What is bartholinitis, its symptoms and treatment?

Bartholinitis is an infectious inflammation of the bartholin( large) glands located on the threshold of the vagina, in most cases of a one-sided nature. The disease is more common in young sexually active women, but sometimes it is diagnosed in juvenile girls. To prevent complications, it is necessary, at the first symptoms, to see a doctor who will conduct the examination and prescribe the treatment.

• reasons
• Classification
• Symptoms and signs
• acute Bartholinitis, false abscess
• Acute Bartolini, a true abscess
• chronic Bartholinitis
• Diagnostics
• Complications
• Treatment
• Conservative treatment
• Surgery
• At home
• conditions during pregnancy
• Children
• Prevention

Causes of

The disease develops when infectious agents enter the Bartholin gland: a conditionally pathogenic microbial microflora( streptoPCC aureus, Candida, Escherichia coli, etc.) or pathogens( trichomonas, gonococcus).

Most pathogenic microorganisms enter the duct of the Bartholin gland from the vagina or urethra with colpitis and / or urethritis. However, there are cases when the infection gets directly into the gland itself with a flow of blood or lymph.

The risk of bartholinitis is increased in the following situations:

• Local microtrauma( sexual intercourse with insufficient moistening, combing).
• Non-compliance with personal hygiene( especially with monthly).
• Wearing tight underwear disturbs the outflow of the secretion of the gland, so it stagnates and creates ideal conditions for the multiplication of pathogens in the duct of the gland.
• The presence of foci of chronic infection( pyelonephritis and others) is the cause of the entry of microorganisms into the Bartholin gland with a current of lymph or blood.
• Random sex life increases the likelihood of contracting diseases that are sexually transmitted.
• Surgical interventions on the genitourinary system( for example, abortion), performed with violation of medical and sanitary standards during the procedure and non-compliance with recommendations in the postoperative period.
• Violation of the immune system, lack of vitamins, local or general hypothermia leads to a weakened protection of the female body, which contributes to the penetration of pathogens of infections both in the gland itself and in its duct.

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Classification of

Bartholinitis may occur in acute or chronic form.

Acute process manifests itself as:

• of a false abscess( primary - canaliculitis or secondary - with inflammation of a previously formed cyst);
• is a true abscess.

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Symptoms and signs

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Acute bartholinitis, false abscess

• Appearance of pus with pressure on the excretory duct of the gland;
• reddening of the skin around the gland opening area;
• increase in body temperature to 38-39 degrees;
• pain intensification during defecation, in a sitting position, with active movement and especially during sexual contact;
• weakness and chills;
• swelling of the skin in the large labia;
• acute pain in the palpation of the labia.

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Acute bartholinitis, true abscess

• Chills, headache and weakness;
• increase in body temperature to 40 degrees;
• increased pain in the resulting cyst, the pain becomes pulsating;
• increased inguinal lymph nodes;
• sometimes the abscess is opened independently, with the pain becoming less pronounced, the body temperature decreases.

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Chronic bartholinitis

• Normal state of health between periods of exacerbation, there is discomfort during sexual intercourse.
• Perhaps the development of the cyst of the large gland of the vestibule: if it is small, then it does not cause discomfort, but if it is large, the woman feels an increase in pain in the lower abdomen in a sitting position and walking.
• Increases body temperature to 38 degrees and the appearance of common signs of body intoxication with a large cyst.
• During the period of exacerbation of the disease, the cyst can be opened.
• Sometimes the disease is accompanied by the formation of a seal on the mucous membrane of the labia. The gland increases in size. Discomfort is manifested in the form of tingling, burning or itching.

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Diagnosis

Diagnosis is made during a gynecological examination based on the characteristic appearance of pathological changes in the genital area.

In order to identify the causative agent, the following laboratory tests are assigned:

• PCR diagnostics( study for the presence of causative agents of the main sexual infections: trichomoniasis, gonorrhea, chlamydia, HPV, and so on).
• Smear from the vagina.
• Bacteriological study of purulent discharge obtained after spontaneous dissection of the abscess or after a gentle pressure on the excretory duct of the gland.
• Sowing of vaginal discharge for detailed study of the composition of the vaginal microflora and identification of its sensitivity to antibiotics.
• General blood test, immunogram, blood test for HIV and RW.

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Complications of

• Frequent relapse of the disease;
• spread of infectious inflammatory process to surrounding tissues( colpitis, urethritis and so on);
• seldom form non-healing fistulas;
• development of sepsis( a serious infectious disease associated with the entry of purulent discharge into the circulatory system).

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Treatment of

Modern gynecology has several effective methods of treating bartolinite both conservative and surgical. The chosen tactics of treatment depend on the stage of the inflammatory process. When diagnosing severe forms of the disease, therapy is performed under steady-state conditions. In mild forms, treatment is performed at home.

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Conservative treatment

Local and general drug therapy is prescribed for this purpose:

• Non-steroidal anti-inflammatory drugs ( Ibuprofen, Baralgin and others) eliminate pain syndrome and stop the inflammatory process.
• Local anti-inflammatory therapy. Warm sessile baths with a weak solution of potassium permanganate( pale pink) or chlorhexidine, applications with ointments to the affected area( Ointment Vishnevsky, Ichthyol, Tetracycline, Levosin, Levomekol and others).
• Antibacterial drugs. Treatment with antibiotics begins without waiting for the results of laboratory tests. At the first stage, prescribes a broad-spectrum medicine that is effective against most pathogenic microbes. After detection of the pathogen, the antibiotic is prolonged or replaced with another drug. Broad-spectrum antibiotics include the following groups: imidazoles( Tinidazole, Trichopolum, Metronidazole), fluoroquinolones( Ciprofloxacin, Ofloxacin, Ciprolet), cephalosporins( Cefazolin, Ceftriaxone), macrolides( Azithromycin, Ermithromycin, Clarithromycin, Sumamed), penicillins( Amoxiclav, Amoxicillin) and others.
• Analgesics for pain relief - Analgin and others.
• Antihistamines ( Claritin, Eden and so on) are prescribed to prevent allergic reactions to other drugs.
• Immunostimulants ( Candlesticks Genferon and others) and restorative medications are prescribed to restore the functioning of the immune system so that the body can independently prevent relapse of the disease. Medications are prescribed after receiving the results of the immunogram.

After elimination of the symptoms of the inflammatory process( 3-4 days), physiotherapy( UHF, UFO, magnetotherapy) is prescribed.

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Surgical treatment of

Unfortunately, due to untimely contact with the doctor and rapid progression of infection, many cases of bartholinitis are treated surgically.

In the most neglected cases, when the effects of bartholinitis can not be eliminated, the gland must be completely removed. After the operation, a course of antibiotics is prescribed.

• Marsupilation of ( surgical treatment of an abscess or cysts under general anesthesia).The abscess cavity or cysts are opened and the contents are removed, then treated with an antibacterial agent. To ensure that the cavity is not filled again, drainage is placed in it( a rubber tube for discharge of the separated contents outwards), through which, if necessary, antibacterial or antiseptic solutions are introduced. After 5-6 days drainage is removed.
• Extirpation of ( complete removal) of the bartholin gland. Anesthesia is performed with a scalpel on the inside of the small lips. Then, remove and remove the gland, and then apply seams. Further, rehabilitation treatment is prescribed for 7-10 days: magnetotherapy, UHF, phonophoresis, applications with ointments and so on.

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At home

With mild illness at the initial stage, therapy at home is possible, but only after consultation with the attending physician. It is important to remove the symptoms of intoxication( pain, weakness, itching, etc.) and prevent the development of the abscess and the formation on the threshold of the vagina of the cyst of the large gland. Simultaneously with folk remedies, one must take painkillers and antipyretic drugs.

• Lotion with salt solution : in 1 liter of warm boiled water put 3 tablespoons of salt and mix thoroughly. To the inflamed place for 30-40 minutes, attach a tampon of gauze, pre-moistened in a solution. The procedure should be repeated at least 6 times a day daily.
• Cold on the genital area of ​​the will relieve severe itching and aching pain, also prevents the spread of infection and reduces swelling. To do this, you need to attach a towel with ice cubes wrapped in it for 30 minutes to the sick site. After 25 minutes repeat the procedure.
• Baths with herbs have anti-inflammatory effect and reduce pain. Most often use sedentary baths with infusions of eucalyptus, chamomile, calendula.3 tablespoons of any herb to brew in 300 milliliters of boiling water, insist 30 minutes and strain. Ready to pour the infusion into a basin with warm water or a bath and sit for 15-20 minutes.
• Decoction of aloe and honey with wine: 100 grams of aloe leaves finely chopped, add 400 grams of honey and 1 glass of red wine. Put the mixture on a water bath and simmer for 1 hour, then squeeze and take 1 tablespoon 25 minutes before meals three times a day.
• Baked onion for lotions : bake onion, cool, mash with fork and wrap in gauze. Apply in warm form 2 times a day.
• Candles with sea buckthorn oil have a wound healing and anti-inflammatory effect. They are recommended to be used after the opening of bartholinite. Recipe: melt 300 grams of beeswax, add 100 milliliters of sea buckthorn oil and 5 ampoules of liquid vitamin E. Mix well and pour into molds( you can use a finger from a medical glove, rolled foil, syringe pistons).After solidification apply daily for 20 days. Keep candles in the refrigerator.
• Candles with tea tree oil : in a water bath, melt cocoa butter, remove from heat, cool a little, add the essential oil( 100 ml of liquid cocoa butter 2 ml of tea tree oil), mix thoroughly and pour into molds. Use candles before bedtime for 10-15 days.

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In pregnancy,

Pregnant women are rarely diagnosed with illness, as future mothers undergo regular examination and receive timely preventive therapy. Bartholinitis in pregnancy is mainly due to a change in the normal composition of the microflora in the direction of increasing its opportunistic component and reducing immunity.

Treatment of the disease in pregnant women also depends on its stage. The appointment of antibacterial agents is justified when the progression of the process and the deterioration of the patient's condition. Operative therapy of an abscess is better to spend after sorts, but if the infection progresses and does not give in to medicamental treatment, the operation is carried out without delay.

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In children

Treatment of the disease depends on the stage:

• With mild form( canal), antibacterial drugs are prescribed. In parallel, physiotherapy is prescribed, which includes UHF therapy and UV irradiation.
• If a false or true abscess has been found, the doctor will recommend a surgical procedure that involves dissection of the excretory duct of the gland and suturing the mucous gland to the vulvar mucosa. In the case of relapse with exacerbation, a decision can be made to remove the gland. Simultaneously with surgical treatment, a course of antibacterial and anti-inflammatory drugs is prescribed.

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Prevention of

To prevent bartholinitis, it is necessary: ​​

• to avoid hypothermia;
• observe the rules of personal hygiene;
• to exclude casual sexual contacts, to use barrier methods of contraception( condoms);
• avoid bathing in contaminated rivers, lakes;
• regularly( 2 times a year) to visit a gynecologist;
• refuse to wear tight clothes and linen;
• is a modern treatment for any inflammatory processes in the body;
• take vitamins and monitor your diet.