Patient's question:
Doctor, hello! My Bartholin gland abscess has flared up again (medical history: I had it twice before, with a swelling of about 1.5 to 2 centimeters, hard, tender to touch, no difficulty walking or sitting, treated with phototherapy, penicillin, and another topical medication, oral Gentian Formula, after each treatment it didn't fully disappear, and there was still a swelling about the size of a green bean). This time it's much worse. The onset of this episode was about a week ago. At first, it was just tender to touch. Because guests came over for the New Year's holiday, I didn't stay in bed, and by that night, it had become severe. Symptoms: There is a swelling about the size of a yolk, hard, painful even without touching, walking or sitting causes pain. These past few days, I've been taking Gentian Formula and Cephalosporin IV. Today, I went to the hospital, and the doctor still had me continue with phototherapy.Doctor's answer:
Hello: OverviewThe Bartholin glands are located on both sides of the vaginal opening, with their openings in the vaginal vestibule. Pathogens easily invade and cause inflammation when the external genitalia are contaminated during sexual intercourse, childbirth, or other situations.
Causes
The pathogens are mostly staphylococcus, E. coli, streptococcus, and enterococcus, often involving mixed infections.
Symptoms
Acute Bartholin glanditis first affects the glandular ducts, presenting as acute purulent inflammation with local redness, swelling, heat, and pain. Sometimes, there may be a sense of fullness and difficulty urinating or defecating, along with fever and elevated white blood cell counts. The duct openings are often blocked due to swelling or the accumulation of exudate, leading to the formation of an abscess, known as a Bartholin gland abscess. The affected area may have a fluctuating sensation, and inguinal lymph nodes may swell. When the pressure inside the abscess increases, it may rupture spontaneously. If the rupture is large and the drainage is unobstructed, the inflammation can subside and heal quickly. However, if the rupture is small and drainage is poor, it may recur repeatedly, causing the patient significant discomfort in walking or sitting.
After the acute inflammation subsides, if the duct openings remain blocked, the glandular secretions cannot be expelled, or the purulent fluid gradually transforms into mucus, forming a cyst, known as a Bartholin gland cyst.
Examination
Acute Bartholin glanditis first affects the glandular ducts, causing local redness, swelling, heat, and pain. The duct openings are often blocked due to swelling or the accumulation of exudate, leading to the formation of an abscess. The affected area may have a fluctuating sensation, and inguinal lymph nodes may swell.
Treatment
During the acute phase, antibiotics (penicillin,IV,VI) can be administered via intramuscular injection or oral ingestion, along with rest, local heat application, sitz baths, or heat therapy. After the abscess forms, an arc-shaped incision can be made along the inner side of the labia majora where the fluctuation is most prominent.