What are Bartholin gland cysts. How are Bartholin gland abscesses diagnosed. What treatments are available for Bartholin gland cysts and abscesses. When should women seek medical attention for vulvar symptoms.

Understanding Bartholin Gland Cysts: Causes and Prevalence

Bartholin gland cysts are the most common large vulvar cysts, affecting approximately 2% of women, primarily those in their 20s. These mucus-filled cysts develop on either side of the vaginal opening when the Bartholin gland ducts become obstructed. While the exact cause of obstruction is often unknown, in rare cases, sexually transmitted infections like gonorrhea may be responsible.

The Bartholin glands are small, normally nonpalpable glands located deep in the posterolateral vaginal orifice. Their primary function is to secrete mucus that lubricates the vagina. When the ducts become blocked, mucus accumulates, leading to cyst formation.

Risk Factors and Age-Related Incidence

As women age, the likelihood of developing Bartholin gland cysts decreases. However, it’s important to note that in women over 40, any new vulvar growth should be evaluated carefully to rule out the rare possibility of vulvar cancer, including Bartholin gland carcinoma.

Recognizing Symptoms of Bartholin Gland Cysts and Abscesses

Many Bartholin gland cysts are asymptomatic, but larger cysts can cause noticeable symptoms. Common signs and symptoms include:

• Vulvar pressure or pain
• Dyspareunia (pain during sexual intercourse)
• Vulvar asymmetry
• Difficulty walking

Cysts are typically nontender, unilateral, and palpable near the vaginal opening. They cause distension of the affected labia majora, resulting in visible asymmetry of the vulva.

When Cysts Become Abscesses

In some cases, Bartholin gland cysts can become infected, forming abscesses. Abscess formation is characterized by:

• Severe vulvar pain
• Fever (in some cases)
• Tenderness and erythema of the affected area
• Possible cellulitis with localized redness and swelling
• Vaginal discharge

It’s worth noting that methicillin-resistant Staphylococcus aureus (MRSA) has become increasingly common in Bartholin gland abscesses and other vulvar infections.

Diagnosing Bartholin Gland Cysts and Abscesses

Diagnosis of Bartholin gland cysts is typically straightforward and based on a thorough pelvic examination. During the exam, the healthcare provider will look for signs of vulvar asymmetry and palpate the area to assess the size and tenderness of the cyst.

Diagnostic Procedures and Tests

In some cases, additional diagnostic procedures may be necessary:

1. Discharge sampling: If discharge is present, it may be tested for sexually transmitted infections.
2. Abscess fluid culture: In cases of suspected abscess, fluid may be cultured to identify the causative organism and guide antibiotic therapy.
3. Biopsy: For women over 40, some experts recommend a biopsy to exclude the possibility of Bartholin gland carcinoma or other vulvar cancers.

Treatment Options for Bartholin Gland Cysts and Abscesses

The management of Bartholin gland cysts and abscesses depends on the severity of symptoms, the size of the cyst, and whether infection is present. Treatment options range from conservative measures to surgical interventions.

Conservative Management

For asymptomatic cysts in women under 40, no treatment may be necessary. When mild symptoms are present, conservative measures include:

• Sitz baths: Warm water soaks can help relieve discomfort and may promote spontaneous drainage of small cysts.
• Pain management: Over-the-counter pain relievers can help manage discomfort.

Drainage Procedures

For larger, symptomatic cysts and abscesses, drainage procedures are often necessary. These include:

1. Incision and drainage: A small incision is made in the cyst or abscess to allow drainage of fluid.
2. Catheter placement: After incision, a small balloon-tipped catheter may be inserted and left in place for 4 to 6 weeks. This stimulates fibrosis and creates a permanent opening, reducing the risk of recurrence.
3. Marsupialization: In this procedure, the cyst wall is sutured to the surrounding tissue, creating a permanent opening for drainage.

Surgical Interventions

In some cases, more extensive surgical procedures may be necessary:

• Cyst excision: Complete removal of the cyst and gland may be recommended for recurrent cysts or in women over 40 to rule out malignancy.
• CO2 laser therapy: This minimally invasive technique can be used to vaporize the cyst wall.

Antibiotic Therapy for Bartholin Gland Abscesses

When a Bartholin gland cyst becomes infected and forms an abscess, antibiotic therapy is typically necessary in addition to drainage procedures. The choice of antibiotic depends on several factors:

• Severity of the infection
• Results of culture and sensitivity testing (if available)
• Local antibiotic resistance patterns
• Patient allergies and tolerances

Commonly prescribed antibiotics for Bartholin gland abscesses include:

1. Broad-spectrum antibiotics like amoxicillin-clavulanate or cephalosporins
2. Clindamycin for patients with penicillin allergies
3. Combination therapy with anaerobic coverage in severe cases

In cases where MRSA is suspected or confirmed, antibiotics effective against this resistant strain, such as trimethoprim-sulfamethoxazole or doxycycline, may be prescribed.

Prevention and Long-Term Management of Bartholin Gland Issues

While it’s not always possible to prevent Bartholin gland cysts, certain measures can help reduce the risk of complications and recurrence:

• Practicing good hygiene
• Wearing breathable, cotton underwear
• Avoiding irritating soaps and douches
• Promptly treating any vaginal infections
• Regular gynecological check-ups

For women with recurrent Bartholin gland cysts or abscesses, long-term management strategies may include:

1. Periodic drainage procedures
2. Consideration of gland excision in severe cases
3. Regular follow-up with a gynecologist

When to Seek Medical Attention for Vulvar Symptoms

While many Bartholin gland cysts are asymptomatic and may resolve on their own, certain symptoms warrant prompt medical evaluation. Women should seek medical attention if they experience:

• Severe vulvar pain or swelling
• Fever accompanying vulvar symptoms
• Difficulty urinating or walking due to vulvar discomfort
• Any new vulvar growth, especially in women over 40
• Recurrent Bartholin gland cysts or abscesses

Early intervention can help prevent complications and ensure appropriate treatment, whether it’s conservative management, drainage procedures, or surgical intervention.

Potential Complications and Long-Term Outlook

While Bartholin gland cysts and abscesses are generally benign conditions, they can lead to complications if left untreated. Potential complications include:

• Spread of infection to surrounding tissues
• Sepsis in severe cases
• Chronic pain or discomfort
• Sexual dysfunction due to pain or embarrassment
• Recurrent cysts or abscesses

The long-term outlook for women with Bartholin gland cysts is generally good, especially with proper treatment. Most women experience complete resolution of symptoms following drainage procedures or surgical interventions. However, recurrence is possible, particularly if the underlying cause of duct obstruction persists.

Follow-up Care and Monitoring

After treatment for a Bartholin gland cyst or abscess, follow-up care is important to ensure proper healing and to monitor for recurrence. This may include:

1. Regular check-ups with a gynecologist
2. Self-examination to detect any changes in the vulvar area
3. Prompt reporting of any new symptoms or concerns
4. Continued practice of preventive measures

In rare cases where malignancy is suspected or confirmed, more intensive follow-up and specialized care will be necessary.

Impact on Quality of Life and Psychological Well-being

While Bartholin gland cysts are primarily a physical health concern, they can also impact a woman’s quality of life and psychological well-being. Some women may experience:

• Anxiety about their condition or potential recurrence
• Embarrassment or self-consciousness, particularly during intimate relationships
• Frustration with recurrent symptoms or the need for multiple treatments
• Concerns about fertility or long-term sexual health

Healthcare providers should be sensitive to these psychological aspects and provide appropriate support and reassurance. In some cases, referral to a mental health professional or support group may be beneficial.

Patient Education and Empowerment

Empowering patients with knowledge about their condition is crucial for effective management and peace of mind. Healthcare providers should aim to:

1. Provide clear, accurate information about Bartholin gland cysts and abscesses
2. Discuss all available treatment options and their pros and cons
3. Teach patients how to perform self-examinations
4. Encourage open communication about any concerns or symptoms
5. Provide resources for further information and support

By fostering a collaborative approach to care, healthcare providers can help women feel more in control of their health and better equipped to manage Bartholin gland issues effectively.

Advances in Research and Future Treatment Possibilities

While current treatments for Bartholin gland cysts and abscesses are generally effective, ongoing research aims to improve management strategies and patient outcomes. Some areas of focus include:

• Minimally invasive treatment techniques
• Novel antibiotic delivery methods for abscesses
• Improved understanding of risk factors and prevention strategies
• Development of targeted therapies to prevent recurrence

As research progresses, new treatment options may become available, potentially offering more efficient, less invasive, and longer-lasting solutions for women affected by Bartholin gland issues.

The Role of Genetics and Personalized Medicine

Emerging research is exploring the potential role of genetics in Bartholin gland disorders. This could lead to:

1. Identification of genetic markers for increased susceptibility
2. Development of personalized prevention strategies
3. Tailored treatment approaches based on individual genetic profiles

While still in its early stages, this area of research holds promise for more targeted and effective management of Bartholin gland cysts and abscesses in the future.

In conclusion, Bartholin gland cysts and abscesses are common gynecological conditions that, while generally benign, can cause significant discomfort and concern for affected women. With proper diagnosis and treatment, most cases can be effectively managed, allowing women to maintain their quality of life and sexual health. As research continues to advance our understanding of these conditions, we can look forward to even more effective and personalized treatment options in the future.

Bartholin Gland Cyst and Bartholin Gland Abscess – Gynecology and Obstetrics

By

Kilpatrick

, MD, MEd, Baylor College of Medicine

Reviewed/Revised Feb 2023

View Patient Education

Topic Resources

Bartholin gland cysts are the most common large vulvar cysts. They are mucus-filled and are located on either side of the vaginal opening. Symptoms of large cysts include vulvar pressure or pain, dyspareunia, and vulvar asymmetry. Bartholin gland cysts may form abscesses, which are painful. Diagnosis is by pelvic examination. Large cysts and abscesses require drainage and sometimes excision; abscesses require antibiotics.

Bartholin glands are round, very small, nonpalpable, and located deep in the posterolateral vaginal orifice. Obstruction of the Bartholin duct causes the gland to enlarge with mucus, resulting in a cyst. Cause of obstruction is usually unknown. Rarely, the cysts result from a sexually transmitted infection Overview of Sexually Transmitted Infections Sexually transmitted infection (STI) refers to infection with a pathogen that is transmitted through blood, semen, vaginal fluids, or other body fluids during oral, anal, or genital sex with… read more (eg, gonorrhea).

Vulvar Anatomy

Bartholin gland cysts develop in about 2% of women, usually those in their 20s (1). With aging, cysts are less likely to develop.

A cyst may become infected, forming an abscess. Methicillin-resistant Staphylococcus aureus (MRSA) has become more common in such infections (and in other vulvar infections).

Rarely, vulvar cancers Vulvar Cancer Vulvar cancer is usually a squamous cell cancer, most often occurring in older women. It usually manifests as a palpable lesion. Diagnosis is by biopsy. Treatment typically includes excision… read more originates in Bartholin glands.

• 1. Berger MB, Betschart C, Khandwala N, et al: Incidental Bartholin gland cysts identified on pelvic magnetic resonance imaging. Obstet Gynecol 120 (4):798–802, 2012. doi: 10.1097/AOG.0b013e3182699259

Most Bartholin gland cysts are asymptomatic, but large cysts can be irritating, cause pressure or pain, and interfere with sexual intercourse or walking. Most cysts are nontender, unilateral, and palpable near the vaginal orifice. Cysts distend the affected labia majora, causing vulvar asymmetry.

If an abscess develops, it causes severe vulvar pain and sometimes fever; abscesses are tender and typically erythematous. Cellulitis Cellulitis Cellulitis is acute bacterial infection of the skin and subcutaneous tissue most often caused by streptococci or staphylococci. Symptoms and signs are pain, warmth, rapidly spreading erythema… read more with localized erythema, and tenderness may develop. A vaginal discharge may be present. Sexually transmitted diseases may coexist.

• Clinical evaluation

Diagnosis of Bartholin gland cysts is usually by examination of the vulva. A sample of discharge from the cyst, if present, may be tested for sexually transmitted infections. Abscess fluid should be cultured.

In women > 40 years old, some experts recommend biopsy to exclude Bartholin gland carcinoma or other vulvar cancer.

• Sitz baths for mild symptoms

• For abscesses, incision and drainage and usually placement of a catheter for drainage

• Surgery for more severe symptoms and for all cysts in women > 40

In women &lt 40, asymptomatic cysts do not require treatment. Mild symptoms may resolve with sitz baths. Otherwise, symptomatic cysts may require a procedure to drain or remove the cyst.

For abscesses, a procedure is done to produce a permanent opening from the gland to the exterior because abscesses often recur after simple drainage. A small incision is made in the cyst and/or abscess, and then one of the following is done:

• Catheter insertion: A small balloon-tipped catheter may be inserted, inflated, and left in the cyst for 4 to 6 weeks; this procedure stimulates fibrosis and produces a permanent opening.

• Marsupialization: The everted edges of the cyst are sutured to the exterior.

Abscesses are sometimes treated with a procedure and an oral antibiotic regimen that covers MRSA (eg, trimethoprim 160 mg/sulfamethoxazole 800 mg once or twice a day OR trimethoprim 160 mg/sulfamethoxazole 800 mg once or twice a day PLUS amoxicillin-clavulanate 875 mg twice a day OR trimethoprim 160 mg/sulfamethoxazole 800 mg once or twice a day PLUS metronidazole 500 mg 3 times a day). Oral antibiotics should be used when cellulitis Treatment Cellulitis is acute bacterial infection of the skin and subcutaneous tissue most often caused by streptococci or staphylococci. Symptoms and signs are pain, warmth, rapidly spreading erythema… read more is also present; antibiotics should be chosen based on that region’s antibiogram. Inpatient admission for IV antibiotics should be strongly considered if patients have poorly controlled diabetes mellitus or are immunocompromised.

Recurrent cysts or abscesses may require complete excision of the Bartholin gland.

In women > 40, newly developed cysts or abscesses should be surgically biopsied (to exclude vulvar cancer) or removed. Cysts that have been present for years and have not changed in appearance do not require biopsy or surgical removal unless symptoms are present.

• Bartholin gland cysts are vulvar cysts.

• They result from ductal obstruction; the cause is usually unknown.

• Cysts may become infected, sometimes with MRSA, and form an abscess.

• For abscesses and for cysts that cause bothersome symptoms, treat with an incision and drainage procedure (eg, with catheter insertion, marsupialization, and/or excision).

• In women > 40 years old, biopsy newly developed cysts to exclude vulvar cancer

• Surgically remove a Bartholin gland if a patient has recurrent cysts or abscesses or if cancer is suspected.

NOTE:


This is the Professional Version.


CONSUMERS:



View Consumer Version

Copyright © 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved.

Test your knowledge

Take a Quiz! 

Bartholin Gland Cyst – StatPearls

Continuing Education Activity

A Bartholin gland cyst is usually a unilateral, asymptomatic blockage of the Bartholin gland that may be incidentally discovered during a pelvic exam or imaging studies. The activity describes the evaluation and management of Bartholin gland cyst and reviews the role of the interprofessional team in improving care for patients with this condition.

Objectives:

• Describe the common causes of gland obstruction which lead to Bartholin gland cysts.

• Outline the appearance of a Bartholin gland cyst and differentiate it from Bartholin gland abscess during the physical examination.

• Identify the treatment of symptomatic Bartholin gland cysts by incision and drainage with Word catheter placement.

• Outline the importance of collaboration and clear communication among the interprofessional team members to enhance care coordination and delivery of the best possible standard of care for patients with Bartholin gland cyst.

Access free multiple choice questions on this topic.

Introduction

Bartholin glands, also known as the greater vestibular glands, are a pair of 0.5 cm glands located in the lower right and left portions at the 4 o’clock and 8 o’clock positions of the vaginal introitus. The Bartholin gland is a mucus-secreting gland, which plays a role in vaginal lubrication. Bartholin glands are generally nonpalpable when not obstructed. Cysts and abscesses are often found after the onset of puberty and a decrease in incidence after menopause.[1]

Etiology

A Bartholin gland cyst is a benign blockage of the Bartholin gland that is usually unilateral, asymptomatic, and maybe incidentally found during a pelvic exam or imaging studies. Bartholin gland obstruction may occur after trauma to the area, episiotomy, or childbirth; however, it may also occur without an identifiable cause.[2]

Epidemiology

Bartholin cysts/abscesses are predominantly found in women of child-bearing age. The incidence of Bartholin cysts is most often noted at the onset of puberty and increases with age until menopause.[3] Symptomatic Bartholin cysts and abscesses account for 2 percent of all gynecologic visits per year.[4]

Pathophysiology

Bartholin glands can form a cyst and an abscess in women of reproductive age. Both are difficult to differentiate on a physical exam. The cyst is usually 2-4 cm in diameter and may cause dyspareunia, urinary irritation, and vague pelvic pain. The cyst is usually filled with nonpurulent fluid that contains staphylococcus, streptococcus, and E.coli.

History and Physical

When examining a patient with a suspected Bartholin gland cyst/abscess, it is important to inquire about the duration of symptoms; tenderness with activities such as walking, sitting, standing, or sexual intercourse; purulent drainage; and history of previous Bartholin gland cyst/abscess, vaginal bleeding/discharge, or sexually transmitted infections. Bartholin cysts often have a protracted course as they are mainly asymptomatic. Take into consideration the patient’s age, because malignancy, while rare, may have a similar presentation.

The physical exam will often reveal asymmetry with a protrusion of one side (left or right) of the inferior aspect of the vulva. Bartholin gland abscesses, unlike Bartholin cysts, are very painful. While both are primarily unilateral, Bartholin abscesses are often tender to palpation, erythematous, indurated, and may have an area of fluctuance and/or purulent drainage.

Evaluation

Bartholin cyst abscesses do not frequently require further laboratory or radiographic studies; however, wound cultures and biopsy may be performed during incision and drainage of the abscess. If sexually transmitted infections are suspected, then a sexually transmitted infection panel (including gonorrhea, chlamydia) should be considered and appropriate treatment initiated. 

If malignancy is suspected due to an atypical presentation of the mass or if the patient is over 40 years old, then a biopsy should be considered.[5]

Treatment / Management

Asymptomatic Bartholin cysts do not require further treatment. Bartholin cysts or abscesses that are spontaneously draining may be managed conservatively with sitz baths and analgesics.

Although no modality of treatment, surgical or conservative, is superior to any other in terms of recurrence rate,[6] first-time Bartholin abscesses may be treated with incision and drainage with Word catheter placement due to ease and effectiveness of treatment.

Allergy history should be obtained before beginning the procedure as the Word catheter stem is composed of latex, and marsupialization is the procedure of choice in those with latex allergies.

Although this is not a sterile procedure, a mask with a face shield and a gown are recommended.

Incision and drainage with Word catheter are performed by first cleaning the region with povidone-iodine and anesthetizing the location where the incision will be made with 3 mL of 1% lidocaine. A small, approximately 3 mm, a vertical incision should be made with a #11 scalpel along the mucosal surface of the labia minora to avoid obvious scarring and to reduce the risk of Word catheter displacement. Purulent discharge evacuated may be sent to the lab for cultures, and biopsy may also be performed at this time. Word catheter is then inserted with the balloon tip sitting within the abscess cavity. Inflate the balloon tip with 3 to 5mL of saline water. For comfort and to reduce the chance of displacement, the external portion of the Word catheter is pushed into the vagina. Word catheters should be left in place for at least 4 weeks for appropriate drainage and tract epithelization.[7]

Incision and Drainage with Word catheter placement may be attempted a second time for recurrent Bartholin abscess with the addition of antibiotics. Antibiotics should cover staphylococcal, specifically methicillin-resistant Staphylococcus aureus, and streptococcal species as well as enteric gram-negative aerobes, including Escherichia coli. Antibiotic choices include trimethoprim-sulfamethoxazole alone, amoxicillin-clavulanate plus clindamycin, or cefixime plus clindamycin. Referral to gynecology for marsupialization may also be considered at this time.

Antibiotic therapy should be considered for those who have failed initial I&D (incision and drainage) with Word catheter placement, patients with systemic symptoms including fever, patients who have suspected sepsis, and those considered at high risk for recurrence.

Marsupialization is performed by a gynecologist in the operating room, and for this reason, incision and drainage with Word catheter placement are usually attempted first. Marsupialization is performed by creating a 2-cm incision lateral to the hymenal ring, everting the edges with forceps, and suturing the edges onto the epithelial surface with interrupted absorbable sutures.[8]

Other less common procedures include silver nitrate ablation,[9] carbon dioxide laser vaporization,[10] Jacobi ring placement [11], and Bartholin gland excision as a last resort when other modalities have failed.

Women who are pregnant and have Bartholin abscesses should be treated in the same manner as nonpregnant women, with the exception of Bartholin gland excision due to the increased risk of bleeding.

Differential Diagnosis

• Other cysts (inclusion, Gartner, Skene, sebaceous, canal of Nuck)

• Vaginal prolapse

• Vulvar angiomyofibroblastoma

• Endometriosis

• Choriocarcinoma

• Myeloid sarcoma

• Perineal leiomyoma

• Myxoid leiomyosarcoma

• Fibroma

• Angiomyxoma

• Hematoma

• Myoblastoma

• Ischiorectal abscess

• Folliculitis

• Fibroadenoma

• Lipoma

• Papillary hidradenoma

• Syringoma

• Adenocarcinoma

• Squamous cell carcinoma

Pertinent Studies and Ongoing Trials

In the WoMan-trial (world catheter and marsupialization in women with a cyst or abscess of the Bartholin gland), a randomized controlled trial in the Netherlands and England between August 2010 and May 2014, 161 women were randomly allocated to treatment by Word catheter or marsupialization to compare recurrence of a cyst or abscess within 1 year.  

Recurrence occurred in 10 women (12%) in the Word catheter group and 8 women (10%) in the marsupialization group. Within the first 24 hours after treatment, 33% used analgesics in the Word catheter group versus 74% in the marsupialization group. Time from diagnosis to treatment was 1 hour for placement of Word catheter versus 4 hours for marsupialization.

Recurrence rates were found to be comparable within the two groups; however, the marsupialization group had increased use of analgesics within the first 24 hours and increased the duration of treatment.[6]

Prognosis

The prognosis is excellent but if the cyst is just aspirated, high recurrence rates have been reported. The healing and recurrence rates are similar among fistulization, marsupialization, and silver nitrate and alcohol sclerotherapy. Needle aspiration and incision and drainage, the two simplest procedures, are not recommended because of the relatively increased recurrence rate.[12]

Complications

The treatment of Bartholin’s gland cysts by traditional surgery is characterized by some disadvantages and complications such as hemorrhage, postoperative dyspareunia, infections, the necessity for general anesthesia. Contrarily, CO2 laser surgery might be less invasive and more effective as it solves many problems of traditional surgery.[13]

Postoperative and Rehabilitation Care

Sitz baths are recommended for a few days. Early ambulation and consumption of an ample amount of water are highly recommended.

Deterrence and Patient Education

The clinician, the nurse, and the pharmacist play a pivotal role in educating patients and their families about their condition. Women should be instructed to observe for any signs of infection, such as foul-smell vaginal discharge or any abnormal bleeding. Women should be encouraged to drink an ample amount of water and ambulate early, as this will help to speed their recovery.

Enhancing Healthcare Team Outcomes

The nurse, the clinician, and the pharmacist must collaborate efficiently during the care of women with Bartholin gland pathology, in order to achieve the best possible outcome for these women and their families. Women with a Bartholin gland cyst are usually first seen by the primary care provider, nurse practitioner or internist. Because of the extensive differential, it is important to involve the gynecologist in the care of these patients.

The pharmacist has a very important role in educating patients about the available antimicrobial agents and in providing them with the required information about drug-drug interactions, in order to avoid any possibly preventable complications. The pharmacist should educate the patient on compliance and encourage them to immediately report any adverse events or any concerns. 

While the actual drainage or marsupialization is done by the gynecologist, the patient follow up and teaching are done by the nurse practitioner. The nurse practitioner should educate the patient on how to perform sitz baths and maintaining perineal hygiene. If antibiotics are prescribed. All patients need a follow up to ensure healing has occurred.

The best standard of care to women with Bartholin gland cysts or abscesses could never be achieved without the interprofessional collaboration between the nurse, the clinician, and the pharmacist. Clear and effective communication among the members of the interprofessional team is key to the successful management of women with Bartholin gland pathology. [Level V] 

Review Questions

• Access free multiple choice questions on this topic.

• Comment on this article.

Figure

Bartholin Gland Word Catheter example used in the management of Bartholin cysts in some cases. Contributed by Tammy J. Toney-Butler, AS, RN, CEN, TCRN, CPEN

Figure

Bartholin’s Gland Cyst. StatPearls Publishing Illustration

References

1.

Lee WA, Wittler M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Jan 30, 2023. Bartholin Gland Cyst. [PubMed: 30335304]

2.

Pundir J, Auld BJ. A review of the management of diseases of the Bartholin’s gland. J Obstet Gynaecol. 2008 Feb;28(2):161-5. [PubMed: 18393010]

3.

Yuk JS, Kim YJ, Hur JY, Shin JH. Incidence of Bartholin duct cysts and abscesses in the Republic of Korea. Int J Gynaecol Obstet. 2013 Jul;122(1):62-4. [PubMed: 23618035]

4.

Marzano DA, Haefner HK. The bartholin gland cyst: past, present, and future. J Low Genit Tract Dis. 2004 Jul;8(3):195-204. [PubMed: 15874863]

5.

Visco AG, Del Priore G. Postmenopausal bartholin gland enlargement: a hospital-based cancer risk assessment. Obstet Gynecol. 1996 Feb;87(2):286-90. [PubMed: 8559540]

6.

Kroese JA, van der Velde M, Morssink LP, Zafarmand MH, Geomini P, van Kesteren P, Radder CM, van der Voet LF, Roovers J, Graziosi G, van Baal WM, van Bavel J, Catshoek R, Klinkert ER, Huirne J, Clark TJ, Mol B, Reesink-Peters N. Word catheter and marsupialisation in women with a cyst or abscess of the Bartholin gland (WoMan-trial): a randomised clinical trial. BJOG. 2017 Jan;124(2):243-249. [PubMed: 27640367]

7.

Reif P, Ulrich D, Bjelic-Radisic V, Häusler M, Schnedl-Lamprecht E, Tamussino K. Management of Bartholin’s cyst and abscess using the Word catheter: implementation, recurrence rates and costs. Eur J Obstet Gynecol Reprod Biol. 2015 Jul;190:81-4. [PubMed: 25963974]

8.

JACOBSON P. Vulvovaginal (Bartholin) cyst treatment by marsupialization. West J Surg Obstet Gynecol. 1950 Dec;58(12):704-8. [PubMed: 14798829]

9.

Ozdegirmenci O, Kayikcioglu F, Haberal A. Prospective Randomized Study of Marsupialization versus Silver Nitrate Application in the Management of Bartholin Gland Cysts and Abscesses. J Minim Invasive Gynecol. 2009 Mar-Apr;16(2):149-52. [PubMed: 19598336]

10.

Fambrini M, Penna C, Pieralli A, Fallani MG, Andersson KL, Lozza V, Scarselli G, Marchionni M. Carbon-dioxide laser vaporization of the Bartholin gland cyst: a retrospective analysis on 200 cases. J Minim Invasive Gynecol. 2008 May-Jun;15(3):327-31. [PubMed: 18439506]

11.

Kushnir VA, Mosquera C. Novel technique for management of Bartholin gland cysts and abscesses. J Emerg Med. 2009 May;36(4):388-90. [PubMed: 19038518]

12.

Omole F, Kelsey RC, Phillips K, Cunningham K. Bartholin Duct Cyst and Gland Abscess: Office Management. Am Fam Physician. 2019 Jun 15;99(12):760-766. [PubMed: 31194482]

13.

Frega A, Schimberni M, Ralli E, Verrone A, Manzara F, Schimberni M, Nobili F, Caserta D. Complication and recurrence rate in laser CO2 versus traditional surgery in the treatment of Bartholin’s gland cyst. Arch Gynecol Obstet. 2016 Aug;294(2):303-9. [PubMed: 26922440]

Disclosure: William Lee declares no relevant financial relationships with ineligible companies.

Disclosure: Micah Wittler declares no relevant financial relationships with ineligible companies.

Types, Symptoms and Methods of Treatment

The information provided in this article cannot be used for diagnosis, treatment and does not replace the advice of a doctor.

Created: 01/27/2020

Last edited: 03/22/2021

41158

Contents:

• Types of tooth abscess
• Symptoms of tooth abscess
• Causes of tooth abscess
• Complications of tooth abscess
• Diagnosis of tooth abscess
• Treatment of tooth abscess
• Dental abscess prophylaxis

Tooth abscess is an acute infectious disease that develops in the area of ​​the tooth roots. Often, this disease is faced by people who do not carry out sufficient oral hygiene. When there are defects on the teeth, expressed by cracks and chips, carious lesions, bacteria penetrate into their soft parts and settle there, which is why an inflammatory process occurs, pus forms and the gums swell.

There are nerve endings in the area of ​​the pulp, so any inflammation is accompanied by a strong pain syndrome. The development of an abscess occurs quite quickly, if urgent measures are not taken, the bone tissue will be affected, and the integrity of the tooth becomes jeopardized.

With self-treatment of a tooth abscess, it will not be possible to achieve a good result, perhaps for a short period of time the pain will be stopped, but this threatens with more serious consequences. In order for the treatment to be successful, it is necessary to contact a specialist in a timely manner and receive qualified assistance.

Tooth abscess photo:

Types of tooth abscess The process of the tooth is located in the dental cavity as a result of the necrosis of the pulp.

Its main difference is that pus accumulates directly under the root of the tooth.

When the amount of accumulated pus is small, it is kept in a limited space, as if in a sac. As the inflammation and volume of pus increase, a fistula occurs – this is a kind of channel that connects the abscess and the external environment. This is a round hole that appears in the gum that swells around the edges. Pus is released from the wound in the form of a white spot.

Symptoms of tooth abscess

Bacteria begin to infect one tooth, but if emergency measures are not taken, suppuration will spread to nearby neighbors. The abscess begins painfully – swelling and severe pain appear at the site of the lesion. Taking painkillers, the pain goes away for a short period of time, and subsequently manifests itself with greater force.

If you are worried about a tooth abscess, the symptoms will be:

• Pain when chewing and pressing on the tooth.
• Pain in the gum area when there is pressure on it.
• There is an unpleasant taste in the mouth, bitter, and also an unpleasant odor.
• The gums are swollen.
• Facial asymmetry may appear.
• Lymph nodes increase in size.
• Fever and headache.

If emergency measures are not taken, wounds with pus will begin to appear on the gum. Please note that if the abscess bursts, the pain will subside, but this does not mean that the disease has passed. The bacteria that caused the development of the disease will still be located in the tissues of the tooth, so the recurrence of inflammation will not be long in coming.

Causes of a tooth abscess

The onset of the disease often occurs in the dead pulp after root canals have been unsuccessfully treated. In children, an abscess occurs as a consequence of untreated caries. With adults, the situation is a little different, since the formed and strengthened immunity makes it easier for the body to cope with various inflammations.

Main causes of gum or tooth abscess:

• Gum disease.
• Carious destruction of teeth.
• Cysts on teeth, granulomas.
• Cracks and chips of teeth.
• Various injuries in the oral cavity.
• Poor oral hygiene.
• Weak immunity.

Please note that infection can occur anywhere in the body, and the bacterium enters the gum through the bloodstream. That is why, any infectious diseases require careful attention, in particular, in the ENT part, as well as methods and ways to increase immunity, if there are problems with it.

Complications of a tooth abscess

Please note that a festering tooth abscess does not go away on its own. Even if the pus has flowed out, you have opened the abscess yourself, the pain syndrome will be reduced, but dental treatment is necessary and mandatory. Without drainage of the abscess, complications will arise in the tissues of the lower jaw, in the head or neck, in extreme cases, sepsis will develop, the infection will spread throughout the body through the circulatory system.

Diagnosis of a tooth abscess

The dentist examines the affected tooth, oral cavity, tissues located near the site of inflammation, after that:

• the affected tooth is tapped, it will be painful, sensitive to touch and pressure;
• X-ray examination is performed to see the extent and localization of tooth damage;
• CT of the head and neck is performed to determine the location and spread of the infection throughout the body;
• undergo laboratory tests to determine which bacterium caused the infection. This is necessary in order to correctly prescribe antibiotic therapy;
• When the abscess is diagnosed and confirmed, the extent of the lesion is determined, appropriate treatment is prescribed.

Treatment of a tooth abscess

If a tooth abscess is diagnosed, treatment will be aimed at minimizing and nullifying the infectious process. In particular, the treatment consists of:

• Opening, drainage of abscess – an incision is made near the location of the abscess to neutralize pus, after which the open cavity is washed with saline, the tissue near the open wound is treated in the same way.
• Forming the root canal of the dental pulp – the affected tissues are removed, the abscess is drained, a special sealant is introduced into the voids formed to neutralize the development and spread of the infection, and also make every effort to save the tooth. To strengthen the tooth, a crown can be added later.
• Extraction of the affected tooth occurs if it cannot be saved. The tooth is then removed and the abscess drained.
• Antibacterial therapy is necessary in order to prevent the spread of infection to tissues, teeth, located near the affected area.

To relieve the pain of a tooth abscess, you can rinse with warm salt water or use a special dental solution. You can also take painkillers.

Tooth abscess prevention

Teeth require some care to prevent further inflammation and decay:

• when drinking water, when rinsing the mouth, give preference to fluoridated water;
• brush your teeth twice a day with a special fluoride toothpaste, rinse your mouth after each meal;
• Replace your toothbrush with a new one every 3-4 months;
• give preference to healthy food, minimize sweets, starchy foods;
• every six months visit the dentist for examination, professional dental hygiene.

If you are faced with the fact that an abscess has appeared on the gums, immediately contact your dentist to receive high-quality and professional help, because you will not be able to cope with the disease on your own. By following all the recommendations for treatment, you will quickly get rid of the disease and its consequences.

Did you like it here? – Share the page with your friends!

31 votes, rating: 4.5 out of 5

Adhesions in the corners of the mouth – causes, treatment, prevention

Adhesions

Table of contents

• How do seizures manifest themselves?
• Causes of jamming in the corners of the mouth
• Symptoms of pathology
• Diagnosis of angulitis
• Treatment of jamming in the corners of the mouth
• Help in the clinic “Mama Papa Ya”
  
  

  ---

900 27

{loadposition banner-pv}Lip sticks, or corner cheilitis – a disease accompanied by the formation of areas of inflammation in the corners of the mouth. This condition can be unilateral or bilateral. In severe cases, it causes severe pain and an aesthetic defect.

How do seizures manifest themselves?

Seizures in the corners of the mouth are the result of swelling, inflammation and cracks in the skin that occur when the skin is malnourished. As a result, skin erosions and sores may appear.

Although this disease looks like herpes, it is not contagious. The inflammation also does not spread to other parts of the body. However, unilateral bites often affect both corners of the mouth over time.

Causes of jamming in the corners of the mouth

Cheilitis occurs if the corners of the mouth are constantly moistened, and there is a violation of the local immune defense of the skin. The most common causes of corners of the mouth are a fungal or bacterial infection that causes angulitis in the presence of these risk factors:

• braces on teeth;
• improperly fitted dentures;
• habit of constantly licking lips;
• salivation;
• malocclusion;
• missing part of the teeth, eg in the elderly;
• decreased elasticity of the skin around the mouth as a result of rapid weight loss or aging;
• smoking;
• deficiency of B vitamins, zinc and/or iron in the body;
• malnutrition;
• associated atopic dermatitis and other allergic diseases.

Thumb sucking is the cause of seizures in children.

Angular cheilitis often develops in patients with anemia, leukemia, Down’s syndrome, weakened immune system, oncological diseases, as well as in people with diabetes mellitus. Fungi of the genus Candida – the direct cause of inflammation – multiply well with a high level of glucose in the blood. In addition, diabetes weakens the immune system, making it difficult to fight infection.

Seizures often occur in people suffering from anorexia or bulimia. They are also included in the complex of signs of the Plummer-Vinson syndrome (damage to the esophagus, iron deficiency anemia, glossitis and cheilitis). Finally, this symptom appears with hypervitaminosis A, which can develop when it is excessive in food (for example, in cod liver) or in food supplements taken.

Symptoms of pathology

In case of slight inflammation, there is peeling in the corner of the mouth and discomfort when it is opened wide. Later, swelling and redness occur at the site of the lesion, small cracks appear, and the pain intensifies.

With significantly pronounced seizures, the following are noted:

• pain during eating or talking;
• sores and crusts in the corners of the mouth;
• non-healing cracks.

Stuck at the corners of the mouth – causes and treatment – require a visit to the dentist and dermatologist. Independent attempts to cope with this pathology are rarely successful. Patients suffer for a long time not only from pain. They may have problems communicating with family members, colleagues, clients at work, because with severe angulitis, the external manifestations of the disease are pronounced and unpleasant for others.

Angulitis Diagnosis

To diagnose angular cheilitis, your doctor will perform a thorough examination of the lips and oral mucosa, looking for cracks, redness, swelling, or blistering of the skin. He will also find out the possible causes of the disease in order to choose the most effective treatment for zaed.

To diagnose similar-looking conditions, such as herpes labialis and erosive lichen planus, a specialist may take a swab from the damaged surface and send the material for analysis.

Treatment of seizures in the corners of the mouth

To determine how to treat seizures, sometimes you have to consult with specialists in various fields, including an endocrinologist, an infectious disease specialist, a gastroenterologist, a hematologist. It is better if the patient can be treated by a team of doctors in one clinic.

How to get rid of a jam forever? To do this, it is necessary to eliminate the infection and high humidity of the affected area. Usually, an antifungal ointment is prescribed for seizures, and in the presence of a secondary infection, antibacterial drugs. In some cases, a dermatologist may prescribe a cream with glucocorticoids, but self-medication with such drugs is strongly discouraged. For children, special safe ointments and other medicines are selected.

How to treat bites in the corners of the lips, if they are not caused by an infectious process? In this case, it is necessary to clarify their cause (vitamin deficiency, anemia, diabetes, and so on) and, if possible, eliminate it. The skin lesions themselves are treated with a neutral agent, for example, petroleum jelly. It is important to stop smoking and organize proper nutrition, rich in proteins and vitamins.

Many patients are looking for an effective home remedy for jam. In this case, the doctor suggests the following methods:

• rubbing the skin with fresh cucumber slices;
• treatment of the corners of the mouth with aloe juice;
• lubrication of cracks with tea tree oil, which can be purchased at the pharmacy and mixed with honey or a few drops of liquid vitamin E;
• drinking plenty of water;
• eating leafy greens, tomatoes, carrots, fruits rich in vitamins.

Anti-seizure medicine should be used for a sufficiently long time until the cracks are completely healed and signs of inflammation disappear.

Help at the Mama Papa Ya Clinic

The Mama Papa Ya family clinic network invites patients who are worried about angulitis to get a doctor’s consultation and learn how to cure seizures most quickly and effectively.

We offer:

• consultations of doctors of different profiles (dentist, dermatologist, endocrinologist and others) in one medical center;
• thorough diagnosis of the causes of the disease and their elimination;
• affordable prices for medical services;
• treatment of patients of all ages.

Make an appointment with a dermatologist by phone or using the form on our website.

Description:

Seizures – inflammation and cracks in the corners of the mouth, usually caused by a fungal infection against the background of increased skin moisture, nutritional deficiencies and reduced immunity.

Reviews

Good clinic, good doctor! Raisa Vasilievna can clearly and easily explain what the essence of the problem is. If something is wrong, she talks about everything directly, not in a veiled way, as other doctors sometimes do. I don’t regret that I went to her.

Anna

I would like to thank the staff of the clinic Mom, Dad, me. The clinic has a very friendly atmosphere, very friendly and cheerful staff and highly qualified specialists. Thank you very much! I wish prosperity to your clinic.

Anonymous user

Today I removed a mole on my face at the dermatologist Kodareva I.A. Doctor is very thorough! Correct! Thanks a lot! Administrator Borshchevskaya Julia is friendly, clearly fulfills her duties.

Belova E.M.

Today I was served in the clinic, I was satisfied with the staff, as well as the gynecologist. Everyone treats patients with respect and care. We thank them very much and continue to prosper.

Anonymous

The Mama Papa Ya clinic in Lyubertsy is very good. The team is friendly and responsive. I recommend this clinic to all my friends.