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Bartholin Abscess: Causes, Diagnosis, and Treatments

The Bartholin glands are present on each side of the vaginal entrance. These glands produce a lubricating fluid that helps to keep the vaginal area lubricated. These glands’ openings can become clogged, allowing fluid to back up into the gland. A Bartholin’s cyst is the outcome of this generally painless enlargement. 

A patient may develop a collection of pus surrounded by inflammatory tissue if the fluid within the cyst becomes infected (abscess). Bartholin’s cyst or abscess is very common. The size of a Bartholin’s cyst, how painful it is, and whether it is infected all influence the treatment of the cyst. Sometimes a simple therapy at home is all that is required. In some cases, Bartholin’s cyst requires surgical drainage. An infected Bartholin’s cyst requires antibiotics to treat it.

What are the symptoms of Bartholin abscess?

The cyst usually occurs on only one side of the vaginal opening. Bartholin abscess may not be visible if the cyst is small. Once the cyst grows, a lump or mass appears in the opening of the vaginal. The cyst can get infected in a few days. A cyst infection shows the following symptoms:

  • Painful and tender lump near the vaginal opening 
  • Causes discomfort while walking and sitting 
  • Pain during intercourse 
  • Fever

What are the causes of Bartholin abscess?

There are about two types of Bartholin glands. The size of these glands is about the size of a pea. They aid in providing lubrication to the vaginal mucosa and are present on either side of the opening of the vagina. The infections that cause Bartholin abscess are bacteria like E. coli and sexually transmitted organisms like chlamydia. The presence of bacteria in the Bartholin gland can cause swelling, infection and eventually result in obstruction. 

When the gland fills with fluid, the pressure on the surrounding area rises. Although it may take years for enough fluid to accumulate to produce a cyst, an abscess can develop rapidly afterwards. If the infection and swelling progress, the gland may develop a spot, causing the skin to break open. The Bartholin abscess can be intensely painful. Generally, it only affects one side of the vaginal canal at a time.

How are they diagnosed?

A surgeon diagnoses a Bartholin abscess based on symptoms and a physical examination. They will do the following during the exam: 

  • Look for bumps in the vaginal area. 
  • Check the temperature to see whether the patient had a fever 
  • Test for sexually transmitted diseases (STIs) using a cervical swab 

Bartholin’s gland malignancies may rarely be mistaken for cysts. A biopsy should be performed to rule out cancer, especially in persons over the age of 40. A biopsy is a procedure that includes obtaining a small sample of tissue to examine under a microscope.

What are the treatment options for Bartholin abscess?

A Bartholin’s cyst usually does not require treatment, especially if it causes no indications or symptoms. The factors that lead to the treatment of the cyst are: 

  • The size of the cyst
  • Level of discomfort
  • The infection in the cyst

The doctor may suggest the following treatment options: 

  1. Surgical drainage – A cyst that is sick or particularly large may require surgery to drain. The removal of the cyst requires the patient to be under local anaesthetic or sedation. The doctor will create a small incision in the cyst, let it drain, and then insert a small rubber tube (catheter) into the incision. The catheter is left in place for up to six weeks to maintain the incision open and allow thorough drainage.
  2. Antibiotic – If the cyst is infected or the testing confirms that the patient has a sexually transmitted illness, the doctor may prescribe antibiotics.  If the abscess drains completely, antibiotics are not required.
  3. Marsupialization – A marsupialization operation may be helpful if cysts reoccur or disturb the patient. Stitches are placed on each side of a drainage incision to provide a permanent aperture of less than 1/4 inch long. An implanted catheter enhances the drainage and recurrence is avoided for a few days after the treatment. 

If the cysts are persistent and not treated on time with the help of the procedures mentioned above, the surgeon recommends surgery to remove the gland. 

Home remedies that help to cure Bartholin abscess are: 

  1. Sitz bath – A tiny, infected cyst can be ruptured and drained on its own by soaking in a tub filled with some warm water (sitz bath) several times a day for three or four days. 
  2. Topical treatments – Some natural topical treatments provide immediate relief from the abscess. Though there is no scientific evidence for the same, people trust the use of these remedies. The popular treatments are: 
  3. Tea tree oil – Since tea tree oil has natural antibacterial properties, a mixture of tea tree oil and castor oil makes the abscess drain. Gauze is used to apply the mixture in place. The top of the gauze has a hot compress that is held in place for at least 15 minutes.  
  4. Pain medications – Activities such as sitting and walking can be made easy with the help of some over-the-counter medications. 
  5. Treating fever – A Bartholin abscess is usually accompanied by fever. A mild fever requires the following treatment: 
  6. Drink plenty of fluids 
  7. A cold compress on the forehead 
  8. The room temperature should be at a comfortable level

When do we need to visit a doctor?

Patients experiencing Bartholin abscess should visit the doctor immediately for treatment. If Bartholin abscess is left untreated, the bacteria spread to other locations and causes infections. The fatal condition of the abscess leads to sepsis.  

Consult the doctor if the patient has any of the following 

  • High fever 
  • Ruptured abscesses 
  • Severe pain

How to prevent Bartholin Abscess?

It is not possible to treat Bartholin abscess completely. Safe sex, condom use, and proper hygiene, on the other hand, can help keep bacteria out of the area, which can help avoid infection. It’s also critical to determine whether the patient has an STD.

What can you expect during the recovery stage and the outcome of the procedure?

Consult the doctor if you suspect you have a Bartholin abscess. If you have a fever or if the pain affects everyday activities, you should seek medical attention right once. The recovery period is brief once the abscess drains. Thus, most women feel much better within 24 hours. 

If your abscess requires surgical removal, the length of your surgery will depend on the type of treatment. The patient should be in a reclined position for a few days post-surgery. Make sure you get enough rest and stick to your doctor’s advice. It’s critical to let any incisions heal fully and to take any antibiotics prescribed by your doctor. 

Apart from some skin scars from the treatment technique, there should be no long-term effects from the abscess once it is completely treated.

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