Revealing 12 Fascinating Insights into Bartholin’s Abscess Development
October 25, 2023
This condition is often poorly understood but can lead to painful episodes in many women. So, this post explores 12 facts about Bartholin’s abscess, a very common cause of painful vaginal swelling.
In addition, we also consider why many doctors appear to hesitate to provide any preventive or definite treatment unless there is a lump. Many women find this incredibly frustrating – what do you think?
You can’t get a Bartholin’s abscess without a Bartholin’s cyst. And you can only get a Bartholin’s cyst if you have a Bartholin’s gland. In other words, there is a progression from one condition to the next.
Yes, everyone has a pair of Bartholin glands, although, in men, they are known as bulbourethral glands and located deep within the base of the penis.
The Bartholin’s glands are found on the L and R sides between the vulva and the opening or entrance of the vagina.
But what are glands – well, remember, you have glands all over your body; generally, a gland’s job is to produce or secrete some fluid or chemical like a hormone.
Examples are the thyroid gland or adrenal glands and so on.
Back to your Bartholin’s glands, these produce mucus, a slightly alkaline fluid whose essential job is lubricating the vagina.
This is similar to what the corresponding glands do in men, where they serve as a lubricant during sex.
The following fact is a bit of trivia. But did you know that your Bartholin’s glands are named after a Danish professor of Medicine called Caspar Bartholin the Younger, who first described the Bartholin’s glands in 1667, over 300 years ago?
Now we know a little bit about the gland; how do we get from gland to cyst?
Well, inside the gland are several cells which work to produce the fluid. Eventually, this fluid is emptied through a tube or channel called a duct. If the duct becomes blocked, the gland becomes swollen with fluid, which is how a Bartholin’s cyst develops.
The duct blockage, which leads to a cyst developing, can happen most commonly due to an infection but may be caused by injury to the vulva area.
Before continuing, let’s discuss who will likely develop a Bartholin cyst.
Any woman can develop a cyst. However, it happens more often in women in their reproductive age, and especially those aged 20 to 29 are the most affected.
It seems you are also less likely to have it if you have been pregnant more than once, for reasons we do not fully understand.
The following fact looks at the symptoms of a Bartholin’s cyst.
The cyst can be very small and cause no symptoms. Or it may be a small lump that disappears after a couple of days.
You may feel a small lump if you examine your vulva carefully as you wash – it may not be too uncomfortable and, sometimes, may resolve itself.
Often, this is not caused by an infection. It may develop due to some friction from your clothes or during exercise when tissues rub against each other.
So your cyst has developed because the duct is blocked. But what if this is not the case?
The cyst is infected and gets bigger.
In that case, you may experience a very painful or tender lump in the vaginal opening, often to one side (as both glands do not get infected at the same time), pain when walking or sitting, pain during sex, or even a fever.
And this is where we enter the realm of Bartholin’s abscess.
An infection in the Bartholin gland is commonly caused by the germ E coli, found naturally around your anus
This may easily transfer from the back to the front during the day-to-day activity, and the germ infiltrates the gland.
But other germs that cause sexually transmitted infection can also infect the Bartholin’s gland, like Chlamydia or Gonorrhoea.
Sometimes, an infection within the cyst can grow very quickly. An abscess is an infection in relatively advanced stages.
Early on, the infection may be controlled with antibiotics. Still, if treatment is not provided, the cyst can become a closed-off sac filled with pus, which is an abscess.
In this case, the treatment is incision and drainage, which means what that sounds like – a cut is made into the abscess to drain the pus, clean the cyst, and relieve blockage.
It is performed under a local anaesthetic, and you may be given a course of antibiotics to prevent further multiplication of germs.
But let’s back up a little bit.
Suppose we are still at the cyst stage – it’s a small lump but painful, and you know something’s not quite right.
What are the treatment options? Many times, these types may go away on their own.
The body’s natural immune system, which is trying to stamp out the inflammation, can be supported. You could use a warm water compress or soak in a Sitz bath.
Sitz baths help treat conditions like piles, Bartholin’s cysts, episiotomies, etc.
You can soak the affected area with warm salt water several times daily. This effective treatment can take two or three days, after which the cyst will burst and drain on its own.
So these are some facts about Bartholin’s abscess, starting with how it develops.
The last fact is the trouble these can cause when they happen repeatedly.
If you’ve experienced this, you know just how quickly it can go from 0 to a hundred in terms of pain and swelling.
There is often no warning, and just like that (snaps finger), you may need an admission for treatment like a cut and drain.
And one of the questions you may wonder about is: why can’t we stop this from happening repeatedly?
Why not just remove the glands or cyst instead of waiting for an abscess before treatment?
Well, there are surgery options for recurring cysts. One of them is marsupialisation. In this case, the surgeon creates a permanent opening within the cyst after cutting to drain it.
Surgery can be done to remove the glands for very persistent cysts, but this can be risky surgery requiring general anaesthesia.
It needs to be performed by a competent surgeon as there is a huge risk of bleeding during or after surgery.
The reason for this is that the tissues around are full of an extensive and rich network of blood vessels, which is why it is performed only with great care!
Given these potential complications, some specialists may be reluctant to remove the gland. I urge you to discuss your condition with your gynaecologist and see what they think.
We hope you found this exploration into Bartholin’s abscess useful; please keep track of any vaginal lumps, and see your Dr if it’s growing or painful or if you have other concerns.
Let us know if you’ve had or are having issues with recurring vaginal lumps below.
Editing by AskAwayHealth Team
All AskAwayHealth articles are written by practising Medical Practitioners to help promote quality healthcare.
The advice in our material does not replace a qualified healthcare practitioner’s management of your specific condition.
Please get in touch with a health practitioner to discuss your condition, or reach us directly here.
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