinidazole, Ciprofloxacin, Azithromycin, Erythromycin etc. A course of antibiotics is prescribed for at least a week. The remaining drugs should be taken as needed until the symptoms of inflammation disappear and the abscess opens.

Hypertonic saline solution very good high osmolar agent for removing pus from the abscess cavity. To do this, take one liter of boiled water at room temperature and dissolve 3 tablespoons of salt in it. Every three hours for 30 minutes, apply a compress of sterile gauze soaked in the solution.

Also, for the fastest opening of the abscess at night, you can apply ointment Levomekol or Balsamic liniment of Vishnevsky . Ointments can be alternated. It is possible to treat an abscess at home only under the supervision of a doctor. Self-medication in this case is not allowed.

Treatment of canaliculitis or false abscess

Canaliculitis is the initial stage of the development of inflammation of the Bartholin's gland. It is very important immediately after the first symptoms appear to seek medical help and begin treatment immediately. If you quickly start anti-inflammatory therapy, then a false abscess will not turn into a true one and a cyst will not form.

To begin with, in the hospital, it is urgent to do an analysis for the flora and prescribe antibiotics, taking into account the results. The course is not less than ten days. Antibacterial therapy is the same as for the treatment of a true abscess.

Add anti-inflammatory drugs and analgesics ( Diclofenac, Ibuprofen, Nalgesin ). Also, in the treatment complex, introduce immunostimulating drugs, for example, Echinacea extract. Multivitamin preparations will help the body cope with the inflammatory process faster ( Duovit, Supradin, Vitrum ).

Local therapy includes anti-inflammatory suppositories and Tampons with Miramistin ointment . Such an extended complex of treatment is aimed at the rapid removal of the inflammatory process and the elimination of the main cause of the disease. Because lost time can cause the duct of the gland to become clogged with purulent discharge, which will lead to the development of a true abscess, cyst and inevitable surgical intervention.

Causes of a Bartholin gland cyst

A cyst occurs if the duct of the Bartholin gland is blocked due to the accumulation of secretions or with bartholinitis. Such a neoplasm is quite often large in size and causes discomfort. Most often it is infectious. The cause can be sexually transmitted infections (chlamydia, gonococci, Trichomonas), as well as staphylococci and E. coli. You can also bring an infection during epilation, hygiene violations. The reason may even be tight underwear. Blockage of the duct of the Bartholin gland can cause an abortion.

Antibacterial therapy is aimed at eliminating the pathogenic flora that caused the formation of a Bartholin gland cyst. If it is a gonococcal infection, drugs of the penicillin and tetracycline series are prescribed ( Amoxil, Tetracycline ); Doxycycline prescribed for the treatment of cysts caused by gonococcus or chlamydia. A good effect is given by the parallel administration of sulfa drugs such as Biseptol or Bactrim . Local treatment of the cyst includes the application of an ointment Vishnevsky , Ichthyola and Miramistina . It is also appropriate to prescribe multivitamin complexes and immunomodulators.

Treatment of bartholin gland cysts with folk remedies

Together with drug therapy for a Bartholin gland cyst, alternative methods can be used. Then the healing process will speed up. Such methods include:

apply every six hours for 20-30 minutes gauze pads soaked in hypertonic salt solution . Dilute a tablespoon of salt in a glass of hot water;
prepare a potion from 200 g of ground aloe pulp (it is possible together with the skin, only pre-cleaned of thorns), 350 g of honey and 300 g of red wine. Mix everything well and boil for about one hour in a water bath. Strain and take 30 minutes before meals, 1 tablespoon;
apply compress from a mixture of crushed black bread, a clove of garlic and liquid honey;
do baths from decoctions of chamomile, calendula and oak bark;
a decoction of valerian root, pine shoots, walnut leaves, immortelle flowers. All herbs take two tablespoons. For two cups of boiling water 2 tbsp. l ready collection and cook in a water bath for 30 minutes. Take one quarter cup 30 minutes before meals;
make sitz baths from a weak solution potassium permanganate 20-30 minutes daily.

It must be remembered that traditional medicine cannot be independent. Only together with medical methods

You should not hope that the treatment of bartholinitis can be independently carried out at home without the risk of complications. All diseases ending in “-it” are pathologies provoked by the inflammatory process.

Any inflammation must be treated under the guidance of a qualified specialist, otherwise the life of the patient will sooner or later be in jeopardy. A woman suffering from manifestations of bartholinitis can use home remedies in addition to standard methods to speed up recovery.

What is bartholinitis?

With a combination of adverse factors in women of childbearing age, inflammation of the Bartholin gland occurs, located on both sides of the vestibule of the vagina.

It can be acute, subacute, chronic. To endure the symptoms of bartholinitis is often extremely painful, since purulent inflammation provokes severe pain at rest, with tension and during palpation.

Main manifestations:

Puffiness of one or both labia, the appearance of a dense formation in the thickness of the tissue;
Soreness of the inflamed labia on palpation, during defecation, sexual contact and physical exertion;
Itching and burning in the area of inflammation;
Discharge on pressing a small amount of pus.
Hyperemia of the affected area.

Normally, the Bartholin gland produces a special secret during sexual intercourse to moisten the entrance to the vagina.

With its inflammation, a false abscess can form, which disrupts the outflow of mucus due to blockage of the excretory duct, and purulent bartholinitis (true abscess), which destroys the secretory part of the gland and fills it with pus. With inflammation of the excretory duct, a woman is diagnosed with canaliculitis.

Complex therapy prescribed by a doctor includes drugs of the following groups:

antibiotics;
Analgesics;
antipyretic drugs;
vitamins;
Ointments and solutions with antiseptics for local treatment.

If there are indications, the surgeon-gynecologist performs an opening of the abscess or removal of the gland in a gynecological hospital. For a speedy recovery, physiotherapy procedures are prescribed. Such a complex effect cannot be carried out at home.

Consequences of unskilled treatment

Typical complications of the inflammatory process in bartholinitis are the formation of an abscess or cyst, the formation of a non-healing fistula in the tissues of the labia. The fistulous tract can form its exit into the vagina, from where the causative agents of the inflammatory process will spread through the woman's reproductive system.

This situation is especially dangerous during pregnancy. The source of infection in the female body can lead to the death of the fetus or the appearance of malformations in it.

Unqualified treatment of the disease at home, expectant management can lead to the development of sepsis, the entry of toxins and microorganisms into the circulatory system.

Home remedies - an addition to the main treatment

After diagnosing the pathology and developing a treatment plan, the gynecologist gives the woman recommendations on how to cure bartholinitis on an outpatient basis, or directs her to surgery.

Emergency measures

Sometimes circumstances are such that it is impossible to get medical help immediately, or the prescribed treatment does not fully relieve pain and swelling. In this case, a woman needs to alleviate her condition with home remedies.

If bartholinitis develops - emergency treatment at home:

Compress.

Applying a compress with ice to the focus of inflammation for 20-30 minutes, a break for 15-20 minutes.

Tablets.

1-2-fold pre-medical administration of analgesics and antipyretics (Diclofenac, Dolaren, Ketorolac).

Ointments.

Applying ointments Levomekol, Levosin, Vishnevsky ointment to the focus of inflammation to reduce swelling, stop the inflammatory process, reduce the concentration of pathogenic microbes in the focus of inflammation.

Self-administration of antibiotics is prohibited. They are prescribed by a doctor, taking into account the severity of the situation, the stage of development of the disease, and the patient's contraindications.

Folk remedies

If, in addition to the main therapeutic methods, the treatment of acute and chronic bartholinitis with folk remedies is carried out, the recovery time can be significantly reduced.

Traditional medicine:

Salt compress 10%.

Draws out pus, reduces puffiness, anesthetizes. Use napkins soaked in a solution prepared at the rate of 3 tbsp. l. salt per 1 liter of water. They are applied to the inflamed area 3-4 times a day for 30 minutes.

Sitting baths from the collection of herbs (St. John's wort, oak bark, chamomile, celandine, yarrow).

Anesthetize, relieve swelling, soothe and disinfect the area of inflammation. From a mixture of herbs or from components taken separately, a strong infusion is obtained. It is insisted for 40-60 minutes, filtered, poured into a basin, diluted with warm water. The duration of the bath is 20 minutes, the water should not be hot.

Herbal teas.

They soothe, strengthen, increase immunity, replenish the supply of vitamins. Use lime blossom, rose hips, sage, oregano, St. John's wort. One st. l. berries, herbs, or a mixture of herbs pour 200 ml of boiling water, insist 1-2 hours, drink in small sips.

General strengthening decoction.

Increases the body's resistance to inflammatory processes. Iceland moss, horsetail, wild rosemary, knotweed, nettle leaf mix 1 tbsp. l., cook in a liter of water for 10 minutes over low heat. After straining, cool and drink ½ cup three times a day.

It is forbidden to make hot lotions on the area of inflammation, use herbal treatment if you are allergic to the components of the fees.

Hirudotherapy

Treatment with leeches effectively reduces the intensity of the inflammatory process in bartholinitis. The duration of hirudotherapy, the frequency of sessions is determined individually for each patient by a hirudotherapist.

Before starting treatment, you need to undergo a simple examination - donate blood and urine for a general analysis, get a conclusion from a gynecologist and therapist about the absence of somatic diseases in which hirudotherapy is contraindicated.

The method is not applicable in the following cases.

Reduced blood clotting;
The patient has cancer;
There are metal implants;
There is an allergy.

During an exacerbation of a purulent process and during a course of antibiotic therapy, hirudotherapy sessions are not recommended.

Prevention of bartholinitis

Self-prevention of relapses is part of the home treatment of this pathology. Measures aimed at preventing the disease:

Strict observance of the rules of personal and intimate hygiene;
Refusal of casual connections;
Use of barrier contraception;
Strengthening immunity;
Use of cotton underwear;
The use of sitz herbal baths during periods of increased risk of exacerbations.

Whether or not to supplement the course of treatment prescribed by a gynecologist with home remedies, each woman decides for herself. The use of additional therapeutic measures does not replace, but complements the methods of conservative medicine. When used correctly, they will speed up recovery.

In the structure of inflammatory diseases of the female genital organs, the proportion of bartholinitis and its complications is approximately 2%. The disease often affects young women (20-30 years).

Bartholin's glands are paired vestibular glands located in the thickness of the large pubic lips, they are responsible for maintaining the optimal level of moisture in the mucous membrane of the vaginal vestibule. During arousal, sexual intercourse and simple pressure, the Bartholin glands secrete a transparent grayish secret rich in protein and mucin.

The work of these glands provides the necessary level of vaginal moisture, including for the painless insertion of the penis into it during intercourse.

Figure 1 - The structure of the external genital organs of a woman. Bartholin's glands are defined as small rounded formations 0.5-1 cm in diameter, located in the thickness of the labia majora at 4 and 8 hours.

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1. Basic concepts

Bartholinitis is understood as an infectious and inflammatory disease of the Bartholin gland. For this pathology, a unilateral lesion with the formation of a purulent cavity is more characteristic.

An experienced gynecologist may suspect acute bartholinitis by the appearance of the patient alone. Pain that accompanies the disease can change the patient's gait.

In practice, there is often a subacute course of bartholinitis, which in most cases leads to a chronic process. In this case, both the reactivity of the woman's body and her personal attitude to her reproductive health are important.

A woman can endure mild symptoms at home without seeking help from a specialist. It is this behavior of a woman that leads to incomplete cure, and then to the recurrence of the disease and the formation of a Bartholin gland cyst.

Thus, they distinguish:

1 acute bartholinitis and abscess of the Bartholin gland;
2 recurrent bartholinitis;
3 Bartholin gland cyst.

The formation of an abscess takes place in 2 stages:

1 False abscess resulting from mechanical blockage of the excretory duct of the gland. In this case, the secret secreted by the glandular cells accumulates, becomes infected, and inflammatory infiltration of the surrounding tissues occurs. At this stage, there is no purulent fusion and involvement of the glandular tissue itself in the process, there is no symptom of fluctuation.
2 True abscess - the final stage, in which a pyogenic capsule with purulent contents is formed. The tissues surrounding the gland are involved in the inflammatory process. It is not difficult for a gynecologist to distinguish one form of bartholinitis from another, since the clinical picture of each of them is significantly different.

2. Etiology and risk factors

The cause of inflammation of the Bartholin gland are various microorganisms. The inflammatory process can cause:

1 ( , and so on).
2 Conditionally pathogenic microorganisms, components of normal microflora (staphylococci, streptococci, E. coli).
3 Polymicrobial associations (mixed infection, the most common variant).

Not all women suffer from bartholinitis; predisposing factors are necessary for the onset of the disease.

These include:

1 Microtrauma in the area of the entrance to the vagina, labia majora. They can form with unsuccessful shaving, epilation, itching in the perineum (scratching), sexual intercourse without prior preparation of the woman and sufficient moistening of the vaginal opening.
2 Wearing uncomfortable, tight underwear made of synthetic fabrics.
3 Neglect of the principles of intimate hygiene, especially during menstruation.
4 Inflammatory diseases of the urogenital tract (vulvitis, vaginitis), abundant discharge facilitate the penetration of infection into the lumen of the gland duct.
5 Chronic foci of infection in the body.
6 Decreased immune forces of the body (diabetes mellitus, long-term hormonal or antibacterial therapy, cytostatics, radiation therapy and other causes of immunodeficiency).
7 Non-compliance with the rules of asepsis and antiseptics during gynecological and / or urological surgical interventions.

With the penetration of infection into the ducts of the Bartholin gland, an inflammatory reaction develops with all its inherent manifestations (hyperemia, edema, soreness, local temperature increase, development of an adhesive process). The glandular epithelium "tries" to get rid of foreign microorganisms by increased secretion. The composition of the excreted secret includes living and dead microbial bodies, a large number of leukocytes.

With further spread of the infection, the surrounding tissue is involved in the inflammatory process. To delimit the pathological focus, the body forms a capsule with purulent contents - an abscess. The increase in edema, the gradual thinning of the capsule lead to the opening of the abscess and the removal of pus to the outside.

After that, 3 outcomes are possible: 1) cure and recovery, 2) chronicization of the process, 3) spread of infection to surrounding tissues.

3. Clinical picture

Symptoms of acute, chronic bartholinitis and its complications are significantly different, have varying degrees of severity.

For acute bartholinitis, the following symptoms are most characteristic:

1 The general condition of the woman is slightly or moderately impaired.
2 Inside the labia majora (more often than one) a painful seal is formed. When pressed on it, a drop of pus may be released. It is this formation that women often mistake for a “pimple” and squeeze out the resulting pus.
3 With further development of the disease and compression of the excretory duct, the seal increases in size and interferes with normal walking. Soreness increases, the skin of the labia turns red.

Figure 1 - Bartholin gland abscess. Source - Medscape.com

With the formation of an abscess, the symptoms are more pronounced:

1 The general well-being of a woman suffers more.
2 Symptoms of general intoxication are observed - fever up to 38.5 degrees, weakness.
3 There are pains in the perineum, when sitting, walking. Sex is extremely painful.
4 On the affected side, pronounced edema and hyperemia are observed, the entrance to the vagina can be completely closed. Palpation of the labia is extremely painful. The skin is tense, mobile.
5 The appearance of a symptom of fluctuation (that is, a sensation of fluid movement) on the affected side indicates the formation of a cavity with purulent contents (a true abscess). A true abscess may be accompanied by severe fever (up to 39-40 degrees), chills, and sweating. In the area of the abscess, a woman may feel a pulsation, hyperemia of the skin and mucous membranes extends beyond the labia.

Chronic bartholinitis, like any other chronic process, proceeds with exacerbations and remissions. During the period of remission, a woman is disturbed by minor discomfort in the perineum, more often on the affected side, sometimes causing discomfort during sexual contact.

The stage of exacerbation proceeds with all the clinical manifestations inherent in acute bartholinitis.

The result of the recurrent course of bartholinitis may be the formation of a cyst of the Bartholin gland. When a cyst of the Bartholin gland is formed, a woman has a rounded formation with liquid contents in the area where the gland is located.

The degree of enlargement of the labia depends on the volume of the cyst. The skin over the cyst is not changed, of normal color, the formation is painless on palpation. Bartholin gland cysts, 1–3 cm in diameter, are usually asymptomatic.

The quality of life of the cyst of the Bartholin gland, if it violates, is insignificant: the patients note some inconvenience when walking, sitting, sexual intercourse. But the expressed pains, as a rule, are not present.

Bartholin gland cyst may be complicated by secondary infection of the contents. In this case, the clinical picture of an abscess is observed.

4. Diagnosis of pathology

As a rule, the diagnosis of bartholinitis is not difficult, the doctor can make a diagnosis after the first treatment of a woman. The minimum amount of research to verify the diagnosis is as follows:

1 Inspection, palpation.
2 Complete blood count (indirect signs of inflammation: an increase in the number of leukocytes and an increase in the erythrocyte sedimentation rate. There is a shift of the leukocyte formula to the left).
3 . In acute bartholinitis and abscess in the OAM, an increase in the number of leukocytes and (neither one nor the other should be normal) can be observed.
4 , cervical canal and urethra on the flora. With bacterioscopy of a smear, it is possible to assess the nature of the prevailing flora, as well as to detect gonococci and Trichomonas. In the presence of abundant coccal flora, a minimum number of rods, a nonspecific etiology of the inflammatory process should be suspected.
5 Bacteriological examination of the discharged Bartholin's gland. The most reliable analysis that allows not only to determine the type of microorganism, but also to assess its sensitivity to various groups of antibacterial agents. The only disadvantage of the study is its long execution (at least 72 hours). By this time, empiric antibiotic therapy with broad-spectrum drugs has already been prescribed. The results of the analysis are already evaluated retrospectively.
6. With bartholinitis, it is important to exclude infections such as herpes infection, mycoplasmosis, ureaplasmosis, trichomoniasis. Diagnosis of the above microorganisms (with the exception of Trichomonas) is quite difficult. PCR is characterized by high specificity and sensitivity, which means it is the most reliable analysis for their verification.

5. Medical tactics

Treatment of bartholinitis depends on its form: acute uncomplicated bartholinitis does not require hospitalization, it is treated on an outpatient basis. The formation of an abscess with a violation of the general condition of a woman requires hospitalization in the gynecological department and surgical intervention.

An asymptomatic course of a small Bartholin gland cyst also does not need urgent treatment. It is enough to follow the rules of intimate hygiene and dynamic observation without surgery. Large cysts are operated on in a planned manner.

5.1. Therapy of acute bartholinitis

1 Acute bartholinitis can be treated on an outpatient basis.
2 NSAIDs (ibuprofen, ketoprofen, diclofenac, nimesulide, and so on) can be used to relieve pain, reduce body temperature and relieve symptoms of inflammation.
3 In Russian and foreign sources for the treatment of acute uncomplicated bartholinitis, sitz warm baths (with the addition of soda, salt) are mentioned. It is believed that warm baths can relieve symptoms without the use of antibiotic therapy. Antibiotics are indicated for bartholinitis complicated by the formation of an abscess of the gland.

For the treatment of acute bartholinitis, drugs with a local antiseptic effect can be used. Applications with antiseptic solutions (Chloghexidine, Miramistin, etc.) and hypertonic sodium chloride solution can be used.

The listed means are able not only to disinfect the area, but also to "pull" the liquid out of the cavity due to osmosis.

For local therapy of inflammation of the Bartholin's gland, there are many recommendations, they do not always have a reliable evidence base and are used only as adjuvants.

It is unacceptable to treat inflammation of the Bartholin gland at home (and even more so with the help of folk remedies).

5.2. Treatment of a bartholin gland abscess

With the formation of a purulent cavity, the woman's well-being worsens significantly, symptoms of intoxication increase. Bartholin's gland abscess is an indication for surgical treatment and antibiotics.

Table 1 - Antibiotics used in acute bartholinitis complicated by abscess formation. Source -

Opening and drainage of the abscess is carried out only with an abscess formed. After appropriate processing of the surgical field, the cavity of the abscess is opened in the place of the greatest tension of the tissues. The outflowing purulent contents are taken for bacteriological examination.

The emptied abscess is washed with 3% hydrogen peroxide until the purulent contents are completely removed and the capsule is husked. After all the procedures done, a gauze turunda moistened with a hypertonic solution is placed in the surgical wound.

Immediately after the operation, the woman is prescribed antibiotic therapy according to the recommended regimens.
The frequency of abscess recurrence after such an operation is about 15%. Plugging the cavity significantly reduces the risk of re-formation of a purulent cavity (Level of Evidence - B, C).

In addition to simple opening and drainage, other types of surgical interventions can be used for an abscess of the Bartholin gland:

1 Fistulization using Word catheter.
2 Ablation with silver nitrate.
3 Opening of the abscess, its ablation with a laser.
4 Aspiration of contents and subsequent sclerotherapy (usually with ethanol).

The effectiveness of all of the above techniques, their long-term results are still being studied.

5.3. Therapeutic tactics for chronic bartholinitis

Therapy of chronic bartholinitis implies some stages:

Stage 1: conservative therapy. The main goal of this stage is to achieve a long-term stable remission of the disease. A course of antibiotic therapy is carried out according to one of the above schemes. In addition, vitamin therapy, correction of the immune status, and comorbidities are carried out. After achieving remission, the issue of planned surgical intervention is decided.
Stage 2: surgical intervention.

There are 2 main types of surgeries:

1 Marsupialization.
2 Extirpation of the gland.

5.4. Marsupialization

During marsupialization, an artificial excretory duct of the gland is formed. The edges of the opened cavity are sutured to form an artificial pocket. A special catheter with an inflated end is placed in the wound. The catheter remains in the cavity for a period of 1-1.5 months, and then removed.

This time is quite enough for the formation of a new excretory duct. This operation is indicated for frequent recurrences of bartholinitis, a violation of the quality of life of a woman and the presence of a large cystic formation. Another goal of such an intervention is to improve the aesthetic appearance of the perineum.

Such an operation is organ-preserving; after the rehabilitation period, the gland continues to function normally.

5.5. Gland extirpation

This operation is performed with long persistent relapses of the disease, several unsuccessful attempts at marsupialization.

An incision is made on the outer side of the labia minora. The cyst capsule is carefully husked along with its upper pole. The surgical wound is closed with dip sutures. The main disadvantage of extirpation is the cessation of gland function.

For any surgical intervention in the postoperative period, antibiotic therapy is prescribed, anesthesia as needed (at the request of the patient).

6. Features of the management of pregnant women

The occurrence of acute bartholinitis during the period of gestation is an indication for antibiotic therapy, opening and drainage of the abscess.

Bartholinitis is dangerous during the gestational period with spontaneous miscarriage, premature birth, infection of the fetus.

When prescribing etiotropic therapy, it is necessary to take into account the possible teratogenic and embryotoxic effects of antibacterial drugs. During the gestational period, the following antibiotics can be used to treat bartholinitis:

1 Amoxicillin + clavulanic acid (tablets, capsules 0.5 g 3 times / day with an interval of 8 hours, a course of 7 days, orally (GPP)) - can be used in any trimester of pregnancy.
2 Ceftriaxone (intramuscularly, once) + metronidazole (0.5 g tablets 2 times / day, orally, a course of 7 days (GPP)) - strictly from the 2nd trimester of pregnancy.

Opening and drainage of an abscess in pregnant women is carried out in the same order as in non-pregnant women. In chronic bartholinitis, a cyst of the Bartholin gland, treatment is carried out only during the period of exacerbation, planned interventions are postponed to a later date (after delivery).

Inflammation of the Bartholin's gland is provoked by infection of pathogens. The disease is common, occurs in women of all ages. Sometimes it proceeds sluggishly, symptoms occur periodically. The first manifestations: redness, swelling and slight induration in the lower part of the labia majora. The onset can quickly turn into painful purulent inflammation, which often leads to urgent hospitalization with surgery. Inflammation, sometimes, goes away on its own, but over time it resumes, sometimes it becomes chronic. Surgery is the right decision. But with a mild inflammation of the gland, the doctor may prescribe .

Chronic inflammation of the Bartholin gland occurs once or twice a year, it happens less often, sometimes it is very painful. The task of home treatment is to relieve pain, reduce swelling, extinguish, and prevent purulent, abscessing formation. At the time of exacerbation and treatment, it is necessary to exclude intimate relationships, sports, if possible, lie more and walk less.

First aid, painkillers and antipyretics

With inflammation of the Bartholin gland and treatment at home, ice can quickly reduce swelling and pain. To do this, freeze water in a special bubble or a suitable container, wrap it in a clean cloth, apply to the inflamed area for 20-30 minutes, alternating with 15-minute breaks. Repeat this several times, changing the ice if necessary.

The long-term effect of painkillers will give time for restful sleep, food, and necessary procedures.

Diclofenac will relieve pain and swelling for several hours, will have a good anti-inflammatory effect, but weaker, like an antipyretic.
Dolaren - a strong, long-acting analgesic, contains paracetamol and diclofenac, will reduce fever and swelling. Doesn't do much for inflammation.
Ketorolac is an anti-inflammatory, reducing and powerful pain medication.

How to treat inflammation of the Bartholin's gland in women

Vishnevsky ointment

The doctor may recommend as a regenerating, wound healing, antimicrobial agent that accelerates the suppuration of local inflammation. But the ointment can increase the aching throbbing pains. Not everyone can tolerate her smell.

Levomekol

The activity of this ointment against Pseudomonas aeruginosa, Escherichia coli, spirochetes, chlamydia and staphylococci, which can cause inflammation of the Bartholin gland, is of great importance. In addition to immunostimulating and anti-inflammatory qualities, it works well in the treatment of purulent wounds.

Levosin

Anesthetic, quickly relieves swelling, antimicrobial ointment. It prevents the spread of inflammation, eliminates suppuration and necrosis, accelerates the healing and renewal of cells. Deeply gets into fabrics, is well absorbed, acts for a long time.

Attention! The inflamed area is not lubricated, but a gauze napkin soaked in ointment is applied to it.

Antibiotics

In the treatment of hospital and at home, the use of antibiotics cannot be avoided. The causative agents of infection that caused inflammation of the Bartholin gland can only be destroyed in this way. The doctor will prescribe drugs with a broad action that eliminates inflammation and is directed against several types of microorganisms.

Azithromycin

It inhibits the reproduction and growth of bacteria, concentrates in infectious and inflammatory foci, remaining in them up to seven days after the last dose. This allows for a short (3-5 days) course of treatment. Do not prescribe azithromycin during pregnancy, breastfeeding.

Amoxiclav

A combination of the two active substances amoxicillin and clavulanic acid drug. Among the many indications, it is prescribed for infectious inflammations of soft tissues and skin, including inflammation of the Bartholin's gland. It is prescribed during pregnancy and lactating women.

The group of cephalosporins with low toxicity has a high bactericidal effect.

Ceftriaxone

The drug of the third generation of this group. Fairly well tolerated by the body. Contraindicated for breastfeeding and in the first third of pregnancy. Cefazolin is a 1st generation product of the cephalosporin group. Allowed for lactating and pregnant women. Both drugs are used intravenously or intramuscularly.

Fluoroquinolones

Antimicrobial substances that effectively destroy bacteria that are resistant to most antibiotics. Ciprofloxacin and ofloxacin are very effective drugs of this group, quickly concentrating in the blood plasma, and are soon excreted from the body in the urine. Among other indications, it is recommended for the treatment of gynecological infectious and purulent inflammations. Both drugs are not prescribed to pregnant women and nursing mothers. During the use of the fluoroquinolone group, the skin becomes sensitive to direct sunlight.

Trichopolum, Tinidazole are antibiotics of the imidazole group, to which Trichomonas are sensitive.

Attention! Before issuing a prescription, it is necessary to inform the gynecologist about serious diseases of the internal organs, if any. Or consult with a therapist about a prescribed medication. This measure is necessary in order to select an analogue of the drug or adjust the dose and duration of the medication. This is important in some, especially chronic, diseases.

immunoregulators

During infectious diseases, taking antibiotics, analgesics and antipyretic drugs, the immune system weakens, the natural, vital microflora of the body dies. Candidiasis (), disorders of the digestive system (bloating, heaviness in the abdomen,), general weakness, poor sleep are soon detected. Subsequently, intestinal dysbacteriosis, gastrointestinal diseases, frequent colds, susceptibility to viral infections may occur. During the period of treatment at home for inflammation of the Bartholin gland and after (at least a month), it is necessary to take acidophilic lactobacilli and a vitamin complex.

Capsules of the drug "Yogurt" (yogurt) contain four types of active cells of bacterial cultures that are part of the human intestinal microflora or are friendly.

they restore the natural intestinal microflora, increasing the body's defense mechanisms. Reduce the possibility of developing infectious diseases;
form an environment that inhibits pathogenic and putrefactive bacteria. Prevent the manifestation of thrush;
normalize bowel function, lowering its pH, eliminating heartburn;
without them, the synthesis (formation) of certain vital substances is impossible.

Attention! Bacteria in capsules - live, are in a "sleeping" state. In heat, they become more active and, not finding a nutrient medium for their vital activity, quickly die. Cutting such a capsule, you can see instead of a white powder, a gray mass. These are dead bacteria that are absolutely useless for consumption. Therefore, packages with lactobacilli should be kept in the refrigerator, as they do in pharmacies.

A complex of vitamins and microelements is a powerful tonic that restores the female body. For the medical period of treatment, vitamins A, C, E are especially important. These are antioxidants.

with a lack of them in the body, normal immune processes and full tissue repair are impossible;
they are involved in the protection and formation of cells;
the result of their shortage is protracted illnesses and frequent relapses, susceptibility to infections.

Attention! Vitamins are taken before or with food, because food is their natural source for the body.

Treatment of inflammation of the Bartholin gland with folk remedies

Compresses, baths, herbal infusions will not be an independent treatment for inflammation of the Bartholin's gland at home, but will greatly help a speedy recovery.

Salt compresses

Hypertonic sodium chloride solution is the usual 10% saline solution (three tablespoons per liter of water). Salt has an antimicrobial, mild analgesic property, absorbs (absorbs) liquid, which reduces swelling and draws pus from the wound. Wipes soaked in the solution should be kept on the inflamed area for 30 minutes, four times a day.

Herbal baths

Leaves and buds, oak bark - each separately of these herbs, or in combination, will have a tangible anti-inflammatory, soothing and disinfecting effect, relieve throbbing pain, increase blood circulation and reduce swelling. You can brew them with boiling water in a jug or a three-liter jar, insisting for about an hour. The proportion should be such that a very strong infusion is obtained. Half of it (the second is used next time) is filtered into a container suitable for sitting in it (basin, large bowl), diluted with water to a warm comfortable temperature. The bath is taken for 20 minutes, so that the water does not cool down, hot water is added. The environment should not be too warm: slightly above body temperature. You can get rid of relapses of inflammation of the Bartholin gland by periodically doing such baths at home.

Decoctions, teas

Inflammation, infection, and antibiotic treatment require a lot of fluid. Decoction, herbal, black and green tea with lemon is an excellent diaphoretic, diuretic, vitamin and tonic. Young birch leaves, color, will make you sweat, relieve fever and inflammation. , St. John's wort will eliminate stomach problems caused by drugs, will have a general calming and strengthening effect. Teas are drunk hot, in small sips with a teaspoon.

Attention! Women with high acidity should not abuse rosehip broth. It, unlike lemon, can cause heartburn.

Causes of inflammation of the Bartholin gland in women

Bartholinitis is repeated during and after the weakening of the female body: in the off-season (autumn, spring), after infections, colds, prolonged nervous tension, physical exhaustion, overwork, during pregnancy and menopause, with hypothermia of the legs or general. During these periods, you should be especially careful and take general tonic and vitamin remedies, eat better and, if possible, rest as much as possible. And most importantly, visit the gynecologist more often.