Bartholinitis N75.80

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 13.12.2021

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Synonym(s)

abscess of the Bartholin glands; Bartholin glands; Bartholinic abscess; Pseudoabscess of the Bartholonic glands

Definition
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Relatively frequent bacterial inflammation of the excretory duct of a Bartholan gland (Glandulae vestibulares majores: 2 small mucosal secretion glands in the lower third of the large labia, whose excretory ducts open on the inside of the small labia before the introitus vaginae).

Etiopathogenesis
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Staph, strep, E. coli or Neisseria gonorrhoeae. The bacteria penetrate the excretory duct where they cause inflammation and, as a result, adhesions in the duct. This results in obstruction of the purulent secretion and formation of an empyema (often called Bartholin's abscess). The gland itself is generally not involved in the inflammatory process.

Clinical features
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Unilateral, extremely painful redness and swelling in the posterior third of the small labia. With progressive accumulation of secretions and tissue melting, formation of a bulging, fluctuating tumour, up to the size of a chicken egg, which displaces the introitus vaginae. Frequent fever and general feeling of illness.

Therapy
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Antibiotic therapy initially with broad-spectrum antibiotics, as soon as possible after antibiogram. In case of significant fluctuation, incision at the site of the orifice of the excretory duct and drainage of the pus. At the same time marsupialisation to avoid recurrences: carding and subsequent suturing of the wall of the duct with the outer skin.

External therapy
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Initial open wound treatment, sitz baths with disinfectant additives e.g. aqueous quinolinol(e.g. quinosol 0.5-1:1000), R042 or polyvidon-iodine. (Betaisodona solution). Wound irrigations with polihexanide(Serasept, Prontoderm) or polyvidon-iodine solution and Ringer's solution, healing-promoting measures with special wound dressings. S.u. Wound treatment.

Progression/forecast
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Initial inflammations usually subside under antibiotic therapy. If marsupialization is not performed during the development of emphysema, the risk of recurrence is high; after repeated bartholinitides, a Bartholinian retention cyst often develops.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 13.12.2021