Bartholin’s Abscess - Causes, Symptoms, and Treatment

Creator: Dr. Asha. C
Published: 2023-01-09T18:34:54

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Bartholin abscess is a painful swelling that occurs near the vaginal opening. This article explains the causes, symptoms, and treatment for Bartholin abscess.

Written by

Dr. Asha. C

Medically reviewed by

Dr. Richa Agarwal

January 9, 2023

March 17, 2023

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Contents

What Is Bartholin Abscess?
What Are the Causes of Bartholin Abscess?
What Are the Symptoms of Bartholin Abscess?
What Is the Treatment for Bartholin Abscess?
What to Expect After the Surgery?
What Are the Home Remedy Options for Bartholin Cyst or Abscess?
How to Reduce the Risk of Bartholin Cyst?

What Is Bartholin Abscess?

Bartholin glands secrete fluids for the lubrication of the vagina. They are small, pea-shaped glands located on either side of the vaginal opening. If the glands are blocked, the fluid gets stuck inside the gland causing a painful swelling called a Bartholin cyst. If the cyst gets infected, it is filled with pus and surrounded by inflamed tissues; it is called a Bartholin Abscess. It causes severe pain on one side of the vagina, and a person can notice swelling and change in color near the vagina. It can also vary from very small to over an inch in diameter.

What Are the Causes of Bartholin Abscess?

Bartholins abscess occurs when the cyst gets infected with bacteria like Escherichia coli (E. coli) and bacteria that cause sexually transmitted infections such as gonorrhea and chlamydia.

What Are the Symptoms of Bartholin Abscess?

If the cyst is tiny and not infected, there will be no symptoms. When the cyst grows, a lump can be felt near the vagina.

Later if it gets infected, the person can experience,

A painful lump near the vagina.
Discomfort while walking and sitting.
Pain during intercourse.
Redness and warmth around the swelling.
Fever.

What Is the Treatment for Bartholin Abscess?

There are many techniques to drain a Bartholin Abscess; they include:

Balloon Catheter Insertion -

Balloon catheter insertion is also known as fistulization or catheter placement. In this procedure, a passage is created permanently to drain the fluid that may get collected.

The following steps are carried out during this procedure,

Typically, local anesthesia is given to numb the area of operation so the patient does not feel any pain.
A small incision is made, and the cyst or abscess is drained.
A balloon catheter is then passed into the emptied abscess. It is a plastic tube that is thin and small with an inflatable balloon on one end.
Once the balloon is passed inside the empty cyst or abscess, it is filled with saltwater which increases the size of the balloon and fills the abscess or cysts.
Then stitches are made to hold the balloon in position temporarily.
The catheter is left in place for four weeks; meanwhile, new cells grow around it, known as epithelialization.
After the epithelialization, the balloon is drained, and the catheter is removed.

There may be a few complications due to balloon catheter insertion, which include:

Bleeding.
Pain while the catheter is in its position.
Discomfort or pain during sex.
Infection.
Scarring.

Marsupialization:

If there is a recurrence of the abscess or cyst, marsupialization is recommended. The following are the steps carried out during the procedure:

Initially, general anesthesia is provided to the patient.
The abscess is opened with a small incision, and the pus is drained out.
Then stitches are used at each side of the incision to create a permanent opening.
After completing the procedure, the treated area is packed with cotton to absorb the pus and blood from the wound, which would be removed before discharge from the hospital.
The complications after marsupialization may include infection, bleeding, pain, and recurrence of the abscess.

Bartholin's Gland Removal (Bartholinectomy) -

If there is frequent recurrence and failure of other procedures, then Bartholin's gland removal is recommended. Bartholinectomy is done under general anesthesia, and two to three days of hospitalization are required. The surgery complications may include bleeding, bruising, and infection of the wound.

Ablation With Silver Nitrate -

It is a simple and effective technique that makes a small incision near the cyst or abscess. The content is then drained, and silver nitrate is placed into the cyst after draining. After two to three days, the silver nitrate is removed or falls by itself. The complications may include a burning sensation at the surgical site, dyspareunia, and hematoma.

Carbon Dioxide Laser -

This surgical procedure is simple, quick, and causes minimal discomfort to the patient, but it is an expensive procedure. The cyst is removed and destroyed using the laser; at times, a small hole is made to allow fluid drainage.

Needle Aspiration -

A needle and syringe are used to drain the cyst in this procedure. Then the cavity is filled with 70 percent alcohol and left in the hole for five minutes, and drained out.

What to Expect After the Surgery?

A sanitary pad held on with elasticated net pants will be provided. Cotton or gauze inside the wound will be taken out after 24 hours.
The vulva will feel slightly painful for 24 hours after the operation. To control the pain, painkillers would be provided, and antibiotics if there was any infection.
You can wash the wound area with soap and tap water. Saltwater is not necessary.
You can return to a light job after about one week and any heavy jobs after two weeks.
You can start sexual relations again when you feel comfortable, usually after two weeks.

What Are the Home Remedy Options for Bartholin Cyst or Abscess?

Home remedies usually relieve the symptoms but do not provide a permanent cure.

The few frequently followed home remedies include:

Sitz Bath: It helps relieve pain and discomfort. A bathtub is filled with warm water, and a person needs to sit in the water for about 15 minutes; repeat this procedure many times for three to four days or until the symptoms subside. This method helps in the rupture of small abscesses.
Topical Treatment: Topical application of some natural oil and other products can provide relief from Bartholin's cyst or abscess, which includes :
Natural Oils: Applying a mixture of castor oil and tea tree oil to the abscess may help drain the abscess. Soak the oil mixture in the gauze, apply it to the affected area, and place hot compression on top of the gauze.
Apple Cider Vinegar: Dilute the apple cider vinegar and apply it to the abscess with a cotton ball.

How to Reduce the Risk of Bartholin Cyst?

By reducing the following risk factors, Bartholin's cyst can be prevented to some extent:

Maintain good genital hygiene and only clean the outside of the vagina.
Add probiotic supplements to your diet, which will support the urinary tract and vagina.
Drink more water.
Use condoms to avoid sexually transmitted infections.
Get regular checkups to test for sexually transmitted infections.

Conclusion :

Bartholin's cyst or abscess can be painful while doing routine work. The proper treatment will help to relieve the pain and swelling. If the cyst or abscess infection is mild, home remedies will be adequate, but in the advanced stage, surgery may be required.

Frequently Asked Questions

1. How Is Bartholin Gland Abscess Medically Managed?

A bartholin gland abscess is a highly distressing and discomforting condition. Surgical drainage of the abscess content is the most widely preferred treatment option. A cut is made on the abscess, through which the content is driven. Surgical drainage is often accompanied by antibiotic coverage to facilitate the site's healing. In certain patients, pharmacological management with antibiotics collapses the abscess, eliminating the need for a surgical approach. Elimination of the bartholin gland is recommended for cases with higher recurrences.

2. Does Bartholin Gland Abscess Hurt?

A bartholin gland abscess is a debilitating condition with agonizing pain. Extreme pain evoked by a Bartholin abscess destroys the patient’s quality of life and impairs their day-to-day activities. As the abscess develops over the private part, it can impact their sexual life as well. In addition to the pain, the vaginal opening appears reddened and puffy, with extreme sensitivity towards touch or pressure.

3. Is Bartholin Abscess Anyway Related to Cancer?

Bartholin abscesses, as such, are not cancerous; these are infections concerning the bartholin gland. However, cancer does develop over the Bartholin gland, eliciting manifestations mimicking Bartholin cysts. Hence, prompt diagnosis is essential to rule out any carcinogenic origin.

4. What Is the Active Duration of a Bartholin Abscess?

Bartholin's abscess may last a week, within which it breaks off, releasing its content. The active period may last up to four days, during which the abscess gains size and elicits manifestations like soreness and discomfort. However, the Bartholin cyst may last longer and even persist for months.

5. What Is the Age at Which Bartholin Abscesses Tend to Develop?

Bartholin abscesses are frequently reported in the reproductive age group of females. However, there are rare reports of Bartholin abscess encounters in the pediatric population. 20 to 30-year-old women leading an active sexual life are more susceptible to developing a Bartholin abscess.

6. Does Bartholin Abscess Settle by Itself?

Bartholin's abscess settles independently in certain patients, even without rigorous medical interventions. The abscess breaks itself, exposing its content. In such cases, it is advised to wipe off the expelled content to check the spread of infection. Home care measures like sitz bath aid in tackling the associated symptoms.

7. Does Bartholin Abscess Result in Infertility?

No, Bartholin's abscess could not impair one’s fertility. Since the infected Bartholin gland that precipitated the abscess is located at the vaginal orifice, it may elicit painful sex. However, once the abscess resolves, the person can resume their sexual life. Bartholin abscess cannot bring in infertility or other permanent fertility issues.

8. Is Bartholin Cyst a Normal Finding?

Yes, it is quite normal to have a Bartholin cyst. Reports suggest that women under the reproductive age category will develop it at least once in their lifetime. Surgical intervention is not mandatory for all cases. In certain patients, the cyst settles with home care measures and does not entail medical intervention. In women with larger cysts, surgical approaches need to be undertaken to eliminate the cyst.

9. What Is the Antibiotic That Works Well for Bartholin Cysts?

Antibiotics are often prescribed to check the infection's spreading and facilitate healing. Ciprofloxacin, Azithromycin, Flucloxacillin, Ceftriaxone, and Doxycycline are the frequently advised antibiotics that deal with Bartholin abscesses. However, antibiotic treatment is not mandatory for all women who are diagnosed with Bartholin cysts. Pharmacological interventions using antibiotics are employed for patients who do not respond to home care measures.

10. How Is It Possible to Check the Development of Bartholin Cyst?

Sitz bath is the most effective way to check the progression of the Bartholin cyst, where the cyst area will be dipped into warm water. This repeated soaking relieves the discomfort and pain and aids in collapsing the cyst. It needs to be practiced three to four times daily for about four to five consecutive days to elicit obvious alleviation of the symptoms.

11. How Bartholin Abscess Can Be Prevented?

Bartholin's abscess is not a completely preventable condition. However, the risk of acquiring infection in the Bartholin gland can be tackled by incorporating certain measures, like keeping the vagina clean and carrying out safe sex with the aid of protective condoms. Frequent development of Bartholin abscess can be effectively tackled by undertaking appropriate surgical interventions to extract the Bartholin gland from the body.

12. Does Shaving Evoke the Development of Bartholin Cyst?

Shaving the pubic area can create minute trauma on the skin's surface and even plug the Bartholin gland's orifice. It creates room for the gland fluid to gather. Sometimes using an unsterile razor for shaving can provide access for susceptible microorganisms into the Bartholin gland, which eventually give rise to the formation of Bartholin cysts.

13. Does Bartholin Abscess Break or Rupture Driving Out Its Content?

Yes, at times, Bartholin abscess after attaining considerable size break-off by releasing the enclosed content. There is nothing wrong, even if it breaks on its own. Once the Bartholin abscess breaks, it facilitates the shrinkage of the abscess and thereby aids in healing.

14. In What Ways Does a Bartholin Cyst Differ From a Bartholin Abscess?

The Bartholin abscess is the infected form of the Bartholin cyst, whereas the Bartholin cyst is simply the result of a sealed ductal opening of the Bartholin gland. Bartholin cyst encloses fluid without any microorganism, while Bartholin abscess develops only when the fluid acquires microorganisms like bacteria. Once the Bartholin cyst becomes an active abscess, it becomes more fluctuant and touchy, enclosing pus.

15. Is Bartholin Cyst Infectious or Contagious in Nature?

Generally, a Bartholin cyst is not a catchy infection and cannot be acquired from an infected to a healthy person. However, infected cysts do become contagious. The infectious nature of the Bartholin cyst is accounted for by the type of microorganism responsible for evoking the infection. Certain bacteria that are concerned with sexually transmitted infections are also capable of triggering infection in the Bartholin gland. In such cases, sexual activities may result in the transmission of microorganisms into the other person's body, reflecting infection.

Sources

Dr. Richa Agarwal

Obstetrics and Gynecology

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