September 26, 2024 The Bartholin glands are 2 small glands located on each side of the opening of the vagina, in the lower third of the labia majora . They produce a fluid that contributes to vaginal lubrication. When the drainage channel of a gland becomes blocked , the secretion produced can accumulate and lead to the formation of a cyst , which is called a Bartholin cyst. Bartholin's cysts affect 2% of women over 20 years of age. It is usually painless, but when it is large it can cause discomfort when walking, sitting or with sexual activity. When a Bartholin's cyst becomes infected an abscess can form , and this condition is known as bartholinitis or Bartholin's gland abscess. Bacterial cause of bartholinitis is mainly Escherichia coli but the problem can also be due to Neisseria gonorrhoeae and Chlamydia trachomatis . There are no known risk factors for bartholinitis. Bartholinitis symptoms The main symptoms of bartholinitis or Bartholin gland abscess are: Pain and swelling in the vaginal area; Presence of a “lump” near the vaginal opening; Redness and heat in the affected area; Pain and difficulty when sitting, walking and intercourse; In severe infections, fever and malaise may occur. These symptoms require medical attention . A non-treated bartholinitis can lead to infection aggravation and complications, such as generalized infections, permanent pain and discomfort, abnormal scarring with fibrosis and a greater likelihood of recurrence and pain during sexual intercourse. Bartholinitis treatment Treatment depends on the severity of the problem and can range from a conservative approach to surgery. Conservative treatment Conservative treatment may include: Sitz baths : in warm water, for 10-15 minutes, several times a day, which can help with the spontaneous drainage of the abscess and relieve pain; Hot compresses : applied to the affected area for 10-15 minutes, several times a day, which can help reduce pain and swelling, as well as promoting natural drainage of the abscess; Analgesics : taking medications such as ibuprofen and paracetamol may be indicated to control pain and inflammation, particularly after spontaneous drainage of the abscess; Antibiotics : in the early stages, antibiotics may in some cases be prescribed to prevent the abscess development. When prescribed with surgical treatment, the intention is to reduce the risk of systemic infection. Surgical treatment Surgical treatment can be: Incision and drainage of the abscess , which is generally performed under local anesthesia. An incision is made to drain the abscess, and a drain is usually left in for a few days to prevent recurrences; Drainage and marsupialization of the Bartholin gland , which is generally performed under general or locoregional anesthesia. An incision is made, and its edges are sutured to the skin to create a permanent opening. Compared to drainage and drain placement, it is associated with less postoperative discomfort; Excision of the Bartholin gland , which is a treatment that definitively resolves the problem once the gland is removed. Unlike the previous ones, it has a high rate of complications, particularly severe bleeding. Thus, it is performed when there is repeated failure of other approaches. Surgical treatment has the main benefits of rapid relief of pain and discomfort, reducing the risk of infection aggravation and possible septic complications, and reducing the likelihood of recurrence. It also has some risks, including vaginal dryness, pain during sexual intercourse, hematoma, infection of the surrounding tissues (cellulitis), and abnormal healing due to inadequate scarring or the formation of scar tissue. It is also not possible to exclude the possibility of a recurrence. After surgery, strictly following the care recommended by the clinical team promotes adequate healing, prevents infections and reduces the risk of complications . After surgery for bartholinitis, there are warning signs that should motivate you to seek medical care: Signs of local infection, such as increased pain, redness, swelling, heat, purulent discharge; General malaise, nausea and vomiting: Bleeding, opening of the surgical wound or reappearance of the “lump”. This content was written by the Obstetrics-Gynecology clinical team from Hospital da Luz. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
