Bartholin's Abscess: Causes, Diagnosis & Treatments
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Bartholin's Abscess

Overview

Highlights

  1. A Bartholin’s abscess can occur when one of the Bartholin’s glands, located on either side of the opening of the vagina, becomes infected.
  2. Pain when walking, sitting, or having sexual intercourse is a common symptom.
  3. It is rare for a Bartholin’s abscess to get better on its own. Usually, the abscess needs to be drained through surgery.

A Bartholin’s abscess can occur when one of the Bartholin’s glands, located on either side of the opening of the vagina, becomes infected. A cyst will usually form when the gland is blocked. If the cyst becomes infected, it can lead to a Bartholin’s abscess.

A Bartholin’s abscess can be more than an inch in diameter. It usually causes significant pain. While most people with a Bartholin’s abscess completely recover, there is a chance that the cyst will come back and become infected again.

Women of childbearing age are the most affected population, with nearly 2 percent of women experiencing a Bartholin’s abscess in their lifetime.

What causes a Bartholin’s abscess?

Causes Icon

There are two Bartholin’s glands, each about the size of a pea. The glands sit on each side of the vaginal opening. They provide lubrication to the vaginal membranes. Bacteria that get into the gland can cause 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. A Bartholin’s abscess usually only appears 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 can form there quickly. A Bartholin’s abscess tends to be very painful.

Doctors believe that bacteria, such as E. coli, and sexually transmitted diseases (STDs) such as chlamydia or gonorrhea, may cause the infections that lead to Bartholin’s abscesses.

What are the symptoms?

Symptoms Icon

A Bartholin’s abscess usually causes a lump to form under the skin on one side of the vagina. It’s common for a Bartholin’s abscess to cause pain during any activity that puts pressure on the area, such as walking, sitting down, or sexual intercourse.

A fever may also accompany the abscess. The area where the abscess has formed will likely be red, swollen, and warm to the touch.

How is a Bartholin’s abscess diagnosed?

Diagnosis Icon

To determine if you have a Bartholin’s abscess, your doctor will perform a physical exam to check for any lumps within the vagina that would indicate an abscess. They may take a sample from the area to check for any STDs. Those STDs would need to be treated along with the abscess.

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 sources of the problem. Although it is rare, there are cases where a Bartholin’s abscess can indicate cancer.

Treatment options for a Bartholin’s abscess

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In its early stages, a Bartholin’s abscess can be treated at home using sitz baths. A sitz bath refers to sitting in a tub with 2 to 3 inches of warm water. 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 cure the abscess, but a sitz bath can help ease your pain and discomfort. To treat a Bartholin’s cyst, which can lead to an abscess, the Mayo Clinic recommends that you soak in three or four sitz baths a day, for at least 10 to 15 minutes each.

If you have a Bartholin’s abscess, home treatments that are recommended for cyst care may help the abscess to drain and heal on its own. Using a mix of tea tree and castor oil as a topical ointment on the abscess may promote drainage.

You can apply the tea tree and castor oil with a piece of gauze. Adding a hot compress on top of the gauze may make this remedy even more effective. Tea tree oil is known for its antibacterial properties, which may help clear an infection. Castor oil is thought to promote blood circulation in the affected area, which reduces inflammation.

Medical care

It is rare for a Bartholin’s abscess to get better on its own. Usually, the abscess needs to be drained through surgery. In most cases, you can have the procedure at your doctor’s office under local anesthesia. General anesthesia in a hospital is also an option. Talk to your doctor about the best choice 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, your doctor 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 some cases, antibiotics are unnecessary if the abscess drains properly.

It’s common for Bartholin’s abscesses to recur. If, after your treatment, the Bartholin’s abscess comes back repeatedly, your doctor may suggest a procedure called marsupialization.

Marsupialization is a surgery that is very similar to the other drainage procedure. But instead of allowing the incision to close, your doctor will stitch the incision open to allow for maximum drainage. They may use a catheter, or pack the abscess with a special gauze that they remove the next day. Local anesthesia is an option during a marsupialization. The procedure can also be performed under general anesthesia. Your doctor will treat any infection present before the surgery with antibiotics.

If these treatments don’t stop the Bartholin’s abscess from recurring, your doctor may recommend removing your Bartholin’s glands. This surgery is rare and would require general anesthesia in a hospital setting.

How can it be prevented?

Prevention Icon

There is no definitive way to prevent a Bartholin’s abscess. But practices such as safe sex, condom use, and good hygiene will help keep bacteria out of the area, which can help prevent infection. It is also important to find out if you have an STD, and to seek treatment if you do.

Maintaining a healthy urinary tract may help prevent Bartholin’s cysts and abscesses from developing. Drink plenty of fluids throughout the day, and try to avoid waiting a long time to go to the bathroom. Cranberry supplements may help support good urinary tract health.

Complications and emergency symptoms

Warning

If a Bartholin’s abscess worsens and goes untreated, the infection could spread to other organs in your body. The infection may enter your bloodstream, a condition called septicemia. This condition is dangerous because the infection can be carried throughout your whole body.

If you have a fever over 103 degrees, it’s important to seek medical attention. You should also seek medical help if the abscess ruptures abruptly and the pain does not subside.

Outcome and recovery

Icon Outlook

If you think you may have a Bartholin’s abscess, see your doctor. You can try sitz baths at home, but the condition is unlikely to go away without medical treatment. It’s especially important to seek medical care if you have a fever or if the pain starts interfering with your daily activities.

Once the abscess has drained, recovery time is minimal. Most women feel better within 24 hours after a Bartholin’s abscess has drained.

If your abscess needed surgical removal, your recovery time will vary depending on the details of your procedure. Expect to spend the first few days after the surgery reclining as much as possible. Make sure to rest and recover, following your doctor’s instructions. It’s important to let any incisions heal completely, and to take any antibiotics prescribed to you.

You should have no lasting effects from the abscess once it is treated successfully.

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