Bartholin gland cyst

The bartholin gland cyst is the formation that results from the blockage of the gland duct and the accumulation of its secret. Cystic formation can reach significant dimensions (3-4 cm) and is manifested by swelling in the labia, pain and discomfort during walking or sexual intercourse.

[1], [2], [3]

Causes of the bartholin gland cysts

The causes of the most common are urogenital infections. In case of infection of cystic education, an abscess of the Bartholin gland can develop. Treatment can be both outpatient and operative, and also include such manipulations as marsupialization of the Bartholin gland cyst, word-catheter installation, extirpation.

[4], [5]

Pathogenesis

The bartholin gland cyst is formed when the duct that secretes the produced secret is clogged, thereby forming a cystic formation. The cause of obstruction of the duct and inflammation of the gland are most often diseases that are sexually transmitted, such as gonorrhea, chlamydia, etc. Less commonly, the pathogen causes inflammation of the infection - staphylococcal infection, E. Coli, etc., and a decrease in the overall resistance of the body. Provoke infection can and mechanically - epilation of the deep bikini zone, tight synthetic underwear and non-observance of personal hygiene rules often become the causes of the bartholin gland cyst. Traumatic gynecological manipulations, such as abortion or hysteroscopy, can cause blockage of the duct, and hence cystic education.

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Symptoms of the bartholin gland cysts

Symptomatology is usually pronounced where the gland is located. With the bastolin gland cyst, the labia is swollen, a rounded formation is felt under the skin, the size of which can vary from a small pea to a large egg. Often small tumors go unnoticed, and only increasing in size, become the cause of discomfort. Large formations are painful, cause discomfort during walking and intercourse. Cystic formation can become inflamed due to infection, and thereby provoke an abscess of the Bartholin gland. With abscess cysts, the symptoms of bartholin gland cysts are more pronounced - the labia is very swollen, the focus of inflammation is sharply painful, the patient is worried about the feeling of pulsation at the site of the abscess, the body temperature can rise to 38-39C. Since the cause of inflammation cysts and abscesses are most often sexually transmitted infections, then the symptoms listed above are added to the above symptoms of concomitant infectious diseases (cystitis, vaginosis, urethritis, etc.). Sometimes the abscesses are uncovered spontaneously, but even then you should definitely seek the advice of a doctor - the opened cavity should be thoroughly rinsed to prevent further inflammation and relapse.

[7], [8], [9]

Bartholin gland cyst during pregnancy 

The bartholin gland cyst often occurs during pregnancy, because at this particular time the immunity is weakened and susceptible to all kinds of infections. If the cystic formation is not inflamed, then during pregnancy it does not affect. And if the cyst is still inflamed, then depending on the kind of infection that caused it and the severity of the symptoms, the drainage of the cystic education is preferable to postpone the postpartum period. The thing is that during the course of pregnancy the blood flow to the genital organs is sharply increased, which can provoke bleeding. If one can not do without intervention, drainage is performed under local anesthesia, and concomitant infection is treated with antibiotics approved for use during pregnancy. If, before pregnancy, a woman experiences frequent relapses of the disease with suppuration and abscesses, then when planning pregnancy the doctor can recommend a procedure for removing the bartholin gland.

[10], [11], [12]

Complications and consequences

Inflammation of the bartholin gland cyst

As noted above, inflammation of the Bartholin gland cyst occurs because of the concomitant infection. And if an uninflamed cyst of a small size does not bother a woman and does not cause any discomfort, the inflamed cyst is sharply painful. Inflammation of the Bartholin gland or bartolinite is acute or chronic. The acute form is characterized by the development of a false or true abscess, chronic - by frequent relapses with mildly expressed symptoms. Often, in addition to pain, the inflammatory process is accompanied by an increase in body temperature to febrile values (38-39) in acute or subfebrile (37-37.5) with chronic.

[13], [14], [15], [16]

Abscess of bartholin gland cysts 

Acute bartholinitis is characterized by the presence of a true or false abscess of the Bartholin gland. A false abscess (canaliculitis) is caused by the fact that the excretory duct of the Bartholin gland is first inflamed and later clogged, which leads to accumulation of pus in the gland itself, redness and soreness of surrounding tissues and discomfort. Body temperature may increase slightly. Without consulting a doctor and prescribing adequate treatment, the disease can go on into a chronic form. The true abscess is characterized by the penetration of infection into the gland itself, which causes melting of the parenchyma, swelling of the labia (both large and small), an increase in inguinal lymph nodes, leukocytosis, an increase in ESR, a sharp pain even without movement. The body temperature rises sharply to 38-39C. With a true abscess should immediately seek medical attention, because even when the abscess is opened spontaneously, complete emptying of the cavity does not occur, which leads to a relapse of the disease and surgical intervention. Do not try to squeeze out an abscess, because infection can cause sepsis in the bloodstream.

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Diagnostics of the bartholin gland cysts

It is not difficult to diagnose the cyst of the bartholin gland. A gynecologist can diagnose the first admission. On examination, the doctor notes unilateral swelling of the labia, asymmetry of the genital gaps. Non-inflamed cystic formation is slightly painful in palpation, the formation under the skin is elastic. With abscess symptoms are much more pronounced, the area of inflammation is painful, leaky purulent contents can be detected. From laboratory studies, a smear from the vagina, bacterial culture, PCR diagnostics is used to detect sexually transmitted infections that have become the cause of inflammation in the presence of vaginal discharge.

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Treatment of the bartholin gland cysts

Treatment of the Bartholin gland cyst should be aimed at restoring the functions of the gland itself and depends on the accompanying symptoms. Cystic formations of small sizes, not delivering discomfort and not inflamed, do not require treatment. Treatment is indicated with frequent relapses or with inflammation or abscesses. With a bartholin gland cyst, there is no need to observe a special regimen or diet, except when there is a true abscess of the Bartholin gland, which shows bed rest.

Treatment with medicines may include taking the following drugs:

• Antibiotics for getting rid of a concomitant infection. So, if the cyst of the Bartholin gland is caused by gonorrhea or chlamydia, the group of penicillins or tetracyclines is given preference to antibiotics. Doxycycline may be prescribed. With gonorrhea or chlamydia infection, the drug is taken once in a dosage of 200 mg, followed by a dose of 100 or 200 mg per day. Dosage depends on the severity of the disease. The daily dose should be divided into 2 divided doses at an interval of 12 hours, the preparation should be taken with a sufficient amount of water in order to reduce the effect on the gastrointestinal tract. The course of treatment is 10-14 days.
• Sulfonamides. If antibiotics do not bring the expected result, or the patient is intolerant of this group of antibiotics, prescribe sulfonamides such as biseptol and others.
• Local treatment - apply ichthyol ointment or Vishnevsky ointment, but the local treatment does not in any way exclude antibiotic therapy, since only with full treatment can complete recovery.
• Immunostimulants or drugs to increase the body's resistance to infections.

Removal of the bartholin gland cyst

But most often the treatment of the bartholin gland cyst provides surgical treatment - removal of the gland itself or a number of other surgical procedures such as marsupialization, opening of the cyst, laser vaporization of the bartholin gland cyst.

The most radical method is removal of the bartholin gland or extirpation. But it should be resorted to in case of frequent relapses of the disease, inefficiency of other treatment methods, repeated relapses after marsupialization, because despite the simple operation, it is associated with risks, and, as is known, there are no "unnecessary" organs in the body.

The risks and disadvantages associated with the operation to remove the bartholin gland:

• under general anesthesia;
• several days of hospitalization;
• the possibility of bleeding (the gland is in close proximity to the venous junction);
• formation of postoperative hematomas and fistulas;
• overlapping internal and external seams;
• the cost of the operation (in private clinics it reaches 8000 UAH).

Extirpation is the only method that gives a 100% guarantee of no relapse, but the effects of removing the Bartholin gland cyst do not make it preferable. Since the main function of the gland is to develop a secret that maintains a constant moisture in the vagina, the main negative consequence is the dryness of the vagina, which can adversely affect the quality of sexual life. Another thing to add here is that the perineum is injured, and the seams can cause painful sensations even after a long time after the operation.

Marsupialization of the bartholin gland cyst

Marsupialization of the bartholin gland cyst or the creation of an artificial duct refers to outpatient procedures and is performed under local anesthesia. The procedure is relatively simple and lasts about 20-30 minutes. The doctor performs anesthesia at the site of the largest swelling of the cyst and cuts out an oval flap of the mucosa with an approximate size of 1.5 cm. The cyst is dissected in exactly the same cut, symmetrical to the first one. Its contents are removed, the cavity is washed and further the wall of cystic formation is hemmed to the edge of the mucous lip, thereby leaving an artificially formed duct. This manipulation preserves the gland and its functions. Sometimes after the procedure of marsupialization, relapses do occur, but their probability is about 10%, and the procedure itself can be rescheduled, because it is simple and less traumatic, which is incomparable with the removal of the gland completely.

Laser vaporization of the bartholin gland cyst

Laser vaporization of the bartholin gland cyst also refers to outpatient procedures. The cystic formation is affected by a laser beam, which "evaporates" pathological tissues. The procedure takes 10-30 minutes, its duration depends on the size of the cyst, is performed on an outpatient basis, does not require hospitalization and anesthesia, completely eliminates the altered tissues and only them, the laser power is strictly dosed, there is no chance of bleeding. Before laser vaporization requires a minimum of analysis and preparation, rehabilitation is quick and consists only in respecting the rules of personal hygiene and abstinence from sexual activity.

Also, some private clinics offer a procedure for installing a Word-catheter. This procedure is probably the most modern approach to the treatment of bastolin gland and bartholinitis cysts. Its essence lies in the fact that the cavity of cystic formation is opened, it is emptied and washed. Then put a small catheter, at the end of which the balloon is inflated, which prevents it from falling out. The catheter is left for about a month, during which the artificially formed new duct is completely epithelized, which prevents the adhesion of its walls in the future. The procedure takes 5-10 minutes, almost completely painless, the probability of relapse is less than 10% and only in case of repeated infection of the patient.

Treatment of bartholin gland cyst by alternative methods

Alternative and alternative medicine also offers several ways to treat bartholin gland cysts. Hirudotherapy or treatment with leech cyst Bartholin gland is one of them. Its benefits include the possibility of recovery without the use of drugs or surgery, as shown, for example, to nursing mothers. By the minus - a decrease in hemoglobin, small bleeding in places of bites, cost. The number of leeches and sessions is calculated for each patient individually, depending on the size of the cystic formation.

For treatment at home and to alleviate discomfort, the following recipes can be used:

• hypertonic salt solution. On a glass of hot water you need to take two teaspoons of a large salt, dilute them in water. A pad made of their soft cotton cloth, moistened in a solution and applied to a sore spot. It is recommended to change the gasket 2 times a day.
• leaves of aloe without spines (200 gr) to grind, add 400 grams of honey and natural red wine. The resulting mixture cook for about an hour on low heat in a water bath and then strain through gauze. Take 1 tablespoon three times a day for half an hour before meals.

Crumble the black bread, add to it one grated chive of garlic, mix everything with the liquid honey. Compress apply to the affected area. You can combine with the sedentary baths with chamomile and bark of oak.

Prevention

Prevention of the Bartholin gland cyst is as follows:

• compliance with personal hygiene;
• monogamous way of life, avoidance of casual sexual relations;
• timely treatment of urogenital infections;
• regular visit to a gynecologist;
• strengthening immunity, maintaining a healthy lifestyle.

[19], [20], [21], [22], [23]