Definition:
Abscess, bartholin (Bartholin's abscess) is characterized by the accumulation of pus that results in the formation of a lump or swelling in one of the Batholin glands, which are located on each side of the vaginal opening.
Diagnosis:
To diagnose Bartholin's abscess, a pelvic examination may be done to screen for characteristic tenderness and enlargement of the Bartholin's gland.
In addition, lab tests may be performed to determine the presence of gonorrhea. A lab analysis may be performed on the fluid sample for further testing. A biopsy may also be recommended to rule out Bartholin's gland tumor in women over 40.
Treatment:
Initial treatment for Bartholin's abscess includes soaking the affected area in warm water at least four times a day for a period of several days. This method will provide some temporary relief by restricting the infection in one area and forcing the abscess to open up and drain on its own. However, the site of rupture is often too small and closes very quickly before complete fluid drainage occurs.
A more effective alternative is to make a small surgical cut to completely drain Bartholin's abscess. In this procedure, local anesthesia is applied to the area, and then a small catheter is used to allow draining as the affected region heals. This approach provides the fastest symptom relief and recovery.
Antibiotics may also be prescribed in treatment. However, antibiotics are no longer needed if the abscess has been properly drained.
For women who repeatedly have Bartholin's abscess, marsupialization may be considered. Marsupialization is a surgical procedure in which a small, permanent opening is created to help drain the gland.
In some cases, if the abscess persists, physicians may recommend surgical removal of Bartholin's glands.
Of course, it is also important to treat the gonorrhea or other bacterial infection that caused the abscess in the first place.
Symptoms and Signs:
Classic signs of Bartholin's abscess include: the appearance of a tender lump on both sides of the vaginal opening, pain during sexual intercourse, and fever.
In women older than 40 years old, a swollen Bartholin's gland may indicate the presence of a tumor in the gland, albeit only rarely. If the abscess is scraped off from the surrounding tissue, a chronic Bartholin's duct cyst may potentially develop.
In most cases, the abscess appears and becomes very hot and swollen after 2-3 days. Any type of activity that puts pressure on the vulva, even sitting down or walking around, may cause excruciating pain.
Causes:
Bartholin's abscess develops when there is an obstruction blocking the small opening of Bartholin's glands. The fluid builds up in the gland and may become infected.
While Bartholin's abscess is not strictly a sexually transmitted disease, it is often caused by a number of bacteria such as gonorrhea which are sexually transmitted.
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