cyst Bartholin gland
cyst Bartholin gland - is delimited rounded education in the field of Bartholin's gland, filling it with a secret that is formed after the blockage of ductless glands.Most Bartholin gland cyst found in the young, leading an active sex life of patients. Among the causes of their appearance in the lead-specific infections, particularly gonorrhea, non-specific inflammation and cause microbial associations.On both sides of Bartholin's gland cysts are rare.
in the mucosa of the vestibule is a significant amount of operating glands.They protect the vulva and the overlying structures from infection and injury by continuous wetting and self-purification, and during intimacy produced by glands secret the function of "lubrication".
functioning of the glands of the vulva is related to cyclic hormonal changes and central nervous system.
Bartholin's glands are located in the lower third of the vestibule (one gland on each side) at the base of the labia majora, have a round shape,
reason for the formation of a cyst Bartholin gland is often an acute infectious process in the area of the external genitalia.Under the influence of the external opening of infection ductless closed, and her secret accumulates inside the body gland, forming a cyst.If the infection gets into the cavity of the prostate, the contents of the cyst becomes purulent, forming an abscess.
Sometimes the cyst is large gland vestibule formed without the participation of the infection.Blockage of its flow can be caused by a mechanical obstacle outflow of its content with the development of fibrosis or hyperplasia (overgrowth) of surrounding tissues.In such cases, the symptoms appear only in the case of secondary infection of the cyst.
Area vestibule contains a large number of nerve endings, and a well-developed network of blood, so all acute pathological processes in this area, including the Bartholin gland, accompanied by severe clinical manifestations.When an infectious inflammation of the Bartholin gland duct in bright no symptoms, and the disease quickly eliminated by simple therapeutic techniques.If the infection manages to capture the entire gland, symptoms of acute purulent process.
Uncomplicated Bartholin gland cyst small size may not cause subjective feelings of the patient and detected by chance.
If acute inflammation in the gland vestibule is not treated properly or treated the patient alone, it can be transformed into chronic inflammation, which is worsening clinically manifested.
cysts cancer therapy vestibule assumes conservative antibiotic therapy and surgical removal of the cyst in its inefficiency.
With good condition of local immunity uninfected cysts small size can pass on their own, however, such a scenario does not guarantee the absence of disease recurrence.
key to successful treatment of Bartholin gland cyst is a time to initiation of treatment.Often the patient to find education in the labia, trying to get rid of it yourself, and seek medical advice in the case of septic complications.
Prognosis generally favorable.Timely and adequate treatment of the following preventive measures eliminate pathological changes in the tissues of the prostate.
reasons Bartholin gland cyst
sole cause of the Bartholin gland cyst is a blockage of its excretory duct.Skopje gland secret stretches its walls and forms a large cavity filled with thick serous content.
Output duct gland becomes blocked after being hit by the infection.Specific inflammation caused by gonococci and Trichomonas and nonspecific - representatives of conditionally pathogenic microbial flora: staphylococcus, streptococcus, E. coli and others.
in the Bartholin gland infection spreads from flowing into the area of the vulva abnormal vaginal discharge.Initially, it penetrates into the narrow duct gland and stimulates the local pathological changes, resulting due to inflammatory edema clearance duct becomes blocked.
presence of infection in the vagina does not necessarily imply the development of inflammation in the Bartholin gland.This can happen only if the violation of the local immune defense mechanisms.
to the formation of cysts in the vestibule glands also have:
- Ignoring the rules of hygiene of intimate areas, especially during menstruation.Regular hygiene mechanically remove excessive amounts of undesirable microorganisms in the external genitalia.Refusal of simple prevention of inflammatory processes can lead to inflammation.
- Underwear from improper glandular tissue promotes accumulation of secretions, and does not allow the skin to "breathe".
- promiscuous, not only increases the risk of contracting a sexually transmitted disease, but also increases the number of pathogenic microflora.
- Injuries to the vaginal mucosa or the vestibule during surgery or abortion.Damaged mucous easily pass the infection to be layers.Sometimes the healing process of injuries of the vulva is incorrect, in the glands appear mucous scars or growths that may prevent the normal outflow discharge Bartholin glands.
- infectious-inflammatory processes in the vagina.
- State, accompanied by violation of the immune defense mechanisms: the presence of foci of chronic infection, diabetes, immune deficiencies, as well as stress and hypothermia.
Symptoms of Bartholin gland cyst
Bartholin cysts can be the size of a pea, and may look like an egg.Clinically Bartholin gland cyst begins to manifest itself after reaching a considerable size.Small cysts with no signs of infection do not disturb the patient and found by chance.Sometimes, with good immunity, they are alone.
Big Bartholin gland cysts are less common.They are accompanied by a feeling of discomfort when moving and sometimes interfere with the normal intimacy.
Diagnostics Bartholin gland cyst begins with a tour of the outside of the genital area and vaginal examination.External signs of cysts is determined by its size.Can be found asymmetry gender gap, the unilateral increase of the labia majora of the inflammatory edema, and for large cysts visualized towering above the skin labia rounded education.In the absence of inflammation of the skin over and around the cyst it looks unchanged.
On palpation inside the labia majora is determined by the rounded, flexible, mobile and slightly painful education.
If the cyst starts inflammatory changes, the skin over it may be red, and palpation to become more sensitive.
With the predominance of inflammatory processes in the Bartholin gland diseases clinic differs from that in the formation of cysts.Initially, in both cases, the infection penetrates gland duct and provokes local inflammatory changes.Develops kanalikulit - inflammation of the ductless glands vestibule.Clearance ductless sharply narrowed due to inflammatory edema, but does not close completely, so the pressure on the affected area there is a small amount of pus.
During the canalicular development of inflammation in the patient may appear slight feeling of discomfort or pain in the affected sexual lip.On examination revealed slight inflammatory cushion is soft and hyperemia in the projection of a sealed gland.On palpation of the roller on the surface appears pus.Extremely undesirable situation at this stage of development of the disease is to try self-medication with thermal treatments or attempt to squeeze out the pus.Vulva loose and well supplied with blood, and it contains many of the lymphatic vessels, all of which contribute to the rapid spread of infection through the body until it is generalization, ie sepsis.However, skilled care at this stage of disease can quickly eliminate the infection and prevent its further development.
In the absence of proper treatment the infection is completely occludes the excretory duct.It accumulates in the pus can come out, so he stretches the walls of the duct, forming a false abscess - pus cavity delineated walls ductless Bartholin gland.False abscess called because iron is not destroyed, but pushed away and deformed.Clinical disease becomes brighter.There are severe pain in the side of the abscess, symptoms of intoxication.When viewed from the affected genital lip swollen, reddened, at its base is visible to most "tumor", palpation is accompanied by severe pain.
False Bartholin gland abscesses can be opened independently from the subsequent outpouring out pus.In this situation the patient is thinking about recovery and do not seek help, meanwhile, remained in the cavity revealed the abscess pus may trigger a relapse of purulent inflammation or cause sluggish chronic inflammatory process.Against the background of his excretory duct narrows in the oral cancer accumulates the liquid contents and forms Bartholin gland cyst.
If the infection manages to get directly into the breast tissue, is the destruction of its contents.It appears true abscesses - capsule with pus.He is accompanied by symptoms of acute purulent process: fever, intoxication, severe throbbing pain in the cyst.The skin in the abscess becomes crimson and hot to the touch, sexual lip swells strongly and can block the entrance to the vagina.Palpation in the affected area is acutely painful.Unlike false, true stationary abscess on palpation, and its dimensions are larger.
Typically, Bartholin gland abscesses appear in the background of genital infections, so the clinical picture includes symptoms of vaginitis: Inflammation and swelling of the vaginal mucous, serous-purulent discharge, itching, or other violation of urination.
tasks of laboratory diagnosis is to identify the pathogen, and the choice of antibiotic to eliminate it.We study a smear and bacterial seeding of the vulva and vaginal discharge cables.When inflammation of the specific conduct additional research on the presence of genital infections.
for a reliable assessment of the clinical situation it is necessary to examine the patient's immune status and get information on related neginekologicheskih diseases.
negative consequences Bartholin gland cyst is its purulent transformation after infection, the development of chronic inflammation and relapses.
When expressed immune disorders infection can enter the bloodstream (sepsis) or form fistulas - unphysiological moves between the gland and surrounding tissues.Similar scenarios are developing very rare.
Treatment of Bartholin gland cyst
Therapeutic strategy depends on the size of the cyst and the presence of inflammatory changes in it.Small, less than two centimeters in size, Bartholin gland cyst in the absence of the patient's complaints do not require emergency treatment measures.Often chosen tactics of dynamic monitoring, as often these cysts resolve on their own.
If the patient is experiencing physical or psychological discomfort, small cyst removed.
Large Bartholin gland cyst, breaking the rhythm of life of the patient, subject to surgical removal.
Subsequent pathological processes in the Bartholin gland duct while plugging it can be prevented if detected change begins at an early stage.
kanalikulite When inflammation is most often eliminated by simple measures:
- physical rest.When moving (walking, running, etc.), inflammation of sexual injured lip, and inflammation may be exacerbated.
- Chill on the genital area.The artificial lowering of the temperature in the area of inflammation constricts blood vessels, reduces the inflammatory swelling, relieve pain and prevent further spread of infection in the underlying structures.Wrong use of heat treatments the patient when trying to self leads to further expansion of blood vessels, increase of edema and exacerbate the condition.
- Local anti-inflammatory activities.You can use warm (not hot) sitz baths with disinfectant and anti-inflammatory drugs (chlorhexidine, a weak solution of potassium permanganate) and ointment application to the inflamed area with antibacterial ointments like ihtiola, levomikol and the like.
- Antibiotic therapy.The loose structure of the tissue of the vulva and good blood supply to this area creates a favorable situation for the rapid development of the infection.Therefore, the success of therapy is determined by early treatment.Antibiotics begins after the initial diagnosis, regardless of whether bacteriological conclusion.Therapy begins with broad-spectrum antibiotics, and then, if need arises, change the antibiotic.
- Symptomatic therapy for pain, allergic reactions and activation of the local security forces.
If the patient revealed venereal infection, specific treatment is carried out in parallel with a partner.
Surgical treatment of cysts and abscesses are exposed Bartholin gland.If the patient has an infection of the genital tract, surgical removal of the Bartholin gland cyst is carried out only after prior antibiotic therapy.Sometimes, after adequate antibiotic treatment fails to eliminate the inflammation in the excretory duct cancer and restore its patency.
aim of surgery at the Bartholin gland cyst is:
- Restoration of normal anatomic structure of cancer by removing a cyst.Produced husking Bartholin gland cyst, followed by antibiotic treatment of the remaining cavity.Then set the drainage - tube to drain the contents of the gland.
If there are contraindications to surgery (eg, pregnancy) husking Bartholin gland cyst is replaced by its puncture when using a thin long needle puncture is performed and the evacuation of the contents of the cyst.
- Ensuring the proper functioning of the prostate, ie restoration must churn its contents.One only remove Bartholin gland cyst is not enough, because in a short period of time after treatment duct wall again stick together, and the cyst is formed again.To avoid recurrence of the cyst happens, you must restore duct cancer.
catheterization method used: through a small incision in the cyst cavity is set catheter - a small tube of silicone with an expanded end.Through him, the evacuation of the contents of the cyst.It was then left for several weeks to complete healing of the wound.After removal of the catheter remains in its place formed Bartholin gland duct.
have recently been widespread marsupializatsiya Bartholin gland cyst and allows you to remove a cyst to form an artificial excretory duct.
Unfortunately, the re-emergence of a Bartholin gland cyst after any surgery is not uncommon.When repeated relapses shows complete removal of Bartholin gland.