– paired exocrine glands located in the thickness of the labia majora. The excretory ducts of the Bartholin glands open at the border of the posterior and middle thirds of the mucous membrane of the labia minora. Some infectious pathogens (trichomonas, chlamydia, gonococci, opportunistic flora) can cause inflammation of the excretory duct of the Bartholin gland, followed by the formation of a cavity: cysts or abscess.
Inflammatory pathology of the Bartholin's gland occurs in about 2% of women. This article on estet-portal.com describes the technical features of surgical treatment and modern principles of
antibacterial therapy for abscess and Bartholin's cyst. Treatment of Bartholin gland abscess: antibiotic therapy
If the size of the Bartholin gland abscess is large and the patient has a fever, antibiotic therapy should be performed.
Recommended antibiotic regimen (according to EBM Guidelines): amoxicillin with clavulanic acid (875mg/125mg) twice daily for 5-7 days.
The method of choice in the treatment of Bartholin's gland abscess is surgical: opening followed by drainage of the cavity. The operation is performed under local anesthesia.
Word's catheter may be used as an alternative to drainage. Read more about the technical features of the placement of the Vord catheter in the article.
Follow us onTelegram Bartholin's gland abscess: features of inserting a Ward catheter
Word's catheter is inserted into the cavity of the gland after opening the abscess. At the end of the Ward catheter there is a balloon, which must be used for fixation in the cavity of the gland by introducing 3 ml of saline. The other end of the catheter is guided into the vagina.
Word's catheter is left in place for 3 weeks. During this time, a new canal of the Bartholin gland is formed through epithelization.
No antibiotic resistance: modern principles of mycoplasmosis treatment During this period, the woman should be advised to abstain from sexual activity.
Marsupialization is not recommended for the treatment of a Bartholin gland abscess.
If a Bartholin gland cyst is not accompanied by any clinical symptoms, then there is no need to treat – the patient only needs to be observed (according to the recommendations of the EBM Guidelines).
Treatment of a Bartholin gland cyst complicated by an abscess – same as primary abscess of Bartholin's gland.
If the cyst is large and interferes with daily life, it should be surgically removed. The optimal method of treatment is marsupialization of the cyst of the Bartholin's gland – surgical opening of the cyst with subsequent washing of its cavity and the formation of a new excretory duct.
Modern Evidence-Based Medicine Guidelines for the Diagnosis and Treatment of Childlessness Procedure of Bartholin gland marsupialization surgery: a practical guide
Marsupialization of a Bartholin gland cyst is performed on an outpatient basis. For pain relief, local anesthesia is used: an anesthetic solution is injected into the mucous membrane of the labia at the site of the greatest swelling.
On average, the marsupialization operation takes no more than 30 minutes. The chance of recurrence of a Bartholin's cyst is about 10%.
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