What are the symptoms of swollen lymph nodes in the labia majora?

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Question
Hello doctor,
I have a swollen lymph node on the big lip of my vagina. It didn’t hurt at first, but walking and sitting back hurt. So the doctor told me that swollen lymph nodes in the vagina are a sign of disease? How is the treatment? Thank you doctor.
Anonymous customer
Answer
Answered by Master, Specialist II Phung Thi Ly – Obstetrician and Gynecologist – Obstetrics Department, Vinmec Times City International Hospital.
Hello,
With the question “What is the sign of lymphadenopathy in the large labia? “, the doctor would like to answer as follows:
If you have swollen lymph nodes in your big lip, sitting with pain, you may have a Bartholin gland cyst. Bartholin’s cyst or Bartholin’s gland inflammation is a cystic lesion of the Bartholin glands. These glands are located on each side of the vulva (the outer area of ​​the vagina). The function of the Bartholin glands is to secrete fluid into the labia majora to keep it moist and lubricated during intercourse.
Sometimes the ducts become blocked, causing fluid to back up into the gland, resulting in the formation of a thin-walled, swollen, painless cyst called a Bartholin’s cyst. If the fluid in the cyst becomes infected, there is a risk of a discharge of pus surrounded by inflamed tissue (abscess) and causing pain when sitting or walking.
Severe cases of Bartholin’s cyst infection can progress in a few days. If an infection is present, the patient may experience the following symptoms:
The appearance of a painful, painful lump near the vagina; Discomfort when walking or sitting; Pain during intercourse; Ideally, you should go to the hospital soon so that the doctors can diagnose and treat you.
If you still have questions about lymph nodes in the labia majora, you can go to the hospital of Vinmec Health System for further examination and advice. Thank you for trusting and sending questions to Vinmec. Wishing you lots of health.
Best regards!

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XEM THÊM:

• Are bartholin cysts dangerous?
• What is a Bartholin cyst and is it dangerous?
• Which gland helps to secrete mucus that lubricates the vagina?

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Bartholin cyst or abscess Information | Mount Sinai

Abscess – Bartholin; Infected Bartholin gland

Bartholin abscess is the buildup of pus that forms a lump (swelling) in one of the Bartholin glands. These glands are found on each side of the vaginal opening.

External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries, and cervix.

Bartholin glands are found on each side of the vaginal opening. A Bartholin cyst is a buildup of fluid that occurs if the opening of the gland is blocked. A Bartholin abscess may occur if the cyst fluid becomes infected. The Bartholin cyst or abscess appears as a lump or swelling on the side of the vaginal opening.

Causes

A Bartholin abscess forms when a small opening (duct) from the gland gets blocked. Fluid in the gland builds up and may become infected. Fluid may build up over many years before an abscess occurs.

Often the abscess appears quickly over several days. The area will become very hot and swollen. Activity that puts pressure on the vulva, and walking and sitting, may cause severe pain.

Symptoms

Symptoms may include:

• A tender lump on either side of the vaginal opening
• Swelling and redness
• Pain with sitting or walking
• Fever, in people with low immunity
• Pain with sexual intercourse
• Vaginal discharge
• Vaginal pressure

Exams and Tests

The health care provider will do a pelvic exam. The Bartholin gland will be enlarged and tender. In rare cases, a biopsy may be suggested in older women to look for a tumor.

Any vaginal discharge or fluid drainage will be sent to a lab for testing.

Treatment

SELF-CARE STEPS

Soaking in warm water 4 times a day for several days can ease the discomfort. It can also help the abscess open and drain on its own. However, the opening is often very small and closes quickly. Therefore, the abscess often returns.

DRAINAGE OF THE ABSCESS

A small surgical cut can completely drain the abscess. This relieves symptoms and provides the fastest recovery.

• The procedure can be done under local anesthesia in a provider’s office.
• A 1 to 2 cm cut is made at the site of abscess. The cavity is irrigated with normal saline. A catheter (tube) may be inserted and left in place for 4 to 6 weeks. This allows continuous drainage while the area heals. Sutures are not required.
• You should begin soaking in warm water 1 to 2 days afterward. You cannot have sexual intercourse until the catheter is removed.

You may be asked to have antibiotics if there is pus or other signs of infection.

MARSUPIALIZATION

Women can also be treated with a minor surgery called marsupialization.

• The procedure involves creating an elliptical opening along the cyst to help the gland drain. The abscess is removed. The provider places stitches at the edges of the cyst.
• The procedure can sometimes be done in the clinic with medicine to numb the area. In other cases, it may need to be done in the hospital with general anesthesia so that you are asleep and pain-free.
• You should begin soaking in warm water 1 to 2 days afterward. You cannot have sexual intercourse for 4 weeks after surgery.
• You can use oral pain medicines after the procedure. Your provider may prescribe narcotic pain medicines if you need them.

EXCISION

Your provider may recommend that the glands be completely removed if abscesses keep coming back.

• The procedure involves surgical removal of the entire cyst wall.
• Generally performed in the hospital under general anesthesia.
• You cannot have sexual intercourse for 4 weeks after surgery.

Outlook (Prognosis)

The chance of a full recovery is excellent. The abscesses may return in few cases.

It is important to treat any vaginal infection that is diagnosed at the same time as the abscess.

When to Contact a Medical Professional

Call your provider if:

• You notice a painful, swollen lump on the labia near the vagina opening and it does not improve with 2 to 3 days of home treatment.
• Pain is severe and interferes with your normal activity.
• You have one of these cysts and develop a fever higher than 100.4°F (38°C).

Ambrose G, Berlin D. Incision and drainage. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 37.

Dolan MS, Hill C, Valea FA. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary, ultrasound imaging of pelvic structures. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 18.

Smith RP. Bartholin gland cyst/abscess drainage. In: Smith RP, ed. Netter’s Obstetrics and Gynecology. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 251.

Tuggy ML. Bartholin cyst and abscess: word catheter insertion marsupialization. In: Fowler GC, ed. Pfenninger and Fowler’s Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 118.

Last reviewed on: 4/19/2022

Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A. D.A.M. Editorial team.

Bartholinitis – causes and types of disease

Causes of bartholinitis

Inflammation in the Bartholin gland is caused by infectious agents that enter it from the vagina or urinary tract. The causative agent of the disease can be gonococcus, Trichomonas or other microorganisms. Cases of spread of infection through the blood are known.

The entry of a pathogen into the gland does not always cause bartholinitis. The onset of the inflammatory process is provoked by various external and internal factors:

• chronic diseases: caries, pyelonephritis, sinusitis and other sources of infection in the body;
• weak immunity against the background of a cold, lack of vitamins, stress, pregnancy;
• damage to the Bartholin gland as a result of surgery, abortion;
• promiscuous and unprotected sexual intercourse, etc.

At the initial stage, inflammation of the mucous membranes occurs. The natural outflow of the secret is blocked – the secretions begin to accumulate in the gland and form a cyst. Gradually education grows. The cyst of the Bartholin’s gland is filled with purulent contents, and an abscess occurs. A woman can feel education on her own. The abscess is located on the labia, looks like a small bump, painful when pressed.

Forms and symptoms of bartholinitis

According to the severity of the course, inflammation is acute and chronic.

Acute bartholinitis begins with canaculitis. Inflammation affects only one gland, so local symptoms are one-sided. Bilateral canaculitis usually occurs when infected with gonorrhea. The patient during this period may not feel acute symptoms. Anxious signs are noticed by the doctor during the examination. Redness appears at the exit site of the gland duct. The channel itself for the discharge of the secret begins to be palpated well. When pressed, a purulent discharge appears from the gland. At the stage of canaculitis, inflammation can be stopped quickly enough. If no action is taken, the swelling will increase and block the duct. Gradually, the inflammation will move to the gland itself.

Acute bartholinitis exists in two forms:

• true abscess. The infectious agent penetrates the body of the gland. Patients complain of severe pain that worsens with movement. Inguinal lymph nodes increase, a large edema is formed. Fever and high body temperature – up to 40 degrees are added to the signs of bartholinitis. Opening an abscess brings only temporary relief. In addition, damage to the cyst with purulent bartholinitis can lead to sepsis, so you can’t squeeze out the bump on your own – it’s life-threatening. At the first signs, it is necessary to enroll in gynecology to receive qualified assistance;
• False abscess (formed during the progression of canaculitis). A woman with bartholinitis complains of an increase in body temperature up to 37.5 degrees, pain in the perineum. One-sided swelling appears on the labia at the location of the abscess. The focus of infection is not in the gland, but next to it. As pus accumulates, the cyst increases in size, becomes painful, and the skin turns red.

Chronic bartholinitis is a consequence of an untreated acute form. Short remissions are replaced by exacerbations. The next cycle, any infection, stress, beriberi, etc. can provoke a relapse. The chronic form is difficult to treat even when the exact cause of inflammation is established.

Subacute bartholinitis is also distinguished, but such a diagnosis is rare. The disease is characterized by the subsidence of acute symptoms and gradually turns into a chronic process.

Bartholinitis during pregnancy

Any inflammation in the female genital organs is a danger to the fetus. That is why pregnant patients should regularly come to see a gynecologist and take tests. Preventing inflammation is much easier than treating it.

During pregnancy, a natural decrease in immunity occurs. The body suppresses defense reactions so as not to reject the fetus, which is 50% genetically alien. Under such conditions, the mother’s body cannot provide a reliable barrier to infection. When it enters the genital tract, the pathogens rise up and reach the uterus. A disease such as bartholinitis threatens intrauterine infection of the fetus through the umbilical cord. Infections cause multiple mutations, interfere with the processes of organogenesis. In critical cases, we are talking about abortion.

Complications can be avoided with early registration in gynecology and timely diagnosis of inflammation. The doctor may already suspect a dangerous situation based on the results of a smear, even before the onset of symptoms. Inflammation is stopped, not allowing it to spread in the genitals. Under medical supervision, women calmly carry the pregnancy to natural childbirth.

Diagnosis of bartholinitis

The doctor begins by taking an anamnesis and examining the patient. Before your appointment, be prepared to answer the following questions:

• the date of the beginning and end of the last menstruation;
• the onset of puberty and intimate life;
• the nature of menstruation;
• number of pregnancies and their outcome;
• the time of onset of the first symptoms and the rate of their increase;
• the nature of the complaints;
• the presence of bad habits, other provoking factors.

After collecting an anamnesis, the patient is examined on a gynecological chair. On the external genitalia, bartholinitis is visible visually. The doctor examines the abscess, takes a smear from the walls of the vagina and a sample of the secretion of the gland. The received materials are sent for laboratory research. Only after receiving the results of the tests, the doctor can confidently diagnose and prescribe treatment for bartholinitis cysts. Analyzes are then taken several more times to monitor the effectiveness of therapy.

Treatment of bartholinitis

Do not try to heal yourself! Compresses, baths, attempts to open and clean the abscess end very badly. Patients often come to the appointment after self-treatment with severe fever, extensive inflammation, which requires urgent hospitalization. Don’t risk your health. Contact your doctor in a timely manner.

In the initial stage, doctors treat bartholinitis without surgery. The patient is selected a scheme of conservative therapy, prescribed antifungal drugs, antibiotics. To normalize the intestinal microflora, you will need products with bifidobacteria and vitamins. Surgical removal of a Bartholin gland cyst is not required. To relieve swelling a little, you can apply a heating pad or any other ice container wrapped in a soft cloth to the inflamed area. For treatment, therapeutic tampons with levomecol, Vishnevsky ointment, saline applications, solutions of chlorhexidine, miramistin are also used.

After removing the exacerbation, sitz baths are prescribed with a weak solution of potassium permanganate (1 sl. L. per 1 liter of water). You can use a decoction of chamomile for the same purpose. Bath time – 20 minutes. After the condition improves, they proceed to physiotherapy.

A woman must strictly follow the doctor’s recommendations – this is the only way to prevent the complications of bartholinitis.

A true abscess requires surgery. Operations on the Bartholin’s gland are carried out by two methods:

• Complete removal – extirpation. The doctor excised diseased tissue, removes the gland along with the focus of inflammation. After the operation, the woman goes through a period of rehabilitation with complete sexual rest;
• Formation of a new gland duct. An incision is made in the tissues to remove the secret. The technique helps to temporarily alleviate the patient’s condition, but the risk of recurrence of bartholinitis is high. The incisions quickly overgrow, a cyst is formed again.

There are more gentle, modern methods of treating bartholinitis in gynecology. An annular catheter is installed in the body of the gland (marsupialization operation). Within 2 months, the catheter performs the functions of a natural duct and promotes secretion. Such an operation is less traumatic, the risk of recurrence is minimal. During the rehabilitation period, a woman undergoes a course of magnetotherapy, UV irradiation.

Expert opinion

Women who regularly come for examinations to the gynecologist can see such a diagnosis in the chart as an asymptomatic course of a Bartholin gland cyst. The doctor does not comment on this situation in any way, does not prescribe pills, the patient begins to worry. But there is no reason to panic. A cyst with asymptomatic treatment does not require any radical measures. Regular monitoring, proper hygiene, balanced nutrition are necessary. The female body, with sufficient support, copes with the stagnation of the secret on its own. Therefore, listen to your doctor and do not self-medicate.

Prevention of bartholinitis

To reduce the risk of inflammation, it is necessary to strengthen the immune system, observe the rules of intimate hygiene, and have sexual relations with one regular partner. It is important to treat gynecological diseases in time and at least once a year undergo a preventive examination by a doctor.

Be careful with your choice of underwear. It should be sufficiently free, elastic, made of natural fabrics. For intimate hygiene, use gels with a neutral pH, without dyes and fragrances. A healthy lifestyle and proper nutrition is the best prevention for most diseases.

The doctors of the Alfa Health Center clinic will help you cope with bartholinitis and restore your women’s health. Call us to make an appointment and find out the price of the consultation.

Sources:

1. Clinical protocol for the diagnosis and treatment of inflammatory diseases of the perineum, vulva, vagina. Electronic version.

2. Bartholinitis. Medical encyclopedia. Electronic version.

Bartholin’s gland cyst – symptoms, causes, signs, diagnosis and treatment in “SM-Clinic”

The pathology is not common, the frequency of occurrence is about 2%. At risk are women of early reproductive age (from 20 to 30 years).

For a long time, a Bartholin gland cyst may not cause discomfort to the patient. Pain for this condition is uncharacteristic. The only manifestation is the presence of a rounded formation of a soft elastic consistency in the thickness of the labia majora on the left or right side (the process is usually one-sided).

If you start treatment on time, then you can get rid of the Bartholin gland cyst on an outpatient basis. If it reaches a large size, then its surgical removal is required. In some cases, cysts can cause suppuration.

Types of Bartholin gland cysts

Bartholin gland cysts can be of 2 types:

• uncomplicated – there is no inflammation in the glandular tissue (acute bartholinitis or gland abscess);
• complicated – there is an inflammatory process, and often has a purulent character.

Symptoms of Bartholin’s cyst

The main complaint that patients with Bartholin’s cyst present is the presence of a rounded formation in the projection of the large genital lip. On palpation in the absence of an inflammatory process, the cyst is painless, has a softly elastic consistency and clear, even contours. Discomfort joins when the formation reaches a large size. Sometimes cysts can enlarge after sexual intercourse, because. there is an additional secretion of a natural moisturizer.

In cases of infection, a purulent process may develop in the contents of the cyst – acute bartholinitis or abscessing inflammation of the Bartholin gland. This situation is characterized by acute pains of a pulsating nature, the intensity of which increases during walking and intimacy, reddening of the skin in the pathological area and an increase in body temperature to 38-39 ° C. There may even be unmotivated weakness and chills.

Causes of Bartholin’s cyst

The following factors can lead to obstruction of the outlet canal of the Bartholin’s gland:

• trauma to the genital organs;
• infectious inflammation in the external genitalia;
• violent friction during sexual intimacy.

The presence of a Bartholin gland cyst increases the risk of developing an abscess in this localization. The causes of purulent inflammation can be:

• conditional pathogens that constantly live in the genital tract of a woman, but acquire pathogenic properties only with a decrease in immunity;
• pathogens with sexual transmission (infection occurred from a sexual partner).

Abscess formation occurs quickly – 3-4 days is enough. Provoking factors are:

• sexual genital contact;
• non-compliance with hygiene measures on menstrual days, in the postpartum and post-abortion periods;
• wearing compressive underwear;
• mechanical friction of the external genitalia.

Diagnosis of Bartholin’s cyst

To make a correct diagnosis, it is enough for a gynecologist to conduct an objective examination. At the entrance to the vagina in the thickness of the labia, a pathological formation with dimensions of 1 cm or more is detected. In the presence of acute bartholinitis, soreness, swelling and redness of the skin appear, in the case of an abscess, all these signs are more pronounced, and fluctuation is also determined (softening center in the center). To identify possible causes of the formation of a Bartholin gland cyst and assess the overall level of health, the doctor may prescribe additional studies:

• microscopic examination of the discharge from the vagina – allows you to identify the inflammatory process;
• general clinical analysis of urine – with purulent inflammation of the gland, the content of leukocytes may increase;
• general clinical blood test – the number of leukocytes increases and the ESR accelerates with the development of an abscess;
• exclusion of urogenital infections using enzyme immunoassay or polymerase chain reaction.

In some cases, especially in women over 40 years of age, Bartholin’s gland cancer may be suspected. As part of an objective diagnosis under local anesthesia, a biopsy is performed using a needle. The resulting material is subjected to morphological examination.

Expert’s opinion

Bartholin’s gland cyst, formed once and reaching a certain size, may no longer increase. Sometimes, however, its growth can still occur, which can lead to discomfort and the formation of psychological complexes due to the unaesthetic nature of the genital organs (there is asymmetry in the area of ​​​​the entrance to the vagina), this is especially important for female models. Therefore, gynecologists are advised to weigh the pros and cons and make the right decision about the need to remove it. In addition, do not forget that the Bartholin gland cyst can fester at any time, and in most cases, purulent inflammation requires an urgent operation, the risks of which are greater than with a planned one.

Kalinina Natalya Anatolyevna,
obstetrician-gynecologist, reproductive specialist, ultrasound diagnostician

Bartholin gland cyst treatment methods

For small cysts, outpatient treatment is performed, for large cysts, surgical intervention is indicated.

Conservative treatment

Conservative therapy is selected by the gynecologist individually for each patient. It consists in accelerating the resorption of the contents of the cyst. Anti-inflammatory treatment may also be given. Warm sitz baths are recommended.

In the presence of acute bartholinitis on the background of a cyst in the absence of an abscess, timely antibiotic and anti-inflammatory therapy can help to avoid surgery.

Surgical treatment of Bartholin gland cyst

Surgical treatment is performed in 2 cases:

• large cyst;
• the desire of the patient to get rid of the pathological structure (regardless of its size).

There are 2 types of surgical interventions:

• Marsupilization – the gynecologist makes an incision over the cyst, and the edges of the capsule are sutured to the edges of the incision. Thus, a new hole is formed for the outflow of the secret of the Bartholin gland. Gradually, the wound narrows, and the incision site becomes invisible. To prevent the hole from closing prematurely, a drainage tube is inserted into the cyst cavity for 1-2 days.
• Removal of the Bartholin gland – is carried out in the case when marsupilization did not bring the desired result.

If a patient develops an abscess against the background of a Bartholin gland cyst, then its opening and thorough cleaning of the cavity are indicated. Be sure to introduce a drainage tube to prevent the re-accumulation of pus and contribute to the speedy relief of the inflammatory process. All patients with Bartholin’s gland abscess after autopsy are prescribed antibiotic therapy.

Prevention of Bartholin’s cysts

There is no specific prevention of the formation of Bartholin’s cysts. It is recommended to avoid sexually transmitted infections. To do this, in the absence of a permanent and reliable sexual partner, condoms are used.

Rehabilitation after surgery

Immediately after surgery for a Bartholin’s cyst, a woman can be discharged home. In the early postoperative period, it is recommended to carefully carry out hygiene measures, trying to ensure that the established drainage does not fall out. After a few days, you will need to come to the clinic for a follow-up examination, removal of stitches or removal of drainage, depending on the situation.

FAQ

No. This is a disease of adults, because. the glands of the genital organs begin to function only after puberty. However, if the girl has a swelling in the vulva, it is necessary to consult with a pediatric gynecologist.

Yes, relapses are typical for this condition. To reduce their likelihood, you need to consult a gynecologist and be examined for urogenital infections, also follow the rules of personal hygiene (in addition to the fact that you need to wash yourself regularly, it is important to do it right – from front to back, and not vice versa).