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A Bartholin’s abscess occurs when the Bartholin’s glands, located on either side of the opening of the vagina, become obstructed, and eventually infected. A cyst will usually form when the gland is blocked. If the cyst becomes infected, it can lead to a Bartholin’s abscess. The abscess can be more than an inch in diameter and cause extreme pain. While most people with a Bartholin’s abscess completely recover, there is a chance that the condition will come back.
There are two Bartholin’s glands, each about the size of a pea, with one on each side of the vaginal opening. They provide lubrication to the vaginal membranes. Bacteria that get into the gland can cause an infection, swelling, and an obstruction. Fluid builds up in the gland, increasing pressure on the area. If the infection and swelling advance, the gland may abscess, which breaks open the skin. Bartholin’s abscesses usually only appear on one side of the vagina at a time.
It may take years for fluid to build up enough to form a cyst, but an abscess will make itself known right away. A Bartholin’s abscess tends to be extremely painful and the area will likely be red, swollen, and warm to the touch..
Doctors believe that bacteria such as E. coli, or sexually transmitted diseases (STDs) such as chlamydia or gonorrhea, may cause the infections that lead to Bartholin’s abscesses.
To determine if you have a Bartholin’s abscess, your doctor will perform a physical exam to check for any lumps or bumps within the vagina that would indicate an abscess. They will likely take a fluid sample from the area to check for any STDs present that may need treatment as well.
If you are over the age of 40 or have already gone through menopause, your doctor may want to perform a biopsy on any masses found in the vagina to rule out other possible sources of the problem.
It’s possible to treat a Bartholin’s abscess at home using sitz baths. In a sitz bath, you fill the tub with warm water up to hip level. It may take many days of sitz baths to treat the abscess because the opening of the Bartholin’s gland is very small, and it may close before drainage is complete. Soaking may not be the most effective cure, but a sitz bath can soothe your pain and discomfort. With a Bartholin’s abscess, you should soak in three or four sitz baths a day, for at least 10 to 15 minutes each.
If the abscess is very large or persists despite more than a week of conservative care, your doctor may decide it’s best to drain it surgically. This procedure can occur in your doctor’s office under local anesthesia, but general anesthesia in a hospital is also an option. Talk to your doctor about the best course for you.
During the surgery, your doctor makes an incision in the abscess and places a catheter inside to drain the fluid. The catheter may remain in place for several weeks. Once the abscess heals, a surgeon can remove the catheter or allow it to fall out on its own.
Since the abscess is likely the result of an infection, your doctor may prescribe antibiotics. In most cases, antibiotics are unnecessary if the abscess drains properly.
If you continue to develop Bartholin’s abscesses and find they greatly impact your quality of life, your doctor may want to perform a procedure called marsupialization. This is a surgery very similar to the other drainage procedure. However, instead of allowing the incision to close, your doctor will stitch the incision open to allow for maximum drainage. A catheter is typically still used. Local anesthesia is still an option during a marsupialization, but depending on the size and complexity of the abscess, your doctor may perform the procedure under general anesthesia. Your doctor will treat any infection present before the surgery.
If none of these procedures are permanently successful, your doctor may recommend removing your Bartholin’s glands. This surgery is rare and would require general anesthesia in a hospital setting.
If you develop a painful, swollen lump near the opening of your vagina that doesn’t go away after a few days of warm sitz baths, call your doctor. If you develop a fever or the pain starts interfering with your daily activities, talk to your doctor about treatment. You should have no lasting effects from the abscess once it’s treated successfully.
Written by: Carmella Wint, Matthew Solan and Kathryn Watson
Published on: Sep 25, 2015
Medically reviewed on: Apr 28, 2016: Mike Weber, MD
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