Bartholin's abscess

Alternative names

Definition

Causes, incidence, and risk factors

Bartholin's abscesses form when ducts (small drainage openings) from the Bartholin's glands get blocked. Secretions in the glands build 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 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.

Your health care provider may recommend that the glands be removed if abscesses recur.

Expectations (prognosis)

The chance of full recovery is excellent. About 10% of time abscesses recur future.

It is important to treat gonorrhea or any other infection that causes abscesses.

Complications

A chronic Bartholin's duct cyst may develop if the purulent fluid of the abscess is "walled off" from the surrounding tissue. In women over the age of 40, an enlarged Bartholin's gland may signal an underlying tumor in the gland, although this is very rare.

Calling your health care provider

Call for an appointment with your health care provider if a painful, swollen lump is noted on the labia near the vaginal opening and does not improve with 2-3 days of home treatment. Call if pain is severe and interferes with normal activity.

Call your health care provider if you develop a fever higher than 100.4 degrees Fahrenheit.

Prevention

Safer sex behaviors (especially condom use) and good personal hygiene may decrease the risk of developing a Bartholin's abscess.

Update Date: 11/6/2002