Opening the Bartholin gland abscess is a radical solution to the question of the pathology of the female genital organs. The disease is localized in anticipation of the vagina, since it is there that the gland itself is located.
According to statistics, most of the victims of this disease is in the age range from 20 to 40 years. Despite this, there are age exceptions, therefore, no representative of the weaker sex is insured against inflammation, which ignores the medical recommendations for prevention.
Bartholin gland belongs to the category of paired formations, which are referred to as the complex tubular type. In shape, it resembles a large pea. The acini glands are lined with cylindrical epithelial tissue, which is located in one row. The formation of the central duct is due to the connection of several smaller ducts at once.
The main path opens in front of the vagina from the front, being located outside the hymen. The duct itself is lined with transitional epithelium, the length of which reaches only two centimeters.
Causes of inflammation
In order to deal with the extent of damage to such an important part of the female reproductive system, the gynecologist is required to understand the origin of the lesion during the initial consultation. Usually the catalyst of the inflammatory process is getting into the lumen of the duct discharge from the vagina, which have already been infected. There can also be discharge from the urethra, which was also affected by an infection. In rare cases, it is even the case that the infection is the result of the infected contents of the bloodstream entering the lumen.
The classic symptoms of the disease involves purulent inflammation with all the ensuing unpleasant consequences. The lesion is able to shift somewhat over time, affecting the adjacent glandular tissues and the surrounding fiber.
The culprits of true Bartholinitis - that is exactly what the abscess of this gland is called in medical terminology, are pyogenic cocci. Usually, the vital activity of the brightest representative of this family, gonococcus, leads to sad consequences. Automatically, this means that in approximately a quarter of cases, standard gonorrhea leads to a lesion of the gland with the lower parts of the reproductive system. The explanation for this is simple - vaginal secretions, which by default contain pus, enter the lumen.
Doctors distinguish two formats of false Bartholin gland abscesses:
The first option is based on infectious development with abstination of the duct of a retention cyst. The latter is formed by blocking the duct itself.
The secondary course is due to inflammation of the gland itself. This happens because of the beginning of suppuration of the cyst, which "felt well" during the long-term treatment, because no one treated it.
A false disease almost always develops because of the associative flora, the fundamental factors of which are:
- anaerobic microorganisms;
Doctors say that today the majority of patients in the gynecological hospital deal with a false abscess. This disease has another distinctive feature, which is expressed in certain anatomical premises. It is a narrowing of the duct along the entire length. At the point where the small paths intersect, falling into the main one, something like an ampule forms in the gland. A small amount of gland secretion is stored there.
After this, a narrowing of the central duct occurs, which at the outlet is a pinhole. The edema which manifested itself in the specified area with a previously detected vulvitis or coleitis looks like inflammation of the mucous membrane of the duct itself. Edema triggers the closure of the main channel, which triggers a mechanism to slow down the flow of secretions and infect the generated secretions. The result of the pathology is represented by a primary abscess or cyst.
In order to negate the risks of possible side effects after undergoing surgical intervention on the outer part in front of the vagina, doctors recommend that if they detect the first signs of the disease, they should immediately go to the clinic. On site, an experienced gynecologist will prescribe tests, after which it will be clear what the doctor will have to deal with.
Regardless of the type of abscess, be it false or true, the symptoms in both hands are identical, including:
- one-sided process;
- scanty purulent discharge when attempting to palpate the problem area;
- tenderness in the area of the central duct projection;
- infiltration in a potentially infected area;
- swelling of the labia majora and surrounding mucosa;
- friability of subcutaneous tissue at the entrance to the vagina;
In contrast to the standard scheme, when pus accumulates inside a cyst, the melting of glandular tissues manifests itself much brighter. This is a characteristic pain syndrome followed by a fairly extensive swelling. Also, the skin that is located above a true abscess remains immobile. The auxiliary pointer becomes inguinal lymphadenitis.
If you find at least a few of the points listed above, as well as with pain when you touch the tumor, you must immediately make an appointment with a gynecologist. Otherwise, after a short period of time, the deterioration of the condition will affect the problem of increasing the degree of pain in a sitting position. And defecation turn into real flour.
Any self-medication based on the use of analgesics will only have short-term effectiveness, aggravating the situation at the physiological level. Also, when tightening, the patient will necessarily encounter the suppuration phase, which provokes hectic temperature. Difficulties will add manifestation of intoxication with the worst scenario development scenario. It does not cost just a general weakness. A woman will have to deal with a lack of appetite, which, in the end, will undermine the body's immune forces, as well as with insomnia or more complex sleep disorders.
Surgeons who specialize in getting rid of such a pathology in an operational way, note that the symptom called "nights without sleep" is direct evidence of the active stage of suppuration. If you do not open the abscess immediately, then it threatens to turn the disease into a chronic form. The last is characterized by drops of remission and exacerbation.
During the examination, the gynecologist will palpate the lower third of the region of the labia majora, even if the patient turned for help during his period. The results of palpation will reveal a cystic formation, which has a dense consistency. When pressing on the proposed unhealthy area, the girl will feel soreness.
On a periodic basis, an abscess opens naturally through the duct of the gland directly into the vagina. With particularly complex clinical pictures, it is even possible to empty dangerous contents into the rectum.
With a protracted disease, which was not even attempted to be treated delicately, the representative of the weaker sex will quickly face an aesthetic problem. Externally, the disease manifests itself by deforming the labia and vaginal exit. The reason for this - repeated scarring of the former formations, which disfigures the appearance of the perineum. It is even worse if the disease reaches the point where a quite actively functioning fistulous passage has formed in the vagina or next to it. It makes itself felt with repeated dissections of the process in a natural or surgical way.
During remission in patients with Bartholinitis, there is dyspareunia and leucorrhea, which is a logical consequence of chronic vulvovaginitis. At the acute stage, the infection begins to become active, which is expressed in the symptoms of classic acute inflammation.
Unlike many other diseases of the female reproductive system, this type of abscess is quite easy to recognize if the technique is performed by a qualified gynecologist. First, he conducts an external examination, and then uses the basics of palpation.
During the examination of the exit duct opening, the doctor will pay special attention to the features of the discharge, as well as:
- possible edema;
To confirm the diagnosis, the doctor spreads the labia to reach the gland itself. This allows you to detect visible signs of inflammation. At the same time, the specialist must determine the specific:
- degree of pain.
Based on the information collected, it will be possible to determine how far the defeat process has advanced. It is especially important to study the severity of asymmetry, which is the most important beacon of the disease. Sickle genital slit should be a convex side to turn the side of a healthy lip. With an extensive anomaly, the tumor can completely close the entire genital slit entirely.
Another important point of a proper examination is a thorough assessment of the condition of the lymph nodes in the groin area. In severe Bartholinitis without lymphadenitis, located on the problem side, is not complete. And if the disease is caused by gonorrheal primary sources, then attention should be paid to metastatic lesions. This is gonorrheal arthritis.
Doctors agree that the conservative treatment of Bartholin gland lesions will only help in the initial stage of the disease, when there is at least a partial outflow of the secret. Then it will be possible to do with medicines, which are characteristic of the treatment of acute suppurative inflammation.
But usually women are not so vigilant about their genital health. Because of this, they are asking for help with a progressive disease, when only a surgical measure can help. Some ladies who have already undergone the procedure are afraid that they have a seal. But since each organism is individual, it is worth checking personally with your gynecologist if this is normal in each specific situation separately.
If you miss the opportunity to solve everything with a scalpel, you will have to face the dire consequences of your own indifference to health.
This is about:
- spontaneous opening of the abscess;
Ignoring the recommendation of the doctor to carry out the operation immediately may result in the acute illness turning into a classic purulent-infiltrative process of a chronic type.
It is not necessary to assume that the expansion of the inlet of the main duct to improve the outflow of pus is an excellent solution to the problem. Even the puncture or aspiration of pus with the subsequent washing of the gland will not bring long-awaited relief for a long time. This will only drive the disease to the chronic stage. Physiologically, the futility of the above is due to the fact that the evacuation of pus takes place only for a short period of time.
As soon as the hole made for puncture is closed, everything will be repeated again. Because of this, doctors insist on a wide opening of the abscess. An autopsy should occur at the lower pole of the labia, focusing on the zone of fluctuations on the side of the mucous membrane.
After the cavity is completely free of health-threatening contents, the doctor performs a sanitization with an antiseptic solution. Improvement comes immediately. Patients noted a decrease in pain, as well as other symptoms of ordinary purulent intoxication.
Despite the fact that after the operation, which lasts about 25 minutes, many ladies want to rest in bed, you should not do so. Doctors recommend to walk more on the first day, and also gently wash the vacated cavity after an abscess several times a day.
On the second day, you can reduce the number of washes.
But to leave in the cavity turunda and other gadgets, tubes, compresses is strictly prohibited. Handicraft assistants will not be able to provide the former abscess with sufficient drainage, instead only hindering the natural mechanism of secret outflow. Problems are added by the ability of collection items to accumulate pus, which should go away freely.
The postoperative period should be accompanied by a previously approved drug treatment program. Individually selected drugs can successfully deal with atypical microorganisms, edema and swelling.
The final stage is physiotherapy and restorative treatment aimed at leveling the risks of relapse.