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Bartholinitis
Last reviewed: 04.07.2025
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Bartholinitis is an inflammation of the large vestibular glands located in the lower third of the labia majora. The inflammatory process and swelling of the main excretory duct of the gland (canaliculitis) prevent the outflow of gland secretion, which stagnates and becomes infected. This is an acute false abscess. A true abscess (phlegmon) occurs when pus accumulates in the gland, melts it, and the process spreads to surrounding tissues.
[ Causes bartholinitis
Bartholinitis is most often caused by non-spore-forming anaerobes, gonococcus or staphylococcus, less often by streptococcus, E. coli, trichomonas, and also by mixed infections.
Symptoms bartholinitis
Complaints of severe pain in the vulva area: the appearance of a tumor-like painful formation in the labia, up to the size of a chicken egg, which interferes with walking; fever; general malaise.
A true abscess gives a clinical picture of a serious illness (sharp pain, enlargement and soreness of the inguinal lymph nodes, an increase in body temperature to 39-40' C).
Where does it hurt?
Complications and consequences
False abscesses often open spontaneously with emptying of the abscess. When the acute process is stopped, incomplete emptying or insufficient outflow occurs, a Bartholin gland cyst (cystic formation) occurs without inflammatory signs. Bartholinitis tends to relapse.
What do need to examine?
What tests are needed?
Differential diagnosis
A Bartholin gland cyst without signs of inflammation should be differentiated from a Gartner duct cyst. The latter is located in the middle or upper third of the labia minora and is not accompanied by inflammation.
In the presence of an inflammatory reaction - with a furuncle of the labia majora (usually located more superficially and never as large as an abscess); a cyst of the longitudinal duct of the ovarian appendage (a cyst of the Gartner's duct is determined above the lower third of the labia majora, with it you can feel a cord going upward and inward, parallel to the wall of the vagina, there are no signs of inflammation of the tissues covering such a cyst); cancer of the Bartholin's gland (characterized by density, tuberculosis, painlessness, sometimes ulceration of the tumor).
Who to contact?
Treatment bartholinitis
In the initial stage of acute bartholinitis, conservative treatment is prescribed to stop the inflammatory process (bed rest; antibiotics or sulfonamides; ice pack; painkillers).
In case of suppuration and the appearance of fluctuation, it is recommended to open the abscess and insert a turunda with a hypertonic sodium chloride solution into the cavity of the emptied abscess.
It is preferable to open the abscess on the outer surface of the labia majora so as not to infect the vagina. A Bartholin's gland retention cyst is subject to surgical treatment (enucleation with complete removal of the capsule) in the so-called cold period. Marsupialization, the creation of a new external opening for the excretory duct, which consists of suturing the edges of the wall of the opened gland to the edges of the skin wound, is also a surgical treatment method.