hurts in such "interesting" place, that is not something that is difficult to walk, but also to tell someone you can not - inconvenient.General weakness, the temperature exceeds the limit, and is one - go to "give up" the gynecologist.
Those who are familiar with the symptoms listed, are well aware that we are talking about unpleasant disease - Bartolini.Bartolini women fortunately does not occur very often, and is diagnosed primarily in women of childbearing age.
vestibule adequately protected small labia, which is none other than the skin folds, but so gentle that looks like a mucous membrane.Outside labia cover the labia majora, bind top and bottom spikes (front and rear).
In large pudendal lips there adipose tissue and a variety of sweat and sebaceous glands, lip themselves intensively covered with hair (secondary sexual characters).But, in addition to the above large pudendal lips depth localized Bartholin gland (have a rounded shape and size of not more than 1 cm).
duct cancer (also called large glands vestibule) is displayed at the entrance of the vagina, in the place where is located the hymen.Since both large and small pudendal lips has 2, respectively, a large gland vestibule too 2.
main objective is to develop a Bartholin gland secretion, which supports the vaginal mucosa moist and produces lubricant in moments of sexual arousal to facilitate the introduction of the penis.
Bartolini - what is it?
bartholinitis is a disease of the reproductive sphere, which is characterized by an inflammatory process in the Bartholin gland due to ingress of infectious agents.Typically, the process involves the Bartholin gland on one side only.As a result of inflammation of the parenchyma of the prostate and surrounding tissue are melted, formed inflammatory capsule with purulent contents.
Why there Bartolini?
Development bartholinitis due to infectious causes, that is, the direct hit of pathogenic microorganisms in the Bartholin gland.
- often agents of disease are the infections that are spread through sexual contact.Most often it is gonococci and Trichomonas, chlamydia rarely.
- Bartholinitis But often causes nonspecific microorganisms from the category of pyogenic flora (Streptococcus, Staphylococcus and E. coli).
- not excluded and fungal nature of the inflammatory process (fungi Candida).
But the diagnosis of the disease is often not released one but several infectious agents, that is, Bartolini is the result of an attack of microorganisms association.However, not all women with gonorrhea, or, for example, trichomoniasis, ill bartholinitis.To do this, the impact of trigger factors:
- weakening the body's defenses (antibiotic therapy, hypothermia, chronic stress, vitamin deficiency);
- presence of chronic foci of infection (chronic tonsillitis or cavities can serve as a starting point in the development of the disease - the pathogens reach the Bartholin gland hematogenous route);
- menses or the end of the second phase of the cycle;
- microtrauma in the vestibule and / or the labia majora (for example, hair removal);
- wearing narrow and tight underwear (compresses the excretory duct cancer, for which reason the secret centers in the oral cancer and infected);
- neglect of personal hygiene rules;
- promiscuous sex (increased risk of infection with sexually transmitted diseases);
- gynecological intrauterine intervention or surgery on the urinary tract in violation of the rules of asepsis;
- inflammation of the urethra or vagina (urethritis, vaginitis), when the infection is easily penetrates into the excretory duct of the gland.
From personal experience: course of their work I often have to deal with this unpleasant sore.Diagnosis "Bartolini" easily can only be put on how a woman came into the office.Legs "narasshiperku" duck walk, his face a grimace of pain.It is clear that it is very painful, not something to move, and even lie.Of course, all patients are sent straight to the gynecology at the opening of an abscess.I would like to ask, but at the same time to warn all women: "Why endure the pain?What hope? ".Bartolini does not resolve itself, but only faster "mature" and in any case have to go to the doctor when trying to home self-treatment.Therefore, at the slightest discomfort at such a tender intimate place should immediately run to the reception.And further.No woman appealed to the ambulance with acute bartholinitis, because of the sensitivity of the situation, although the ambulance call is possible and necessary, especially when expressed symptoms of intoxication and the inability to move.
As previously reported, predisposes to the appearance of the disease closely underwear.Now there are more fans of strings, especially among young women and young girls.Avoid this "beauty", because in addition to the mechanical inconveniences, wearing strings triggers the development of the disease.
- First, they are too narrow and tightening the external genitalia
- DO Secondly, are made of synthetic materials that do not allow the skin to "breathe".
Depending on how the illness shared by acute and chronic Bartholinitis that often recurs, so it is called recurrent.Acute process may in turn be in the form of false and true abscess Bartholin gland.About false abscess or kanalikulite say when inflamed outer duct cancer, it is sealed, and the inflammatory exudate accumulates in the gland.If true abscesses in the inflammatory process involved not only the iron, but also tissue that surround it.
chronic Bartholinitis develops due to not treat acute process, after spontaneous opening of the abscess.Acute effects subside, but occasionally the disease escalates.Bartholin gland cyst is formed in the case of chronic bartholinitis.
How does Bartolini?
symptoms so characteristic When Bartolini, it is difficult to confuse the disease with something else.
Inflammation of Bartholin gland always starts with kanalikulita, that is festering ductless glands.Marked redness of the skin over the fire of inflammation and swelling of her.At this stage, many patients take Bartholinitis for pimple and try to squeeze it.Thus ductless gland of one or two stands pus drops which are necessary for the tank.study.After some time, the duct becomes blocked (pus such a substance that tends to thicken and form a crust), so that the pus accumulates inside the Bartholin gland, it is stretched and formed the so-called "bump", is located between the lower and middle third large pudendal lips.In tumor formation is marked redness, and skin easily shifted.Since false abscess forms a protrusion large pudendal lips, then closed the entrance to the vagina.Patients experience pain while walking, jogging or coitus, burning sensation in the crotch area.The general condition suffers slightly, the temperature does not rise above subfebrile.
With the introduction of pathogens into the prostate tissue and in tissue that surrounds it, there pyogenic (pus) melting gland parenchyma with the formation of the capsule, which is localized pus.And small and labia swell, and from the unaffected side, too, red and rezkoboleznenny walking, alone, and when you touch.The pain is so intense that the patient can not walk.Noted a significant increase in body temperature (above 38.5 ° C), there are signs of intoxication (weakness, chills, dyspepsia).The pain is different persistence and pulsating character.On examination determined hyperemia and edema of the labia majora, the skin over the abscess hot to the touch, not displaced, and palpation revealed fluctuation (the free movement of the liquid contents in the inflammation).In some cases, increasing the inguinal lymph nodes.
If you do not treat acute process in a timely manner, it is converted into a chronic form.This disease often recurs and the recurrence of different minor phenomena of inflammation and pain.When iron palpation several sealed and sensitive.Chronic Bartolini delivers discomfort during intimacy.The longer the disease, the more likely the formation of Bartholin gland cysts as a result of accumulation of the liquid contents therein.
Diagnosis Diagnosis of the disease is quite simple.bartholinitis diagnosis can be made already during the first treatment of the patient to the doctor.The clinical examination includes at least: the KLA, OAM, smear on the microflora of the vagina, the blood from the veins for HIV and syphilis.It is mandatory to be appointed bacteriological seeding or purulent discharge from the breast duct, or discharge from the vagina to determine the infectious agent and its sensitivity to antibiotics.From additional research methods prescribed PCR smear to detect genital infections (chlamydia, genital herpes, trichomoniasis, human papillomavirus).
Bartholinitis: what to do?
When a bartholinitis treatment should begin immediately.The sooner treatment is started, the better the prognosis.The easiest way to treat Bartolini in kanalikulita stage where treatment can be performed at home.
this purpose appointed antibiotics lasting 7, a maximum of 10 days.Appointed antibiotic treatment together with drugs imidazole group, which are effective against anaerobes (metronidazole, tinidazole).In parallel, and local therapy.Offers many sites of cold treatment consider it inappropriate.As applied to the locus of inflammation ice, no doubt, reduce pain due to deterioration of the blood supply to the site of inflammation, but in doing so will reduce the intake of antibiotics and hearth.
Local treatment ointments
to local therapy include applications with medicinal ointments:
- Vishnevsky ointment;
Masi at Bartolini has a warming property, that is, improve microcirculation and lead to one of two options: either the focus of inflammation resolves, or "comes up to standard", that is, until maturity (the appearance of fluctuations).It is important to
and applications with solutions
solutions differ not only antiseptic characteristics, but also by improving blood flow, fluid is pulled from the site of inflammation, thereby reducing edema (swelling).
also a local conservative treatment bartholinitis can use folk remedies.From the popular methods are assigned warm hip baths with a decoction of herbs:
- mother and stepmother;
- St. John's Wort and others.
can instead infusions of herbs to use a weak solution of potassium permanganate or furatsillina.
Physiotherapy - after decrease in acute-phase therapy continue physiotherapy methods (UFO, UHF).
In case of formation of an abscess Bartholin gland surgery is inevitable.The operation is also carried out in chronic Bartholin (Bartholin gland cyst).If an abscess has formed a Bartholin gland, he immediately reveal (the golden rule of surgeons, "where the pus - there shall open") under local or general anesthesia.The wound was washed extensively first with hydrogen peroxide and then an aqueous solution of chlorhexidine or furatsillina.The postoperative hole gauze turundy entered a period of 5 - 6 days, ie until discharge from the wound will not be "pure" (without the admixture of pus).
Dressings are held daily, with processing wounds with antiseptics.In parallel, after opening bartholinitis appointed antibiotics of different groups:
- macrolides (azithromycin);
- cephalosporin (ceftriaxone, cefuroxime);
- fluoroquinolones (tsiprolet);
- penicillins (amoxiclav).
conjunction with antibiotics Trichopolum appointed for a period of 7 days.
In chronic Bartholin cyst formation, and it is removed in a planned manner in the "cold", that is, with no signs of inflammation, period.To use this method two.Either produce marsupalizatsiyu cysts or removal (extirpation) gland.
During marsupalizatsii cyst revealed a linear cut and the edges filed to the edges of the wound of the skin, thus creating a false opening ductless.The catheter wound to cyst contents flowed out, and it tapers towards the end of the second month, and the tube is removed.
When extirpation reveal the inner surface of the small pudendal lips, sharp iron husks by (scalpel) and removed, the wound sutured.
In the case of diagnosis of acute bartholinitis (false or true abscess) during pregnancy make it an immediate autopsy.A Bartholin gland when it detects its removal brush lay on the post-natal period.Acute Bartholinitis during gestation dangerous spontaneous abortion, intrauterine infection of the fetus and premature birth.
Case study: I had a patient 30 years, which, with enviable regularity, 2 times a year came to a relapse of the disease.And in a quiet moment she had no cysts, no-seal or Bartholin's gland, Bartholinitis but recurred consistently, every 6 months.After first opening the abscess and antibiotic treatment successful woman with a recovery she was discharged home.But I came back, six months later.After the second time of opening an abscess on patient recovery was sent to be tested for sexual infections.No infection was detected.After the third admission to the gynecology department this woman for me, is its recurrent Bartholinitis forced to think.After another successful anti-inflammatory treatment, I sent her to the immunologist.Immunologist, assigning tests revealed serious violations of the immunity and appropriate treatment.Travelled therapy benefited the patient and the more she relapses of the disease are not addressed.
Obstetrician-gynecologist Anna Sozinova