Patient's question:
I have had a ten-year history of candidal vulvovaginitis (starting in 1995). In 2000, I also contracted mycoplasma, followed by Bartholin's gland cyst (currently the size of a jujube, varying in size at rest, and enlarging during severe inflammation). Over these ten years, I have been constantly treated in the hospital, with the condition recurring repeatedly. Even after treatment, it would flare up again within a few months. During these ten years, I have basically had to visit the hospital several times a year for this condition, undergoing long-term treatment. The doctors said that after treatment, I needed to take medication for three months to consolidate the results. I followed this treatment, but it failed again after a few months. The doctors here mainly treat the vulvovaginitis and mycoplasma. Regarding the Bartholin's gland cyst, they said there were no symptoms, so it didn’t need treatment. However, my perineum has been consistently red and swollen, and pressing it causes mild pain. The doctor prescribed topical creams (Diphenhydramine cream, Gentian violet ointment) for application, but they had no effect. During intercourse, the perineum becomes painful and may rupture, leading to recurrent candidal vulvovaginitis and mycoplasma, accompanied by symptoms of fever in the external genitalia.In July, the doctor diagnosed the redness and swelling in the perineum as inflammation of the Bartholin's gland cyst, requiring a fistula surgery. First, I received injections and intravenous fluids to reduce inflammation. After a few days, the inflammation showed some improvement. However, since my period hadn’t arrived yet, the surgery was postponed. The doctor said it should be done after my period ends. But after my period did end, the candidal vulvovaginitis and mycoplasma recurred again. While treating these infections, I also tried to reduce the inflammation, but for some reason, the inflammation of the Bartholin's gland cyst never subsided. The perineum remained red and swollen, and after another two months of treatment, there has been no improvement. The doctor said that without resolving the redness and swelling, the fistula surgery cannot be performed. The doctor then suggested a puncture, but I was worried that the redness and swelling might still persist, and the doctor was also concerned that the puncture could lead to infection, making the problem worse. The doctors here are also starting to feel that they don’t know what else to do. Currently, I am in a very bad mood. A small illness has left me without a cure for ten years.
Doctor's answer:
Hello, according to your information, it is recommended to start with intravenous infusion for anti-inflammatory treatment (preferably using erythromycin) for one week, followed by basset adenostomy, and then use antibiotics for irrigation and dressing changes. It might be effective.