BARTHOLIN’S CYST/ABCESS
A fluid-filled swelling (cyst) in the Bartholin's glands.
Bartholin’s glands are pea sized glands, found in the labia minora. The glands are typically non palpable. Bartholin’s glands secrete mucus into duct emerging into vestibule on either side of vaginal orifice. Its main function is to maintain moisture of vaginal mucosa.
CAUSE :
The most common cause of Bartholin's cyst is a gonococcal infection that causes obstruction. However, another probable cause is congenital narrowing of the duct.
The Abscess may arise from a primary gland infection, or an infected cyst. Infection may be caused by N. gonorrheae, C. trachomatis. Other normal flora e.g. Staph spp., E. coli may also play a role.
PATHOPHYSIOLOGY :
Bartholin's cyst occurs when duct becomes obstructed hence distension of duct or gland with fluid. Obstruction is secondary to non-specific inflammation or trauma. The cyst is usually painless. However, if the cyst is very large, one may experience pain, dyspareunia. It may rupture and produce non-purulent discharge.
SIGNS & SYMPTOMS :
~Acute valvular pain
~Labial swelling
~Dyspareunia
~Fever
~Purulent discharge on rupture
MANAGEMENT :
✓Cyst
• Sitz bath result in rupture and spontaneous healing’
• If pain present, give analgesics.
✓Abscess
• Incision and drainage to prevent rapid fluid accumulation pack cavity and remove after 24-48hours.
• Marsupialization- for recurrent abscesses to facilitate proper drainage of pus. This is where a Wide incision is made and inner edges sutured to external mucosa
• The drained pus should be sent for culture and sensitivity to detect any gonococcal infections.
• The patient should be put on appropriate antibiotics
I'm from the UK and I was once a Vaginal Cancer patient and pubic Lice.
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