Bartholinitis is a gynecological pathology that affects the vestibule of the vagina. Infectious causative agents of the disease are pathogenic microorganisms that cause an inflammatory process in the Bartholin gland, with septic damage to its tissues and excretory duct. If the doctor has diagnosed bartholinitis, treatment is carried out with the mandatory use of antibiotics and local procedures. In the advanced stage of the disease, the formed abscess contains pus, which requires urgent surgical intervention with washing the cavity of the affected gland.

Treatment of bartholinitis should begin as early as possible, immediately after the pathology has been diagnosed. To cope with the inflammatory process and prevent further spread of infection to nearby tissues and organs, a woman must follow all doctor’s orders. Bartholinitis has several stages of development, each of which has different characteristics, and therefore treatment will be prescribed to the patient on an individual basis.

Treatment of bartholinitis at the initial stage - the stage of canaliculitis - in most cases is carried out on an outpatient basis. The gynecologist prescribes medications to the patient and advises on all medical procedures that will have to be performed independently at home.

Treatment of the disease at the initial stage includes:

• compliance with bed rest;
• restriction of physical activity;
• applying cold compresses to the affected gland;
• anti-inflammatory treatment using baths with extracts of medicinal plants, salt and potassium permanganate;
• taking extended-spectrum antibiotics;
• vitamin therapy.

Treatment of bartholinitis at the second stage - the stage of false abscess - is also often practiced on an outpatient basis . Only in the case of a serious inflammatory process, complicated by severe intoxication, can the patient be sent to the hospital. An ambulance should be called if the body temperature during bartholinitis exceeds 38.5°C.

Treatment of the disease at the second stage consists of antibiotic therapy, local treatment with Levomekol and Vishnevsky ointment; if necessary, the affected gland is opened on an outpatient basis with the contents removed and the abscess cavity washed.

The third stage of bartholinitis - purulent cyst of the gland - requires treatment in a hospital . The formed purulent abscess is opened surgically. After treating the cavity, the doctor forms an excretory duct from the Bartholin gland, leaving a catheter or drainage tube in it to drain the secretions.

Also, treatment of the third stage of the disease includes mandatory antibiotic therapy and local treatment. In some cases, the Bartholin gland is removed completely if periodic relapses of the disease occur.

Treatment of acute bartholinitis

Treatment of the acute form of bartholinitis is mainly carried out in a hospital. Only the initial stage of the disease can be carried out under the supervision of a doctor on an outpatient basis. The condition for a speedy recovery is strict adherence to all the doctor’s prescriptions.

Treatment of symptoms of bartholinitis in women has the following goals:

• elimination of pain in the source of inflammation and intoxication of the body;
• prevention of the formation of a true abscess - the third stage of the disease;
• prevention of the formation of cystic complications of the Bartholin gland.

The course of treatment consists of antibacterial, anti-inflammatory and antipyretic drugs, and physiotherapy.

Local treatment

For bartholinitis, the following remedies may be effective:

1. Cold . Wrap an ice pack in clean gauze and apply it to the affected gland for about 30 minutes. After this, take a break for the same amount of time and reapply the bubble, filling it with a new portion of ice. The total duration of topical ice treatment is 2 hours daily.
2. Salt compresses . An 8-10% salt solution helps to resolve inflammation and draw out infectious contents from the wound cavity without destroying the tissue structure. A salt solution of the required concentration is prepared as follows: for 1 liter of water, take 3 tbsp. l. salt. The water should be warm so that the salt dissolves better. Moisten gauze, folded several times, in the resulting solution and place on the affected gland for 40 minutes. Perform the procedure at least 6 times a day.
3. Dressings with Vishnevsky ointment or Levomekol . Both of these drugs are used to treat bartholinitis at home. The drug is applied to a gauze swab, which should be secured at the site of inflammation of the gland with a bandage. In this case, dressings with drugs should be alternated, for example, during the day, treat bartholinitis with Vishnevsky ointment, and at night with Levomekol.
4. Antiseptic solutions . Treatment of bartonylitis should be carried out with solutions with a disinfecting effect that do not lead to locally irritating results and burns on the skin. For example, drugs and Chlorhexidine are used, which should be used to wash the inflammation and treat the wound.

Physiotherapeutic treatment

Physiotherapy treatment can be prescribed provided that local treatment has helped improve the woman’s condition. With adequate therapy, this occurs on the 4th day. Physiotherapeutic treatment includes magnetic therapy and UHF, phonophoresis.

Treatment with antibiotics

Treatment of bartholinitis with antibiotics is mandatory, since the pathology is caused by infectious agents. The course of antibiotic therapy is 7-10 days. To increase the effectiveness of treatment, it is important to identify the causative agent of the disease and its sensitivity to antibacterial agents.

But in practice, there is not enough time for this, since the disease develops rapidly, and antibiotic therapy, in most cases, must be started immediately. For this reason, bartholinitis is often treated with extended-spectrum antibiotics without additional research.

What antibiotics are used to treat bartholinitis? These drugs are Azithromycin, Cefazolin, Amoxiclav. Trichopolum and Tinidazole are prescribed less frequently. Along with antibiotic therapy, symptomatic treatment is prescribed, aimed at eliminating pain and relieving fever. It is carried out with non-steroidal anti-inflammatory drugs (Ibuprofen, Nurofen) and analgesics (Analgin, Baralgin).

Surgical treatment

Treatment of acute bartholinitis by surgery is carried out when a purulent abscess forms. During the operation, the doctor opens the inflammatory lesion and removes the pus present in it. Then the wound surface is treated with 3% hydrogen peroxide, and a drainage tube is inserted into the cavity of the gland; it is necessary to remove the remaining pus.

After a few days, if the recovery dynamics are positive, the tube is removed. To speed up the healing process, a course of antibiotics and local treatment is prescribed.

Treatment of chronic bartholinitis

Treatment of chronic bartholinitis requires an individual approach. The fact is that the formed dense capsule in the Bartholin gland can create a barrier to the penetration of medications. Treatment of the chronic form of the disease is carried out in two ways - medication and surgery.

Conservative treatment

The goal of drug therapy is to eliminate the clinical picture of the pathology and relieve the inflammatory process. Treatment in this case may be similar to the treatment of the acute phase of bartholinitis, that is, antibiotics, local and symptomatic therapy are used.

After the condition improves, physiotherapeutic methods are prescribed: UHF, infrared laser, magnetic therapy and ozokerite. Vitamin therapy is used to strengthen immune defense. Anti-inflammatory sitz baths can be prescribed locally using antiseptic solutions of chamomile, oak bark, and potassium permanganate.

Surgical treatment

Surgery for chronic bartholinitis is carried out in two ways:

• marsupialization - the formation of an artificial duct of the Bartholin gland;
• extirpation - complete resection of the gland.

Marsupialization is the preferred surgical treatment option for bartholinitis in gynecology. Indications for its implementation are frequent relapses of the disease, the formation of a large-diameter cystic formation, and inconveniences that arise during sexual intercourse and in everyday life.

The purpose of marsupialization is the formation of an artificial channel, thanks to which the accumulated secretion in the gland can be freely removed to the outside.

How is the operation performed?:

1. The patient is given anesthesia.
2. In the abscess or cyst of the Bartholin gland, the doctor makes an incision no more than 0.5 cm long.
3. The opened cavity is thoroughly cleaned of contents and washed with 3% hydrogen peroxide or other antiseptic solution.
4. A catheter is inserted into the organ cavity and secured with a special ball.
5. After a few weeks, the catheter is removed, and in its place an artificially created duct of the Bartholin gland should be formed, ready to function in the desired direction.

Rehabilitation after marsupialization is easy and quick, complications are rare. Relapses of bartholinitis occur in 2-10% of all patients who have undergone this surgery.

Estirpation is performed less frequently, since this operation is often accompanied by serious blood loss. This is due to the fact that the Bartholin gland has a connection with a large vein. Also, a serious disadvantage of the operation is the disruption of the subsequent natural process of moisturizing the vaginal walls.

But sometimes extirpation is a real salvation for a woman if she has constant relapses of the pathology or has had unsuccessful marsupialization in the past.

How the operation is performed:

1. The patient receives anesthesia.
2. The doctor makes an incision on the inner surface of the labia minora.
3. Through the resulting hole, the iron is completely removed to the surface.
4. Catgut suture material is applied to the incision site.

Rehabilitation after extirpation lasts at least 10 days. At this time, the woman is prescribed physiotherapeutic procedures - UHF, magnetic therapy, phonophoresis and applications using anti-inflammatory drugs.

Treatment with traditional methods

Treatment of bartholinitis with folk remedies is justified if the woman does not self-medicate. If you suspect the development of inflammation of the Bartholin gland, then first of all you need to seek help from a gynecologist, who, in addition to the main treatment, can prescribe herbal medicine methods. It is important to remember that treatment with herbal remedies should be long-term and regular; resorting to it from time to time is pointless.

Let's look at folk recipes that successfully treat bartholinitis.

Sitz baths with herbal extracts:

1. Chamomile based. 2 tbsp. l. pour 2 cups of boiling water over the herbs and leave for about an hour. Add the finished broth to a bowl of boiled water and take a bath for at least 15 minutes.
2. Based on eucalyptus. 2 tbsp. l. Pour 2 cups of boiling water over the plants and leave for 30 minutes. Then pour the eucalyptus decoction into a bowl of water and take a bath as in the previous case.
3. Based on calendula. 2 tbsp. l. plants, brew 0.5 liters of water in an enamel bowl, place it in a water bath for 15 minutes. Cool the finished broth, strain and add to the water for a sitz bath.

Medicinal decoctions for internal use:

1. In a blender, grind 200 grams of freshly picked aloe leaves into a pulp (the plant must be at least 5 years old), add 0.5 liters of honey and 2 tbsp. l. red wine. Stir the mixture, bring to a boil, reduce heat and simmer for at least an hour. After this, the drug must be cooled and taken 1 tbsp. l. 30 minutes before meals.
2. Mix 50 grams of boiled garlic cloves, 25 grams of dill seeds, 200 grams of chopped walnuts and 0.5 liters of honey into a homogeneous mass. Take 2 tbsp. l. 3 times a day, an hour after meals.
3. In equal proportions, take walnut leaves, smoke herb, pine tops, medicinal agrimony and immortelle, combine 2 tbsp. l. the resulting mixture with 1 tsp. crushed valerian. Pour the mixture into 0.5 liters of boiling water and simmer over low heat for a quarter of an hour. Take the cooled broth one third of a glass after meals.

Bartholinitis does not tolerate self-medication. Before turning to traditional recipes, it is important to visit a doctor and choose the appropriate course of treatment depending on how the disease progresses. The combination of adequate diagnosis, identification of the causative agent of the disease, prescription of drug therapy, coupled with traditional medicine methods, guarantees a speedy recovery and relief from such a delicate problem of the female genital area as bartholinitis.

Useful video about bartholinitis

Bartholin's gland is located in the labia majora.

This organ produces a clear lubricant that ensures comfortable sexual intercourse and hydration of the vaginal mucous membranes.

Bartholinitis is an inflammation of the Bartholin gland caused by various negative factors. At an early age, this disease does not manifest itself. Women after puberty are at risk.

Causes

The main causative agent of bartholinitis is considered to be infections. Microbes can enter the body in any way. If there are scratches on the genitals, then improper hygiene leads to the growth of bacteria.

When sharing common facilities with an infected person, the risk of disease increases (towels, shaving accessories, soap, etc.).

In some cases, the infection can be caused by improper sanitary treatment during operations (abortion, surgery in the genitourinary system).

Common causes of bartholinitis:

• sexually transmitted diseases (chlamydia, gonorrhea, trichomoniasis, etc.);
• infection of the body with pathogenic bacteria (streptococcus, E. coli, staphylococcus, etc.);
• chronic inflammatory processes in the body (bartholinitis can even be caused by caries, microbes spread throughout the body through the blood);
• weak immunity (including lack of vitamins in the body). Find out articles on how to strengthen the immune system with folk remedies;
• constant hypothermia of the genitals;
• wearing tight underwear;
• violation of personal hygiene rules;
• consequences of surgical interventions;
• microtraumas.

Characteristic symptoms

Bartholinitis can be chronic, acute, subacute, recurrent. There are several forms of the disease depending on the location of the lesion. If the infection gets into the excretory duct, canaliculitis develops.

Ulcers (abscesses) or blisters with fluid inside (cysts) may form on the Bartholin gland. Each form of the disease is accompanied by a group of general and individual symptoms. Only a doctor can identify a specific disease and stage of bartholinitis based on the results of tests and examinations.

Common symptoms of bartholinitis:

• increased body temperature (up to 38 degrees, may be accompanied by chills);
• discomfort in the labia area while sitting, moving or during sexual intercourse;
• asymmetry of the external genitalia;
• swelling of the upper labia (swelling may cover the vagina);
• pain in the labia area (pain intensifies when palpated);
• redness appears on the excretory duct of the gland;
• when pressing on the excretory duct of the gland, pus is released.

Purulent discharge and an abscess are not mandatory symptoms of bartholinitis. In some cases, the disease is accompanied by the formation of a seal on the mucous membrane of the labia. At the same time, the gland increases in size. Discomfort manifests itself in the form of burning, tingling or itching.

Pain sensations decrease when the abscess is opened. This process can occur spontaneously. You should contact a gynecologist at the slightest suspicion of bartholinitis.

The sooner the disease is detected, the faster treatment will occur. If the patient does not act correctly, the disease can recur in the form of a relapse.

Treatment of bartholinitis should be carried out comprehensively. Taking antibiotics, painkillers and antipyretics is combined with the use of traditional medicine.

The methods complement each other, but cannot be interchangeable. During exacerbations, doctors prescribe physical therapy. Surgery is performed only if an abscess or complications are detected.

How to treat with folk remedies?

When choosing recipes for treating bartholinitis with folk remedies, it is recommended to pay special attention to the ingredients. If the fact of individual intolerance to any component is revealed, then a replacement should be selected from the chosen method.

Recipes based on wine or other alcoholic beverages should be used with caution. Abuse of such drugs can be harmful to health.

Examples of traditional medicine recipes against bartholinitis:

• herbal baths(oak bark, eucalyptus and are mixed in equal quantities, one tablespoon of the herbal mixture is poured with boiling water and infused for at least 30 minutes, the decoction is mixed with water for taking baths, repeat the procedure daily for 20 minutes);
• decoction of aloe and honey in wine(Crush 100 g of aloe leaves, add 400 g of honey, red wine, place the mixture in a water bath, heat for at least an hour, after the specified time, squeeze the mixture through cheesecloth, take a tablespoon 20-30 minutes before meals three times per day);
• herbal mixture(mix 50 g of dill seeds, 100 g of boiled garlic, 300 g of walnuts, 400 g of honey, grind the solid ingredients in a blender, take the mixture one tablespoon two hours after meals);
• baked onions for dressing(the onion head should be baked, cooled, mashed with a fork and wrapped in gauze, the lotion should be used at least twice a day, the onion should not be hot - this is an important nuance that should be remembered);
• herbal lotions(mix blackberry and nettle leaves, yarrow flowers in equal proportions, pour 200 g of boiling water, leave for 20 minutes, cool, use for lotions at least twice a day);
• herbal decoction(mix young pine shoots, valerian roots, immortelle, Icelandic moss and walnut leaves (one tablespoon of each ingredient), pour a liter of boiling water, put in a water bath, the heat treatment process should last at least 25 minutes, squeeze out the broth using gauze and consume three times a day);
• herbal decoction(mix knotweed, nettle, pakulnik, horsetail and Icelandic moss in equal quantities, add a liter of water and cook over low heat for 10 minutes, cool the broth and take half a glass three times a day).

If you do not see a doctor and the abscess breaks out spontaneously, then you should not postpone a visit to a specialist. Pus can remain in the tissues and cause re-inflammation, blood contamination with bacteria and other negative consequences. Under no circumstances should you open an abscess yourself.

• independently choose treatment methods or ignore the symptoms of the disease;
• it is impossible to warm up the abscess (the pus will increase under the influence of heat);
• use dubious recipes of traditional medicine (for example, cold compresses can harm your health and not get rid of bartholenitis);
• take hot baths (as well as visit baths and saunas);
• replace drug treatment with alternative medicine methods.

Prevention measures

The main measure to prevent bartholinitis is a correct lifestyle. Sexual intercourse must be protected, and frequent changes of partners often cause inflammation. Abortion has many negative consequences.

The development of bartholinitis can be facilitated not only by violation of the rules for sanitizing medical instruments, but also by the reaction of the female body to the procedure.

Weakening of the immune system, malfunction of internal systems - these and other factors become the reason for a woman’s tendency to contract infections.

Rules for the prevention of bartholinitis:

• regular visits to the gynecologist (at least twice a year);
• improper or prematurely stopped treatment of bartholinitis becomes the cause of its chronic form;
• taking vitamins and monitoring nutrition;
• timely treatment of any inflammatory processes in the body;
• wearing high-quality underwear (it is better to exclude synthetic fabrics);
• underwear should be changed at least twice a day;
• Washing should be done at least twice a day (after waking up and before going to bed).

Women who are attentive to their own hygiene and control their sex life do not experience bartholinitis. If there is a burning sensation in the labia area, excessive dryness of the mucous membranes or pain during sexual intercourse, you should definitely undergo an examination by a gynecologist. Any discomfort in this case is considered a deviation and should not be ignored.

Bartholinitis is a disease characterized by the development of an inflammatory process in the Bartholin gland. Most often, the pathology is unilateral - that is, only one of the paired glands suffers. If the doctor has diagnosed bartholinitis, treatment is carried out with the mandatory use of antibiotics and local procedures. In the advanced stage of the disease, the formed abscess contains pus, which requires urgent surgical intervention with washing the cavity of the affected gland.

What kind of disease is this, what symptoms a woman should pay attention to, as well as treatment methods - we will look in more detail in this article.

What is bartholinitis?

Bartholinitis is an infectious inflammation of the large (Bartholin's) glands located in the vestibule of the vagina, often unilateral (see photo below). The disease can occur in women of any age, but it most often occurs between the ages of 20 and 35 years. Its prevalence is quite high: 1 case in 50 women.

Bartholin's gland is a paired organ and is located deep in the subcutaneous fat at the base of the labia majora. The main function of the Bartholin glands is the production of a viscous secretion, which is secreted during sexual intercourse through the excretory ducts of the glands and lubricates the entrance to the vagina.

Penetration of a viral infection into the excretory duct of the gland leads to blockage of its lumen. The secretion produced by the gland accumulates and a Bartholin gland cyst is formed. In this case, the pathogen that provoked the inflammation actively develops in the gland duct, thereby causing an abscess.

• The ICD-10 code for bartholinitis is N75.

Reasons

Inflammation of the large gland of the vaginal vestibule develops after the penetration of representatives of opportunistic microbial microflora (streptococcus, and others) or pathogens of specific sexually transmitted infections (gonococcus and trichomonas) into it.

But when diagnosing a disease, not one, but several infectious agents are often isolated, that is, bartholinitis arose as a result of an attack by an association of microorganisms. However, not all women suffering from gonorrhea, or, for example, trichomoniasis, develop bartholinitis.

As a rule, pathogens enter the Bartholin gland duct from the urethra or vagina during urethritis and/or. However, sometimes it is possible for infection to enter directly into the gland itself through the flow of blood or lymph.

There are other risk factors for developing bartholinitis:

• hypothermia of the body;
• sexually transmitted diseases;
• avitaminosis;
• sexual intercourse during menstrual bleeding;
• promiscuous sexual intercourse;
• stress;
• neglect of personal hygiene rules;
• weakened immune system;
• complications after abortion and other uterine surgical interventions.

The likelihood of developing the disease increases many times under the following circumstances:

• the presence of microtraumas that serve as entry gates for microbes;
• the habit of wearing tight underwear, which disrupts the outflow of secretions, resulting in stagnation and the creation of favorable conditions for the penetration of pathogenic microorganisms into the ducts.

Classification of the disease

Bartholinitis, depending on the nature of the course, manifests itself in the following forms:

• acute bartholinitis;
• chronic bartholinitis;
• false abscess (primary or secondary - when a previously formed cyst suppurates);
• true abscess.

Based on the location of the lesion, there are:

• Canaliculitis, in which the excretory duct of the gland becomes inflamed.
• Abscess, or abscess.
• Cyst (formation of a fluid-filled cavity).

Acute bartholinitis

Acute bartholinitis in most cases develops on one side. The labia majora at the site of the gland swells, increases in size, and its skin turns red. In the thickness of the lip, a painful lump ranging in size from one to several centimeters is felt - the gland itself.

In the acute stage of the disease, intimate contacts are very difficult or completely impossible, since any touch to the affected labia causes excruciating pain.

Initial stage (canaliculitis)

Canaliculitis is a unilateral (with gonorrhea often bilateral) inflammation of the excretory duct of the Bartholin gland. Initial symptoms of bartholinitis: redness limited to the area where the duct exits on the inner surface of the labia majora; soreness; upon palpation, the excretory duct can be clearly felt; When pressed, a certain amount of pus appears.

Chronic form of bartholinitis

The disease proceeds for a long time with periods of subsidence and exacerbation (relapses) of the symptoms of the disease, which can be triggered by various reasons: hypothermia, menstruation and others. Outside of an exacerbation, the woman feels well, but may complain of slight pain on the affected side and pain during sexual intercourse.

True abscess

When pathogenic microorganisms invade the gland tissue, as well as the tissue that surrounds it, pyogenic (purulent) melting of the gland parenchyma occurs with the formation of a capsule in which pus is localized. Both the labia minora and the labia swell, and on the unaffected side too, they turn red and become sharply painful when walking, at rest, and when touched.

General symptoms:

• The woman’s condition worsens: body temperature rises to 40°C, intoxication symptoms increase (weakness, chills, headache).
• The pain in the area of ​​the labia majora, in which the cyst has formed, intensifies, becoming constant pulsating.
• White blood cells and ESR (erythrocyte sedimentation rate) increase in the blood.

The main principles of treatment for bartholinitis are antibacterial therapy and pain relief. If a Bartholin gland cyst or abscess develops, surgical treatment is often necessary. During the entire treatment period, the woman is advised to abstain from sexual activity.

Symptoms of bartholinitis in a woman

The disease begins with infiltration of the excretory duct of the Bartholin gland. Its lumen sharply narrows (and then disappears completely), the outflow of the contents of the gland is disrupted, and it accumulates in the gland. In response to these changes, the size of the gland begins to gradually increase; a rounded protrusion appears on the surface of the affected labia majora, surrounded by a zone of hyperemia and edema.

Bartholinitis is manifested by the following symptoms:

• pain in the external genitalia;
• increased temperature (sometimes up to 40C);
• weakness and malaise;
• decreased performance.

During sexual intercourse, itching and burning may be felt at the entrance to the vagina. When pressure is applied to the gland, purulent discharge appears. In subsequent stages of bartholinitis, the inflammatory process spreads deep into the organ with the formation of an abscess or cyst.

This is what bartholinitis in women looks like in the photo

In the later stages, when the abscess has already formed, the woman will feel quite strong, throbbing pain in the area of ​​the vaginal opening, her health will worsen, she may experience chills, an increase in body temperature to 39 degrees or more, general weakness and malaise, and headache. Movement will be accompanied by discomfort or even pain in the perineum, a burning sensation.

Symptoms of acute bartholinitis:

• Redness around the exit site of the excretory duct of the gland - while the patient’s well-being does not change.
• Palpation of the enlarged excretory duct of the gland - when pressed, a small amount of pus is released from it.

Signs of chronic bartholinitis:

• slight pain;
• feeling of discomfort when moving;
• formation of a compaction in the affected gland;
• low-grade or normal temperature.

The rest of the time, the chronic form may not show any special symptoms. Sometimes there may only be slight pain during movement and sexual intercourse. Also, chronic bartholinitis can provoke the appearance of a large gland cyst at the entrance to the vagina.

Bartholinitis during pregnancy

If there is any hint of inflammatory processes in the Bartholin gland, women carrying a child should consult a doctor as soon as possible. A disease such as bartholinitis has the same symptoms during pregnancy as in the normal state, so it will not be difficult to recognize the disease.

It is very important to do this, since this disease, which developed between the fifth day from the moment of conception and the thirteenth week, can lead to fetal death.

When planning a pregnancy, you should definitely completely cure bartholinitis before it occurs. If the disease first arose during the period of bearing a child, you need to approach minimizing harm to the fetus and mother with full responsibility and mandatory medical assistance.

Complications

Without timely treatment, suppuration in the vestibule of the vagina can lead to the spread of infection to other organs of the reproductive system.

There is a risk of spontaneous opening of the abscess inside with the subsequent spread of purulent inflammation to other tissues and organs, up to.

When the abscess is opened, relief comes out, but the disease without appropriate treatment becomes chronic; in some cases, a fistula forms at the site of the abscess breakthrough.

The following complications are possible with bartholinitis:

• Formation of a true abscess from a false abscess, in which the infection spreads to the external genital organs and vaginal mucosa, that is, vulvovaginitis develops;
• The appearance of a cyst, after which inflammation becomes a sluggish process;
• Transfer of infection to neighboring organs (urethritis, colpitis);
• Constant relapses;
• The large size of the formation can cause awkwardness when walking and discomfort during sexual intercourse;

Diagnostics

Bartholinitis - which doctor will help? If you have or suspect the development of bartholinitis, you should immediately consult a doctor such as a gynecologist! Laboratory diagnostics are needed, but its task is to clarify the pathogen after opening the abscess and to exclude sexually transmitted infections. After all, if the problem was initially caused by gonococci or chlamydia that got into the gland, then these infections need to be treated independently and first of all.

To confirm the diagnosis, laboratory tests are performed, which include:

• microflora smear;
• bacterial culture to determine the sensitivity of the pathogen to antibiotics;
• bacteriological examination of pus discharged from the affected gland;
• PCR to determine the nature of the pathogen.

Treatment of bartholinitis

If bartholinitis is detected, treatment must begin immediately. The earlier treatment is started, the better the prognosis of the disease. The easiest way to treat bartholinitis is in the canaliculitis stage, the therapy of which can be carried out at home.

Before prescribing a drug, material is necessarily taken for laboratory tests to determine the type of pathogen and clarify its sensitivity to antibiotics. This method significantly increases the effectiveness of subsequent therapy.

Treatment of symptoms of bartholinitis in women has the following goals:

1. elimination of pain in the source of inflammation and intoxication of the body;
2. prevention of the formation of a true abscess - the third stage of the disease;
3. prevention of the formation of cystic complications of the Bartholin gland.

The course of treatment consists of antibacterial, anti-inflammatory and antipyretic drugs, and physiotherapy.

Additionally, to alleviate the condition, symptomatic treatment is prescribed:

• spraying the affected areas with antiseptics - miramistin or chlorhexidine,
• drugs that relieve inflammation (baralgin, ibuprofen),
• painkillers (nurofen, analgin),
• ointments that improve blood microcirculation and thereby accelerate the resorption of pus (Vishnevsky, Levomekol, Ichthyol).

After discharge from the hospital, to prevent and prevent the onset of symptoms of bartholinitis, on the other hand, a woman must strictly observe the rules of personal hygiene. As an independent measure, we can advise periodically taking sitz baths with a diluted (weak pink) solution of potassium permanganate or chamomile decoction. The time for taking such a bath is about twenty minutes.

The main goal of treatment during the acute stage is to prevent the formation of an abscess, cyst and chronic recurrent form of bartholinitis. It is important to strictly adhere to the regimen and duration of taking medications, since there is a high probability of resistance developing in the microflora.

Antibiotics for bartholinitis

Treatment of bartholinitis with antibiotics is mandatory, since the pathology is caused by infectious agents. The course of antibiotic therapy is 7-10 days. To increase the effectiveness of treatment, it is important to identify the causative agent of the disease and its sensitivity to antibacterial agents.

To combat pathogenic microorganisms, antibiotic therapy is prescribed. Such drugs include:

• Azithromycin;
• Amoxiclav;
• Ofloxacin.

In the case of an STD, both partners must be treated with antibiotics to prevent recurrence of the disease.

To restore the beneficial microflora of the vagina and relieve inflammation, it is necessary to consume a large amount of fermented milk products (kefir, fermented baked milk, whey, sour cream), which are rich in live lacto- and bifidobacteria. These products promote the growth of beneficial microflora in the vagina, promote the synthesis and absorption of vitamins A and E, reduce inflammation and improve immunity.

How to treat the chronic form of bartholinitis?

Since chronic bartholinitis occurs with alternating periods of exacerbation and subsidence of symptoms, treatment of the pathology will be associated with the elimination of clinical symptoms and the removal of inflammatory processes.

Between periods of exacerbation in the chronic form, the following procedures are prescribed:

• sitz baths with decoctions of medicinal herbs such as calendula, chamomile, sage;
• physiotherapeutic procedures - magnetic therapy, ozokerite, UHF therapy, infrared laser;
• the use of vitamin complexes to increase the body's resistance to infection;

Timely contact with a specialist will prevent the development of chronic bartholinitis and significantly reduce the time of therapy and the degree of radicality of treatment. In a chronic process, immunostimulation and rehabilitation of chronic lesions play an important role.

Operation

If conservative treatment of bartholinitis does not bring the expected effect, surgery is indicated to open a purulent abscess or cyst.

Surgically treated:

• acute purulent or recurrent abscess,
• non-healing fistula after opening a false abscess of the Bartholin gland;
• suppurating cysts and ducts of the Bartholin glands.

For the operation, the patient must be in the hospital. The procedure is performed under intravenous anesthesia, because local anesthetic administration is difficult and painful.

Surgery for bartholinitis allows you to solve the problem in 2 ways:

• Marsupialization involves the creation of an artificial duct of the glands to form a channel that does not stick together. Thanks to it, the mucus produced by the gland enters directly into the vestibule of the vagina.
• Extirpation is performed in cases of frequent relapses and unsuccessful attempts to create an artificial duct.

The prognosis for bartholinitis is generally favorable if you seek medical help in a timely manner and follow all the recommendations of a specialist.

How to treat bartholinitis with folk remedies?

Folk remedies for treating bartholinitis at home should be agreed with your doctor.

1. Baths with a slightly pink solution of potassium permanganate or infusion of chamomile, calendula.
2. You will need: chamomile, oak bark or eucalyptus (can be brewed separately, or you can mix all the herbs). Pour a tablespoon of herbs and a glass of boiling water and leave for 30 minutes. Afterwards, pour it into a bath and take it for no more than 20 minutes.
3. 50 g boiled garlic cloves, mix 25 grams of dill seeds, 200 grams of chopped walnuts and 0.5 liters of honey into a homogeneous mass. Take 2 tbsp. l. 3 times a day, an hour after meals.
4. To increase immunity and activate the body’s ability to fight bartholinitis, it is recommended to eat beekeeping products, garlic, aloe, walnuts and pine nuts. Instead of tea, use decoctions of dill, echinacea, ginseng, and rosehip seeds.

Before turning to traditional recipes, it is important to visit a doctor and choose the appropriate course of treatment depending on how the disease progresses.

Prevention

Naturally, like any disease, bartholinitis is easier to prevent than to treat for a long time. And simple preventive measures become most important when a woman is pregnant.

• prevent infection from entering the body in general and the genital tract in particular.
• Treat infectious diseases promptly and fully, maintain sexual culture and monitor its safety and hygiene.

Bartholinitis is a potentially dangerous but treatable disease. The main thing is to be responsible and attentive to your health.

Bartholinitis. Treatment at home

WHAT IS BARTHOLINITIS (PHOTO)

Bartholinitis- this is a gynecological disease vaginal vestibule. The causative agents of bartholinitis are pathogenic microorganisms (Trichomonas, staphylococcus, gonococcus, Escherichia coli ), causing purulent inflammation of the Bartholin gland (see photo below), affecting gland tissue and output stream.

The infection usually spreads through vaginal discharge or urethra along the excretory duct of Bartholin's gland and enters the gland. It is possible to treat bartholinitis at home only with initial stage of the disease , observing all the doctor’s instructions and adhering to the prescribed course of treatment. This article describes symptoms of the disease , the reasons for the development of bartholinitis are named and treatment methods are listed (folk remedies, broad spectrum antibiotics , medicinal ointments, surgery to open a cyst or abscess with pus).

BARTHOLINITIS IN WOMEN. REASONS FOR THE DISEASE DEVELOPMENT

- often the infection penetrates the gland through local microtraumas, which can appear during intimate contact without proper hydration or when scratching itchy area with infection .

Sometimes the infection enters the Bartholin gland from secretions accumulated in the duct (where microbes multiply). The reason for disruption of the normal outflow of gland secretions may be frequent wearing of too tight underwear .

Microorganisms can easily enter the gland duct through the lymph or bloodstream . The risk of infection is posed by chronic diseases such as pyelonephritis and even How to treat deep dental caries in a child caries.

The reason for the development of bartholinitis in women may be a decrease in protective functions in the body with a weakened immune system. Hypothermia of the intimate area also provokes infection into the gland.

Bartholinitis can provoke non-compliance with the requirements of the attending physician during the rehabilitation period after surgery in the genitourinary area .

An infection can penetrate the Bartholin gland due to insufficient hygiene during menstruation.

Women who have promiscuous intimate relationships and expose themselves to the risk of contracting infectious diseases are especially at risk of contracting bartholinitis. .

BARTHOLINITIS. SYMPTOMS OF THE DISEASE

Signs of bartholinitis depend on the location of local inflammation and the course of the disease.

According to the location of the lesion, they distinguish :

Purulent inflammation of the excretory duct of the gland - canaliculitis;

Bartholin gland cyst with fluid;

Abscess.

And according to the course of the disease:

Acute bartholinitis;

Chronic bartholinitis;

Subacute bartholinitis;

Recurrent bartholinitis.


Symptoms of acute bartholinitis:

- with canaliculitis, a woman’s well-being may not change. But the following symptoms appear: when pressure is applied to the excretory duct of the gland, pus is released. The skin around the gland's outlet area turns red (see photo).

- the inflammatory process spreads further , the swelling closes the Bartholin gland and the secretion is not removed from the duct. Bartholinitis develops.

False abscess of the Bartholin gland usually begins acutely due to an abscess in the labia majora. The temperature rises to 38-39°C. The pain intensifies with defecation, with active movement, in a sitting position, and especially with intimate contact. Chills and weakness appear.

Typical symptom in acute form of the disease - the area of ​​the labia majora is noticeably swollen and painful when palpated. When the swelling softens (fluctuation), a true abscess of the Bartholin gland begins.

A true abscess of the Bartholin gland is manifested by chills, weakness and headache, and the temperature rises to 40°C.

* There is pain in the formed cyst noticeably intensifies and becomes pulsating;

* Inguinal lymph nodes enlarge;

* Sometimes the abscess opens on its own. In this case, the temperature may decrease and the pain will not be as severe;

* If acute bartholinitis is not treated, then the disease becomes chronic.

Symptoms of chronic bartholinitis:

- feeling normal between periods of exacerbation. Only unpleasant sensations persist during intimate relationships.

Often with chronic bartholinitis, a cyst of the large gland of the vestibule develops. If it is small, then it practically does not cause discomfort and the woman does not experience any unpleasant sensations.

If the cyst is large (pictured), then when walking and sitting, the pain in the lower abdomen intensifies. The temperature increases to 38°C. Common ones appear
signs of intoxication of the body. During the period of exacerbation of bartholinitis, the cyst may open.

TREATMENT OF ACUTE BARTHOLINITIS

Treatment of acute bartholinitis at the initial stage at home

- With a mild course of bartholinitis at the initial stage, it is possible treatment at home, if you strictly follow all the instructions of your doctor. It is important to prevent the formation of an abscess and the development of a large gland cyst in the vaginal vestibule. Also during home treatment it is necessary relieve all symptoms of intoxication (pain, itching, general weakness). Along with proven folk remedies, it is necessary to take antipyretic and painkillers, as well as antibiotics.

To treat bartholinitis at the initial stage, you can use a saline solution (8-10%).
How to Prepare Hypertonic Saline Solution: for 1 liter of clean warm water - 3 tbsp. spoons of salt. Stir thoroughly.

How to use hypertonic saline solution: Apply a gauze swab soaked in the prepared solution to the inflamed area for half an hour. This procedure can be applied up to 6 times daily. This method is good because the salt solution does not destroy white blood cells and red blood cells. inflamed tissue.

Treatment of bartholinitis with Levomekol (or Vishnevsky) ointment is very effective.
Before going to bed, apply a gauze swab with levomekol ointment to the sore spot and fix it. The next day you can perform the same procedure, but with Vishnevsky ointment.

If the inflamed area with bartholinitis is very bothersome (severe itching, aching pain), then apply a bubble with ice cubes to the sore spot for 30 minutes. After 20 minutes, repeat the procedure (we perform the procedures for several hours).

If the condition of a woman with an acute form of bartholinitis begins to improve, then physiotherapeutic procedures are indicated (magnetic therapy, ozokerite, UHF). Reviews from many women about physiotherapeutic treatment of bartholinitis are very positive, as pain in the lower abdomen is significantly reduced.

Treatment of acute bartholinitis with antibiotics

As a rule, the course of treatment of bartholinitis with broad-spectrum antibiotics is designed for a week or several weeks. Anti-inflammatory drugs should be used at the same time (such as ibuprofen) and pain relievers ( analgin ,For example).
What antibiotics are used in the treatment of bartholinitis: Trichopolum and Tinidazole (drugs of the imidazoles group), Amoxiclav, Azithromycin, fluoroquinolones (Ofloxacin, Ciprofloxacin), macrolides (Clarithromycin, Ermitromycin), cephalosporins (Ceftriaxone, Cefazolin) and others.

Surgery (if there is a strong abscess of the Bartholin gland) for acute bartholinitis

First, applications with antibacterial ointments and broad-spectrum antibiotics are prescribed. During surgery on the Bartholin gland, a lesion with pus is opened, the cavity of the gland is cleaned and then treated with 3% hydrogen peroxide. Since the infection is not completely destroyed by antibiotics For a week, a special drainage tube is installed in the operated gland to drain pus. It is advisable to remain in bed during this time and not become overcooled.

TREATMENT OF CHRONIC BARTHOLINITIS (WITH OR WITHOUT CYST)

- conservative treatment of chronic bartholinitis during the period of exacerbation is approximately the same as the course of treatment of the acute form of the disease.

Between periods of exacerbation in the chronic form, the following procedures are prescribed:

* sitz baths with decoctions of medicinal herbs such as calendula, chamomile, sage;

* physiotherapeutic procedures - magnetic therapy, ozokerite, UHF therapy, infrared laser;

* consumption of vitamin complexes to increase the body's resistance to infection;

- marsupialization (surgery in a cyst or abscess under anesthesia);
, which increases the likelihood of damage to the baby’s umbilical ring, lungs and eyes.

TREATMENT OF CHRONIC AND ACUTE BARTHOLINITIS WITH FOLK REMEDIES

Do not self-medicate under any circumstances and be sure to consult your doctor to choose the best one. course of treatment for bartholinitis at home !
Application combination modern medicines with effective traditional methods of treatment can lead to a speedy recovery. But first you need to pass all the necessary tests and identify the source of the disease in order treat the disease correctly and prevent complications and relapses of the disease.

Bartholinitis- inflammation of the large (Bartholin) gland of the vestibule of the vagina.

The disease can occur in women of any age, but it is most common in women between 20 and 35 years of age. Its prevalence is quite high: 1 case in 50 women.

Anatomy of the female external genitalia

A woman's external genitalia include the pubis, labia majora and minora, clitoris, vestibule and hymen.

• Pubis or "Venus' tubercle"
  This is the lower section of the anterior abdominal wall, which, due to the well-developed subcutaneous fatty tissue, is slightly elevated. At puberty, the pubis is covered with hair, the appearance of which resembles a triangle with the base facing upward. The color of the pubic hair is slightly darker than the color of the hair on the head.

• Labia minora
  They are two longitudinal delicate folds of skin resembling a mucous membrane. They are located between the labia majora and are usually completely hidden.

  The labia minora lack hair and fatty tissue, and their bases are separated from the labia majora by a groove.

  Each fold of the labia minora is divided in front into two legs: outer and inner. Which are connected to each other, forming the frenulum (inner legs) and the foreskin (outer legs) of the clitoris. At the back, the labia minora are connected by a small transverse fold.

  Function of the labia minora— mechanical protection of the vaginal opening.

• Clitoris
  It is located at the upper ends of the labia minora and is an unpaired organ that consists of a head, a double cavernous body and legs.

  The clitoris is richly supplied with blood vessels and nerve endings, so it is very sensitive to touch, and during sexual arousal it fills with blood and increases in size (erection).

  The clitoris is the most erogenous zone for most women . Therefore, its main purpose is to accumulate sexual sensations and transform them into orgasm.

• Vaginal vestibule
  This is the space that is located between the labia minora. The excretory ducts of the Bartholin glands, the opening of the urethra and the entrance to the vagina open into it.
• Hymen
  It is located at the entrance to the vagina and is a fold of tissue from its mucous membrane, which is richly supplied with nerve endings and blood vessels.

  During the first sexual intercourse, as a rule, the hymen ruptures (defloration), which is accompanied by pain and slight bleeding. However, sometimes the hymen does not rupture due to the fact that it can have different degrees of extensibility, shape, thickness, elasticity and holes.

Causes of bartholinitis

Disease occurs when infectious agents enter the Bartholin gland. Most often these are sexually transmitted diseases: gonorrhea, trichomoniasis, chlamydia. Bartholinitis also occurs, the causative agents of which are other pathogens: staphylococci, streptococci, Escherichia coli, candida and others. However, most often bartholinitis is caused by an association of two or three infections.

As a rule, pathogens enter the Bartholin gland duct from the urethra or vagina during urethritis and/or colpitis. However, sometimes it is possible for infection to enter directly into the gland itself through the flow of blood or lymph.

The risk of developing bartholinitis increases at times in the following situations:

• Failure to comply with personal hygiene rules(especially during menstruation), promotes infection directly into the gland duct.
• Any local microtraumas(scratching, sexual intercourse with insufficient hydration) become an “entry gate” for infection.
• Wearing tight underwear disrupts the normal outflow of gland secretions, so it stagnates, creating ideal conditions for pathogenic microorganisms to enter the gland duct.
• Promiscuous life at times increases the likelihood of contracting sexually transmitted diseases.
• The presence of foci of chronic infection in the body(caries, pyelonephritis). In this case, pathogenic microorganisms enter the Bartholin gland through the blood or lymph flow.
• Immune system dysfunction, general or local hypothermia, lack of vitamins leads to a decrease in protective factors in the body. This allows pathogens to enter both directly into the gland itself and into its duct.
• Surgical interventions on the genitourinary area(for example, abortion) performed in violation of medical and sanitary standards during manipulation, as well as in non-compliance with the rules of the postoperative period.

Symptoms of bartholinitis

All manifestations of the disease depend on the course of the disease and the location of inflammation:

• According to the course of the disease there are acute, chronic, subacute and recurrent (recurrent) bartholinitis.
• By location of the lesion- canaliculitis (inflammation of the excretory duct of the gland), abscess (ulcer) or cyst (cavity with fluid inside) of the Bartholin gland.

Acute bartholinitis

Most often the process is one-sided (two-sided is typical for gonorrheal infection).
And, as a rule, canaliculitis develops at the beginning of the disease, and then bartholinitis itself.

Canaliculitis

With this disease, the woman’s general condition remains virtually unchanged.

However, at first the disease manifests itself with the following symptoms:

• A slight reddening of the skin appears around the exit site of the gland duct, caused by the secretion of secretions from it.
• The excretory duct of the gland is palpated, and when pressed, a small drop of pus is released.

Soon, due to increasing swelling, the duct closes and the outflow of secretions is disrupted. This leads to the rapid spread of the inflammatory process to the gland itself and the development of bartholinitis itself.

False abscess of Bartholin's gland

General symptoms

• The disease begins acutely: severe pain occurs in the area of ​​the labia majora, in which an abscess has developed. The pain intensifies when walking, sitting, during sexual intercourse and passing stool.
• Body temperature rises to 38-39°C, fatigue, weakness and chills appear.

Local changes

• There is swelling of the labia majora on the affected side. Moreover, sometimes it is so pronounced that it closes the entrance to the vagina.
• The skin over the swelling is red, but its mobility is preserved.
• Palpation of the labia majora is painful.

The appearance of fluctuations (softening of the swelling) indicates that a true abscess of the Bartholin gland has developed, and a purulent capsule has formed in its cavity.

True abscess of the Bartholin gland

It manifests itself as general symptoms and local changes.

General symptoms

• The woman’s condition worsens: body temperature rises to 40°C, intoxication symptoms increase (weakness, chills, headache).
• The pain in the area of ​​the labia majora, in which the cyst has formed, intensifies, becoming constant pulsating.
• White blood cells and ESR (erythrocyte sedimentation rate) increase in the blood.

Local changes

• Severe swelling (edema) of the labia majora on the affected side, which sometimes reaches up to 5-7 cm in diameter.
• The skin over the swelling is motionless, and its color is bright red.
• Palpation of the swelling is sharply painful.
• Sometimes the inguinal lymph nodes become enlarged.

The abscess may open on its own. At the same time, the woman’s general condition improves: body temperature drops, swelling and pain decrease.

Sometimes acute bartholinitis occurs with erased general and local signs: the pain is not expressed and, as a rule, the body temperature does not increase, and the general condition of the woman does not change. That's when they say about subacute bartholinitis

Consequences of acute bartholinitis

An acute or subacute process can result in complete recovery. However, the most common outcome is transition to chronic bartholinitis or the formation of a cyst of the large gland of the vaginal vestibule.

Chronic bartholinitis

The disease proceeds for a long time with periods of subsidence and exacerbation (relapses) of the symptoms of the disease, which can be triggered by various reasons: hypothermia, menstruation and others.

Outside of an exacerbation, the woman feels well, but may complain of slight pain on the affected side and pain during sexual intercourse.

The period of exacerbations is characterized by all the symptoms of acute bartholinitis.

Unfortunately, the most common outcome of chronic bartholinitis is the formation of a cyst of the large gland of the vaginal vestibule.

Bartholin gland cyst

If the cyst is small, it Not does not cause any unpleasant sensations to a woman who, sometimes, without even knowing about her illness, can live with it for many years.

Things are different when the cyst is large or inflamed. In this case, the signs of the disease are as follows:

If the cyst is not inflamed, but its size is large

General symptoms	Local symptoms
a woman complains of discomfort in the external genital area during walking, sitting and sexual intercourse the patient has pain that periodically appears in the labia majora on the affected side the woman's general health is good	there is a slight swelling of the labia majora, in which a cyst has formed the color of the skin above the swelling is unchanged a small painless or slightly painful formation is felt in the thickness of the labia majora on the affected side

If the cyst is inflamed

Bartholinitis during pregnancy

If the future the mother fell ill during the period from the moment of conception to the twenty-second week of pregnancy, then infection of the fetus can lead to its death (miscarriage).

If a woman falls ill in the last weeks of pregnancy, the likelihood of fetal infection and premature birth is very high. In addition, in this case, sometimes the child becomes infected during childbirth, leading to damage to the eyes, lungs and umbilical ring.

Treatment of acute bartholinitis

Perhaps we should start with the fact that the abscess sometimes opens on its own, after which the patient’s condition improves significantly. However, this is not at all a reason not to consult a doctor, since the abscess can open not outward along the excretory duct, but inward and melt the tissue. Therefore, it is necessary to contact a gynecologist as early as possible for timely treatment.

Treatment of bartholinitis, depending on the severity of the disease and its course, can be conservative (without surgery) and surgical (with surgery).

Treatment of acute bartholinitis without surgery

As a rule, it is carried out in a hospital. However, with a mild course of the disease, bartholinitis can be treated at home. The main thing is to follow all medical recommendations.

Treatment Goals- reducing pain and swelling, relieving symptoms of intoxication, as well as preventing the formation of a true abscess and cyst of the large gland of the vestibule of the vagina.

For this, local treatment is used, painkillers, antipyretics and antibiotics are prescribed.

1. Local treatment

It starts with an ice pack, which must be wrapped in cloth and applied to the site of inflammation for 40 minutes, then take a break for 15-20 minutes and apply again. And so on for several hours. In addition, ointments and hypertonic compresses are used.

Hypertonic saline solution for bartholinitis

An 8-10% saline solution is widely used to treat bartholinitis. The application is based on its ability to absorb liquid without destroying red blood cells, white blood cells and tissues.

Cooking method: Take three level tablespoons of salt and mix thoroughly in one liter of warm water.

Directions for use: soak a gauze swab in saline solution, then apply it to the sore spot for 30-40 minutes. Repeat the procedure three to six times a day.

Treatment of bartholinitis with Vishnevsky ointment and Levomekol ointment

Both ointments are also widely used.

Directions for use: Apply ointment to a gauze pad, then apply it to the abscess and secure it. It is better to alternate applications with ointments. For example, Vishnevsky ointment - for the night, and Levomekol - during the day.

Use of disinfectant solutions

Generally, preference is given to solutions that do not cause burns: Miramistin, Chlorophyllipt, Chlorhexidine and others.

2. Physiotherapeutic treatment

It is prescribed when the patient’s condition improves (usually on the third or fourth day from the onset of the disease), and signs of general intoxication (fever, chills) decrease. UHF, magnetic therapy and others are used.

General treatment

3. Treatment with antibiotics

To combat the infection, treatment of bartholinitis with antibiotics is prescribed. The course is about 7-10 days.

Ideally, antibiotics are used to which the pathogens that cause the disease are sensitive. However, it is not always possible to wait for the results of bacteriological analysis.

Therefore, it is practiced to prescribe broad-spectrum antibiotics: Azithromycin, Amoxiclav, cephalosporins (Ceftriaxone, Cefazolin), fluoroquinolones (Ofloxacin, Ciprofloxacin), macrolides (Clarithromycin, Ermitromycin) and others. Trichopolum and Tinidazole (drugs of the imidazoles group) are also used.

In addition, painkillers (analgin, baralgin) and anti-inflammatory (ibuprofen) drugs are prescribed.

Surgery for acute bartholinitis

Indications for its implementation are abscess of the Bartholin gland.

During the manipulation, the purulent focus is opened and its contents are removed. Then the resulting cavity is treated with 3% hydrogen peroxide, and a drainage tube is inserted into it to drain the pus, which is removed after 5-6 days.

At the same time, antibiotics, compresses with a hypertonic solution and applications with ointments are prescribed.

Note

Treatment of chronic bartholinitis (with or without cyst)

This is a complex and lengthy process, since the large gland of the vaginal vestibule has a very dense capsule, through which antibiotics and other drugs do not penetrate well.

That's why There are two ways to treat chronic bartholinitis: conservative (without surgery) and surgical (with surgery).

Treatment of chronic bartholinitis without surgery

Target- achieving remission (subsidence of symptoms of acute inflammation) for further surgical intervention.

During the period of exacerbation, conservative treatment is carried out, corresponding to that used for acute bartholinitis.

After the acute symptoms of the disease subside, the following is prescribed:

• local physiotherapeutic treatment (ozokerite, infrared laser, magnetic therapy, UHF therapy)
• sitz baths with herbal decoctions (chamomile, calendula, oak bark, sage)
• restoratives (vitamins)

Once stable remission is achieved, surgical treatment is considered.

Surgery for chronic bartholinitis

The main problem with the surgical treatment of chronic bartholinitis is that it is not enough to simply open the abscess or cyst. Since after tissue dissection, rapid adhesion occurs, which leads to the fact that the duct again closes.

Therefore, the operation can be carried out in two options: creation of an artificial gland duct (marsupialization) or removal of the Bartholin gland (extirpation).

Marsupialization

The most preferred method of treatment.

Indications- frequent exacerbations of the disease, improvement in the appearance of the external genitalia, as well as large cysts that interfere with sexual and daily active life.

Target- the formation of a non-stick canal through which the secretion produced by the gland will be discharged into the vestibule of the vagina.

Operation stages:

• Under anesthesia, a small incision (3-5 mm) is made in the cyst or abscess.
• The cavity is washed, then a Word catheter is inserted into it at the end, and a ball is inflated to prevent the catheter from falling out.
• After 4-5 weeks, the catheter is removed. This time is enough for a new excretory duct to form.

It is noteworthy that after installation of the catheter, no treatment is required during the rehabilitation period.

Relapses of the disease with this technique are rare (according to various sources, from 2 to 10%). As a rule, they are associated with re-infection or catheter loss. However, it can always be reinstalled and this is where better, than to lose the large gland of the vaginal vestibule altogether.

After all, removing the Bartholin gland is a rather complicated and bloody operation, since its upper pole is attached to a large venous formation. Moreover, after removal of the gland, the natural hydration of the vaginal mucosa is disrupted. However, there are situations in which such a radical measure is the only way out.

Removal of Bartholin's gland

Indications- frequent relapses of the disease and repeated unsuccessful formation of an artificial duct of the large gland of the vestibule of the vagina.

Operation stages:

• Under anesthesia, an incision is made with a scalpel on the inside of the labia minora.
• Then the gland itself is carefully removed and removed.
• Catgut sutures are placed on the incision.

After the operation, rehabilitation treatment is prescribed for 7-10 days: phonophoresis, UHF, magnetic therapy, ointment applications and others.

Note
During treatment of chronic bartholinitis, in order to avoid infection of the sexual partner, as well as to prevent relapse of the disease, it is recommended to refrain from sexual contact.

Treatment with folk remedies

“Nature’s Pantry” has in its bins the means to combat many ailments. Bartholinitis - no exception.

To treat this disease, you can use baths made from herbal decoctions that have antimicrobial and anti-inflammatory effects (chamomile, calendula, oak bark and others).

It will also have a good effect medicinal mixture for oral administration as a general tonic.

Method of preparation and use of the medicinal mixture

Take 300 grams of walnuts and 100 grams of garlic, pass them through a meat grinder. Add 50 grams of chopped fennel and 1 kg of liquid natural honey to the resulting mixture. Mix everything thoroughly. Take 1 tablespoon twice daily for one month.

Prevention of bartholinitis

It is simple and does not bring any inconvenience into a woman’s life.

The most important- maintaining hygiene of the external genitalia.

To do this, it is enough to wash the vulva, perineum and anus with warm water before going to bed and after defecation (passing stool). In this case, the flow of water should be directed from front to back: from the external genitalia to the anus.

Two to three times a week, it is allowed to use special cleaning agents (pH 7.0). And the use of antiseptics or herbal decoctions for the toilet of the external genitalia is possible only after a doctor's prescription.

It is very important to promptly treat all foci of chronic infection (caries, pyelonephritis, urethritis, colpitis and others).

And, of course, it is necessary to visit a gynecologist for preventive purposes once a year.

How to treat bartholinitis during pregnancy?

If the process is acute, treatment is carried out as usual: baths, applications with ointments, opening the abscess (if necessary) of the Bartholin gland. The only difference is that antibiotics are used depending on the duration of pregnancy, which obviously will not harm the fetus. For example, Amoxicillin, Cefazolin, Erythromycin.

However, if the process is chronic, then surgical intervention (removal of the Bartholin gland or creation of an artificial duct) is recommended after childbirth.

Is it possible to treat bartholinitis with antibiotics?

Certainly. After all, antibiotics are the basis for the non-surgical treatment of acute bartholinitis. It is advisable to use them taking into account the sensitivity of the pathogens that cause the disease. However, it is not always possible to wait for the results of a bacteriological study. Therefore, preference is given to broad-spectrum antibiotics from the group of cephalosporins, fluoroquinolones and others.

Is it possible to treat bartholinitis with folk remedies?

Can. After all, baths with herbal decoctions give good results. In addition, with the help of general restoratives from “nature’s pantry”, recovery is accelerated.

However, traditional medicine alone will not save you from the disease, so before resorting to them, be sure to consult your doctor.

And remember that traditional methods of treatment will lead to recovery many times faster when combined with medications. Moreover, if you miss precious time by giving preference to herbs, the disease can be much more severe. Therefore, do not get carried away exclusively with folk remedies, but rather consult a gynecologist as early as possible.

Bartolitis after surgery or opening an abscess, what is needed to prevent relapses?

Bartholinitis often occurs as a chronic disease and can cause frequent relapses. Opening an abscess on your own increases the risk of developing an early relapse, since the resulting fistula* may additionally become infected by bacteria that come from the vagina or anus. These fistulas take a very long time to heal. Moreover, in the area of ​​the labia there is a good environment for the proliferation of various pathogenic flora (urine, vaginal discharge).

*Fistula - this is a passage or tunnel that forms pus for its exit from the abscess; it is an area of ​​​​destroyed tissues melted by pus.

If, after surgical opening of the abscess, the doctor completely drains (frees) the Bartholin gland from pus, properly treats the surgical field immediately after the operation and until complete healing, then with an independent opening, patients usually do not consult a doctor and try to cope with the inflammation and wound on their own. This is the significant step leading to the development of chronic bartholinitis, the formation of a cyst with all the ensuing consequences.

What to do to prevent the development of a recurrence of a Bartholin gland abscess?

• bartholinitis in the abscess phase is surgical pathology , with which you need to run to the doctor, and the sooner the better;
• It is better to open the abscess surgically, and don’t wait for it to open on its own and fistula formation;
• with spontaneous opening of an abscess the gland is not completely freed from pus , therefore additional surgical intervention is required;
• improper care of the wound at the site of the abscess opening threatens complications .

Principles for treating the area after spontaneous opening of an abscess with bartholinitis:

1. Contacting a surgeon for complete drainage of the Bartholin gland abscess , for this, drainage tubes are installed to drain the resulting pus from the abscess. In some cases, formation of the gland duct is carried out - marsupilization; for this, a Ward catheter is installed for a long period.
2. Compliance with the rules of personal hygiene of the intimate area:

• washing away at least 2 times a day, for this you can use a light solution of potassium permanganate (if available), chamomile decoction, Citeal antiseptic solution (especially for thrush and sexually transmitted diseases), intimate hygiene products with an antibacterial effect;
• wearing loose, comfortable underwear made from natural fabrics, preferably white, without dyes, it is also undesirable to use other narrow items of clothing;
• everyday thin pads not recommended, as they are a good environment for the development of bacteria, and if they are used, a change every few hours is recommended;
• during menstruation it is necessary to change gaskets every 2-4 hours;
• refusal of sex and masturbation.

3. Use of antiseptic drugs:

• treatment of the abscess cavity with brilliant green or iodine;
• tampons in the vagina with a solution of Chlorhexidine, Miramistin;
• rinsing with Betadine solution;
• Levomekol and Balsamic Liniment (Vishnevsky ointment) are applied only after the discharge of pus from the drainage or fistula has stopped; healing ointments help close the outlet for pus.

Use of antibiotics. Antibiotics after opening the abscess are essential for healing the postoperative wound. Moreover, if the antibiotic is selected correctly, according to bacterial culture and drug sensitivity testing, then the risk of developing chronic bartholinitis is significantly reduced. In many cases, the sexual partner will also need antibacterial treatment, especially if the infection that caused bartholinitis is venereal.

What are the stages of bartholinitis? What to do at the initial stage of bartholinitis? How many days does bartholinitis last?

Bartholinitis goes through several stages, each of which has its own clinical picture and treatment principles.

Stages of bartholinitis:

Stage	What is it characterized by?	How does it manifest?	Principles of treatment
Initial stage	Initially, the duct of the Bartholin gland is affected, this condition is called canaliculitis or canalicular bartholinitis.	Redness inside the labia majora; painful sensations that increase when rubbing this area, walking, urinating; swelling of the ducts of the Bartholin gland, they can be easily palpated.	Warm baths, possibly with a light solution of potassium permanganate, chamomile infusion, or saline solution**; lotions with hypertonic saline solution (9%); treatment or vaginal suppositories with antiseptics (Chlorhexidine and others); Levomekol ointment; in the presence of general symptoms (fever, weakness and other manifestations of intoxication), the doctor prescribes broad-spectrum antibiotics.
Stage of false abscess of the Bartholin gland	Or catarrhal bartholinitis. This stage is characterized by inflammation of the Bartholin gland, but there is no pus yet.	Intense swelling of the labia majora at the entrance to the vagina, often the swelling blocks the entrance to the vagina; severe pain in the labia majora area, aggravated by any physical impact; redness of the inflamed area; symptoms of intoxication (fever, headache, weakness).	Contact a gynecologist, observation is necessary; cold to the area of ​​inflammation; antibacterial therapy prescribed by a doctor; lotions with 9% salt solution; anti-inflammatory drugs (Ibuprofen, Nimesulide, Paracetamol, Baralgin and others); treatment of the labia and suppositories with antiseptics; Vishnevsky ointment in combination with Levomekol - change ointments every 12 hours; Surgical treatment at this stage is not effective.
Stage of true Bartholin gland abscess	Or purulent bartholinitis. The formation of an abscess is a complicated course of bartholinitis; pus forms in the cavity of the Bartholin gland. With proper and timely treatment (antibiotics + surgery), bartholinitis ends at this stage.	Severe intoxication, increased body temperature above 39-40 0 C; softening of the enlarged Bartholin gland; the skin is fused to the inflamed area; pain in the area of ​​the abscess.	Contacting a surgeon for surgical treatment; opening the abscess, draining the pus, installing a drainage tube; postoperative wound care; Antibacterial therapy is mandatory.
Stage of chronic bartholinitis and formation of a Bartholin gland cyst.	When an abscess is opened independently, with incomplete drainage of pus and the absence of adequate antibacterial therapy, a cyst is formed at the site of the abscess, which periodically worsens until a purulent inflammatory process forms in it.	During remission - a small compaction in the area of ​​the Bartholin gland, which has no signs of inflammation. During the period of exacerbation - clinic of false and true abscess, while the clinical picture may be erased, intoxication is less pronounced.	Removal of the cyst during a period of remission, in which the surgeon can use the method of marsupialization (restoration of the gland duct) or removal of the Bartholin gland. In case of an abscess - opening the abscess and antibiotic therapy.

**Carefully! Warm baths are not used for abscess of the Bartholin gland.

Very often, bartholinitis ends at the initial stage, but provided that treatment is started in a timely manner and all rules of personal hygiene of the genital organs are observed.

How many days does a woman suffer from bartholinitis?

Duration of the disease depends on the severity, predominance of the stage of inflammation and the presence of complications, timeliness and method of treatment, compliance with all rules of intimate hygiene.

• So, acute canaliculitis lasts from 1 to 4 days, during which time a false abscess is formed or, with timely treatment, recovery occurs.
• False abscess stage - from 2 to 7 days.
• Bartholin gland abscess even with surgical treatment, it may require treatment from 7 days to 2 months. This is due to the fact that surgery for a Bartholin gland abscess is quite complex, postoperative wounds take a long time to heal, and a long recovery period is required. Drainage is installed until the discharge of purulent contents through it completely stops; in severe cases, it is necessary to install a ring-shaped drainage. The advantage of such drainage is that it has two outlets, which allows for a freer outflow of pus.
• Chronic bartholinitis can last for years and even decades, reducing a woman’s quality of life, leading to constant pain and discomfort in the perineal area, sometimes making life unbearable. Such patients often suffer from psychosis, depression, withdraw into themselves, and exclude sex from their lives. The only way out is radical surgical treatment.

To summarize, we can say that a woman with acute bartholinitis falls out of her usual full-fledged life, primarily intimate, for at least 2 weeks. And with chronic bartholinitis, intimate life and the opportunity to give birth to a child can be completely lost. Therefore, timely consultation with a doctor and treatment of this problem is so important for every woman.

Complications of bartholinitis, what does an increase in body temperature indicate with bartholinitis?

Formation of Bartholin gland abscess- this is also a complication of bartholinitis. It is purulent bartholinitis that can lead to the development of various complications, some of which can threaten a woman’s life.

As with any purulent inflammation, doctors are always afraid of complications. After all, you never know where the pus may go next. Such inflammation implies constant production pus***.

***Pus - this is a liquid (exudate) that is released by the body as a result of a reaction to inflammation, contains a large number of immune cells and bacteria, their waste products and decay products of the tissues of the inflamed organ.

And when there is a lot of pus, it does not fit in the capsule of the abscess or cyst and begins to look for ways to go beyond the source of inflammation. Pus can melt (destroy) healthy tissue and vessel walls . In the best case, the abscess will spontaneously open outward. But it is possible for pus to escape into the surrounding tissues, and even into the blood vessels, through which the infection spreads into the blood and throughout the body.

Schematic representation of an abscess and its spontaneous opening.

Complications of purulent bartholinitis.

Complication	Causes and mechanism of development	How does it manifest?
Chronic course and cyst formation	With prolonged inflammation, the body tries to fence off the focus, forming a capsule from the connective tissue - a cyst. In the walls of such a capsule there is a focus of chronic inflammation, which, with predisposing factors, gives a picture of purulent inflammation - exacerbation.	The cyst has the appearance of a slight inflammation; during the period of remission it has no signs of inflammation. In case of exacerbation - a picture of purulent bartholinitis.
Fistula formation	A fistula is a pathological channel that forms pus; the outlet of this hole can be located on the skin or in neighboring organs: vagina, bladder.	On the skin, the formation of a fistula is manifested by the spontaneous opening of an abscess; it looks like a wound from which purulent contents are released. Other types of fistulas are rare and are diagnosed using contrast methods. Such fistulas take a very long time to heal and require surgical intervention.
Complications associated with inflammation of the genitourinary system: vulvitis - inflammation of the labia, clitoris, lower part of the vagina.	Formed when an infection from an inflamed Bartholin gland enters the vagina. Infection is possible due to the anatomical proximity of the glands to the entrance to the vagina or as a result of the formation of a fistula (an abnormal opening from an abscess into the vaginal lumen). In the same way, the infection enters the urinary tract, and then into the bladder and kidneys, causing meningitis Most common complications purulent bartholinitis - transition to a chronic form with the development of a Bartholin cyst, infertility. Sepsis, although possible, develops, fortunately, rarely. In order to prevent complications, it is necessary to seek qualified medical help in a timely manner and adhere to the doctor’s prescriptions, and in the event of an abscess formation, only surgical treatment will help cure the disease and prevent serious complications. How to treat bartholinitis at home? Due to the high risk of developing a chronic form of bartholinitis with the formation of a cyst, self-medication at home is undesirable and can lead to the loss of precious time for a complete cure of bartholinitis. When can you not treat bartholinitis at home? Stage true abscess Bartholin gland - surgical treatment only; self-opening of an abscess (formation of a fistula) - surgical intervention is necessary; high body temperature and severe intoxication, significant impairment of well-being; presence of symptoms indicating complications ; in the anamnesis unprotected promiscuity, sexually transmitted diseases and the presence of symptoms indicating sexually transmitted diseases, since no self-medication method can cure these infections. Principles of treating bartholinitis at home: 1. Desirable bed rest, abstinence from sex and masturbation. 2. Treatment must be started immediately after the appearance of the first symptoms, at the initial stage of the disease. 3. Cold to the area of ​​inflammation with severe swelling and pain (with a false abscess of the Bartholin gland). 4. Genital hygiene: washing at least 2 times a day; wearing comfortable, non-tight underwear made of natural fabric, changing it at least twice a day; refusal of panty liners; during menstruation - changing them frequently. 5. Treatment of the area of ​​inflammation antiseptic drugs(Chlorhexidine, Betadine, Miramistin). 6. Antibacterial therapy: start with penicillins (Augmentin), cephalosporins (Cefodox, Cefuroxime). Other groups of antibiotics are prescribed only by a doctor. 7. Use of ointments Levomekol and Vishnevsky. 8. Warm sitz baths(not possible with an abscess). 9. Traditional medicine suitable for treatment in the initial stages of bartholinitis, before the formation of an abscess, as well as for chronic bartholinitis and cysts to prevent exacerbations. In combination with traditional medicines, folk treatment increases the effectiveness of treatment. Traditional medicine recipes for the treatment of bartholinitis: 1. Baths with herbal decoctions: Take 1 tablespoon of chamomile flowers, calendula, oak bark, pour a liter of boiling water and place in a water bath for 10-15 minutes. Strain and take sitz baths for 15-20 minutes. 2. Lotions with St. John's wort decoction: 1 tablespoon of herb is poured into 200.0 ml of boiling water and boiled for 15 minutes. Lotions are applied at night. 3. Immunity booster: peeled and crushed aloe leaves 200.0 g + 400.0 ml honey + 400.0 ml dry wine. Stir and evaporate for 1 hour, strain and cool. Take 10 ml 30 minutes before meals. 4. St. John's wort ointment: 1 tablespoon of St. John's wort + 2 tablespoons of animal fat (lamb, badger, goose) + 1 teaspoon of beeswax. Stir, heat until completely dissolved in a water bath. The ointment is applied to the site of inflammation overnight. 5. Lotions with herbal decoction: nettle + blackberry foliage + elderberry flowers + yarrow in equal proportions, move, chop, take 40 g and pour 500.0 ml of boiling water, leave for 90 minutes. Strain and use as lotions and irrigations. 6. Compresses with aloe and/or Kalanchoe juice: take the leaves of these plants, peel them, squeeze out the juice, moisten a swab with it and apply it to the inflamed area overnight. 7. Compresses with cabbage leaves: take a thick leaf of white cabbage, wash it well and pour boiling water over it, then apply it to the inflammation site overnight, this compress can be combined with Vishnevsky ointment, you get a good result. 8. Onion compress: The onion in the peel is baked in the oven for 20 minutes, then kneaded into a paste, wrapped in a bandage, forming a pad, and applied to the vaginal opening overnight. If there is no effect from the treatment within 4 days or the condition worsens, you must stop self-medication and consult a doctor. Bartholinitis in the stage of true abscess requires hospitalization in a hospital for surgical intervention. Photo of bartholinitis in women, what are the signs of inflammation of the labia? Photo: surgery to open a suppurative Bartholin gland cyst. This is what chronic bartholinitis with a formed cyst looks like. Photo: true abscess of the Bartholin gland. Photo: chronic bartholinitis in the acute phase. Photo: this is what a fistula looks like when an abscess spontaneously opens.