Abscess - Bartholin's

Alternative names

Bartholin's abscess; Infected Bartholin's gland

Definition

Bartholin's abscess involves an accumulation of pus that forms a lump (swelling) in one of the mucus-producing Bartholin's glands, which are located on each side of the vaginal opening at the innermost part of the labia. This swelling is hot to the touch, sensitive, and painful.

Causes, incidence, and risk factors

A Bartholin's abscess forms when a duct (small drainage opening) from the gland gets blocked. Secretions in the gland builds up and may become infected. Many different types of bacteria can cause the infection, including the bacteria that cause gonorrhea. However, these infected glands are usually not caused by a sexually transmitted infection.

Often the abscess can appear and become full-blown within 2 or 3 days. Any activity that puts pressure against the vulva, even walking and sitting, may cause excruciating pain.

Symptoms

• A tender lump on either side of the vaginal opening
  
• Fever
  
• Pain with sexual intercourse
  

Signs and tests

A pelvic examination reveals an enlarged and tender Bartholin's gland.

• Tests may be done to determine if gonorrhea is the cause.
  
• Fluid drainage may be collected for lab analysis.
  
• A biopsy may be recommended in older women to rule out an underlying Bartholin's gland tumor.
  

Treatment

Soaking in warm water 4 times a day for several days usually provides some relief. This may help localize infection and cause the abscess to open and drain on its own. However, this does not always solve the problem, because the site of rupture is usually very small and closes quickly, before drainage is complete.

Surgical incision, which results in complete drainage of the abscess, provides the greatest relief and the fastest recovery. This procedure can be done under local anesthesia in a doctor's office. Placement of an iodoform (antiseptic) gauze wick or a small rubber catheter allows the abscess to continue draining while healing.

Antibiotics may be prescribed to combat the infection, but they are not usually needed if the abscess is drained properly.

Women who have recurrent abscesses may consider a procedure called marsupialization. In this procedure, a small, permanent opening is surgically created to help the gland drain.