Opening the abscess of the Bartholin’s gland is a radical option for resolving the issue regarding the pathology of the female genital organs. The disease is localized on the eve of the vagina, since that is where the gland itself is located.
According to statistics, most of the victims of this disease are in the age range from 20 to 40 years. Despite this, there are age-related exceptions, therefore, not a single representative of the weaker sex is immune from inflammation, who ignores medical recommendations for prevention.
The Bartholin gland belongs to the category of paired formations, which are classified as a complex tubular type. In shape, it resembles a large pea. The acini of the gland are lined with epithelial tissue of a cylindrical nature, which is located in one row. The formation of the central duct is explained by the connection of several smaller ducts at once.
The main path opens in front of the vagina from the front, located outside the hymen. The duct itself is lined with transitional epithelium, the length of which reaches only two centimeters.
Causes of inflammation
In order to understand the degree of damage to such an important part of the female reproductive system, the gynecologist during the initial appointment must understand the primary source of the lesion. Usually, the catalyst for the inflammatory process is the entry into the lumen of the duct of vaginal discharge that has already been infected. Discharge from the urethra, which was also affected by some kind of infection, can also get there. In rare cases, it even happens that infection is a consequence of the entry of infected contents of the bloodstream into the lumen.
The classic symptomatology of the disease involves purulent inflammation with all the ensuing unpleasant consequences. The lesion focus can shift somewhat over time, affecting neighboring glandular tissues and the surrounding tissue.
The culprits of true bartholinitis – this is how the abscess of the indicated gland is called in medical terminology, are pyogenic cocci. Usually, the vital activity of the brightest representative of this family, gonococcus, leads to sad consequences. This automatically means that in about a quarter of cases, standard gonorrhea leads to a lesion of the gland with the lower parts of the reproductive system. The explanation for this is simple – vaginal discharge enters the lumen, which already contains pus by default.
Doctors distinguish two formats of false abscesses of the Bartholin gland:
- primary;
- secondary.
The first option is based on infectious development with abscessing of the duct of the retention cyst. The latter is formed by blockage of the duct itself.
The secondary course is due to inflammation of the gland itself. This happens due to the onset of suppuration of the cyst, which “felt” well during long-term treatment, because no one treated it.
A false illness almost always develops due to the associative flora, the fundamental factors of which are:
- anaerobic microorganisms;
- fungi;
- streptococci;
- staphylococci.
Doctors say that today most of the patients in the gynecological hospital are dealing with just a false abscess formation. Such a disease has another distinctive feature, which is expressed in certain anatomical premises. It is a narrowing of the duct along its entire length. At the point where the small paths intersect, flowing into the main one, something like an ampulla is formed in the gland. A small amount of gland secretion is stored there.
After this, a narrowing of the central duct occurs, which at the exit is a pinhole. The puffiness that manifested itself in this area with previously detected vulvitis or colpitis outwardly looks like inflammation of the mucous membrane of the duct itself. Edema provokes the closure of the main channel, which triggers the mechanism of inhibition of secretion supply and infection of the generated secretions. The result of the pathology is represented by a primary abscess or cyst.
Anxiety symptoms
In order to negate the risks of possible side effects after undergoing surgery on the outer part in front of the vagina, doctors recommend that if you find the first signs of the disease, you should immediately go to the clinic. On the spot, an experienced gynecologist will prescribe tests, after which it will become clear exactly what the doctor will have to deal with.
Regardless of the type of abscess, be it false or true, the symptoms in both scenarios remain identical, including:
- one-sidedness of the process;
- scanty purulent discharge when trying to palpate the problem area;
- pain in the projection area of the central duct;
- infiltration in a potentially infected area;
- swelling of the labia majora and the surrounding mucosa;
- looseness of the subcutaneous tissue at the entrance to the vagina;
- hyperemia.
Unlike the standard scheme, with the accumulation of pus inside the cyst, the melting of glandular tissues manifests itself much brighter. We are talking about a characteristic pain syndrome followed by a rather extensive edema. Also, the skin, which is localized over the true abscess, remains motionless. Inguinal lymphadenitis becomes an auxiliary indicator.
If at least a few of the points mentioned above are found, as well as if there is pain when touching the neoplasm, you should immediately make an appointment with a gynecologist. Otherwise, after a short period of time, the deterioration will affect the problem of increasing the degree of soreness in a sitting position. And defecation will turn into real flour.
Any self-treatment based on the use of analgesics will only be of short-term effectiveness, exacerbating the situation at the physiological level. Also, when tightening, the patient will definitely encounter a phase of suppuration, which provokes a hectic temperature. Difficulties will be added by the manifestation of intoxication with the worst scenario. This is not just a general weakness. A woman will have to face a lack of appetite, which, in the end, will undermine the immune forces of the body, as well as insomnia or more complex sleep disorders.
Surgeons who specialize in getting rid of such a pathology in an operative way note that a symptom called “nights without sleep” is direct evidence of the active stage of suppuration. If you do not open the abscess immediately, then this threatens to turn the disease into a chronic form. The latter is characterized by changes in remission and exacerbation.
During the examination, the gynecologist will palpate the lower third of the labia majora, even if the patient asked for help during menstruation. The results of palpation will reveal a cystic formation that has a dense texture. When pressing on the supposed unhealthy area, the girl will experience soreness.
On a periodic basis, the abscess opens naturally through the duct of the gland straight into the vagina. With particularly complex clinical pictures, it is even possible to empty dangerous contents into the rectum.
With a protracted disease, which they did not even try to delicately treat, the representative of the weaker sex will quickly encounter an aesthetic problem. Outwardly, the disease will manifest itself as a deformation of the labia and the exit of the vagina. The reason for this is the repeated scarring of the former formations, which disfigures the appearance of the perineum. It is even worse if the disease is extended to such an extent that a quite actively functioning fistulous tract has formed in the vagina or near it. It makes itself felt with repeated openings of the process in a natural or surgical way.
At the stage of remission with bartholinitis, the victims have dyspareunia and leucorrhoea, which are a logical consequence of chronic vulvovaginitis. At the stage of exacerbation, the infection begins to become active, which is expressed in the symptoms of classic acute inflammation.
Fast diagnostics
Unlike many other diseases of the female reproductive system, abscesses of this type are quite easy to recognize if the appointment is made by a qualified gynecologist. First, he conducts an external examination, and then uses the basics of palpation.
During the study of the opening of the excretory duct, the doctor will pay special attention to the features of the discharge, as well as:
- possible edema;
- swellings;
- stains;
- asymmetries;
- hyperemia.
To make sure of the diagnosis, the doctor spreads the labia to get to the gland itself. This allows you to detect visible signs of its inflammation. At the same time, the specialist must determine the specific:
- localization;
- dimensions;
- consistency;
- the degree of pain.
Based on the information collected, it will be possible to determine how much the defeat process has progressed. It is especially important to study the severity of asymmetry, which is the most important beacon of the disease. The crescent-shaped genital slit should turn with its convex side to the side of a healthy lip. With an extensive anomaly, the tumor can completely close the entire genital gap entirely.
Another important point of a proper examination is a thorough assessment of the condition of the lymph nodes in the groin area. In severe cases of bartholinitis, lymphadenitis located on the problem side is not complete without lymphadenitis. And if the disease is caused by gonorrheal primary sources, then it is worth paying attention to metastatic lesions. This is gonorrheal arthritis.
Effective treatment
Doctors agree that conservative treatment of lesions of the Bartholin gland will help only at the initial stage of the disease, when there is at least a partial outflow of secretions. Then it will be possible to get by with medications that are characteristic of the treatment of acute purulent inflammation.
But usually women are not so vigilant about their genital health. Because of this, they seek help already with a progressive disease, when only a surgical measure can help. Some ladies who have already undergone the procedure are frightened that they have a seal left. But since each organism is individual, it is worth checking with your gynecologist personally whether this alignment is normal in each specific situation separately.
If you miss the opportunity to solve everything with a scalpel, you will have to face the grave consequences of your own indifference to health.
This is about:
- spontaneous opening of the abscess;
- lymphangitis;
- the lymph nodes.
Ignoring the doctor’s recommendation to perform an operation immediately may result in an acute illness turning into a classic purulent-infiltrative process of a chronic type.
Do not assume that widening the inlet of the main duct to improve the outflow of pus is an excellent solution to the problem. Even puncture or aspiration of pus followed by washing the gland will not bring long-awaited relief for a long time. This will only drive the disease to the chronic stage. Physiologically, the uselessness of the above is explained by the fact that the evacuation of pus takes place only for a short period of time.
As soon as the hole made for the puncture closes, everything will repeat again. Because of this, doctors insist on a wide opening of the abscess. An autopsy should occur along the lower pole of the labia, focusing on the zone of fluctuation from the side of the mucous membrane.
After the cavity is completely free of health-threatening contents, the doctor sanitizes with an antiseptic solution. Improvement comes immediately. Patients note a decrease in soreness, as well as other symptoms of ordinary purulent intoxication.
Despite the fact that after the operation, which lasts approximately 25 minutes, many ladies want to rest in bed, this is not worth doing. Doctors recommend walking more on the first day, as well as gently washing the vacated cavity after an abscess several times a day.
On the second day, you can reduce the number of washes.
But leaving turundas and other lotions, tubes, compresses in the cavity is strictly prohibited. Handicraft assistants will not be able to provide sufficient drainage for the former abscess, instead only interfering with the natural mechanism for the outflow of the secret. Problems are added by the ability of items for the collection to accumulate pus, which should leave freely.
The postoperative period should be accompanied by adherence to a previously approved drug treatment program. Individually selected preparations allow you to successfully deal with atypical microorganisms, edema and swelling.
The final stage is physiotherapy and restorative treatment aimed at leveling the risks of relapse.