Bartholinitis - is an infectious inflammation of the large (Bartholin's) glands, located in the vestibule, often one-sided.Bartolini occurs predominantly in young, sexually active women.Often bartholinitis women develops against the background of specific inflammation, particularly gonorrhea, but in most cases, inflammation of the large vestibule glands triggered by microbial associations, rather than one specific pathogen.
in the mucosa of the vestibule there is a significant number of active glands.Their function is controlled by the nervous system and is closely related to the cyclic hormonal changes in a woman's body.Produced by glands of the vulva secret performs the following important functions:
- Through constant moisturizing vulvar mucosa does not dry and is not damaged;
- In the tissues of the vestibule is supported by the permanent composition of the microflora and acidity (pH), vulva protecting against infection and inflammation;
- With detachable glands
- While the number of secret intimacy increases, serving as a kind of "lubricant".
the base (lower third) of the labia majora are great paired glands vestibule - rounded education, less than two centimeters in diameter, named in honor of their discoverer anatomist Bartholin gland.
Outlet ducts Bartholin glands open on the mucosal surface of the labia minora inside.If the hole is sealed with duct cancer, produced by her secret accumulates in the cavity of the prostate, followed by inflammation.In most cases, women bartholinitis develops against the backdrop of an acute infection in the vulva or severe somatic pathology, accompanied by deformation of the normal mechanisms of the general and local immune defense.
vulvar mucosa is well supplied with blood vessels and contains many nerve endings.Because of these circumstances inflammation in the zone vestibule often proceeds with bright clinical signs.
on the severity of clinical symptoms Bartolini affects localization of the inflammatory process.If it affects only channel gland signs of inflammation are expressed slightly, and held at this stage of simple therapy leads to complete recovery.If the infection spreads further and captures the entire gland develops acute bartholinitis with severe inflammatory symptoms.
progressive acute bartholinitis has all the signs of acute infection and does not cause diagnostic difficulties.In the event of insolvency of the immune defense mechanisms of acute inflammatory process acquires the features of low intensity chronic infection.As a rule, the period of remission does not cause chronic bartholinitis subjective sensations, and periods of exacerbation of symptoms are limited to small.
Bartholinitis not always infectious nature.Sometimes drain the contents of the gland prevent structural changes in the surrounding tissue - fibrosis, hyperplasia (overgrowth).In such situations, the pathological process at Bartolini asymptomatic and manifests itself only in the event of the accession of secondary infection.
very unfavorable situation is bartholinitis during pregnancy or lactation (nursing).Physiological hormonal dysfunction and reduced immune defense during pregnancy contribute to the development of acute inflammation and increase the risk of complications.
The diagnosis takes a leading role bartholinitis laboratory study separated the vagina and vulva, as the success of treatment depends on the source of infection.
major role in the treatment of bartholinitis belongs antibacterial agents.After thorough laboratory research "culprit" infectious-inflammatory process in the Bartholin gland individually selected and appointed by the appropriate antibiotic related symptomatic therapy.
bartholinitis For successful treatment it is important to detect it early.Timely treatment helps your doctor to get rid of unwanted symptoms and prevent complications.
Sometimes patients try to cope with their own illness and seek help in the later stages of development bartholinitis that accumulates in the gland pus and an abscess is formed.In such cases, any therapy is unsuccessful without surgical removal of the Bartholin gland abscess.
bartholinitis forecast depends on the lifestyle and the immune system of the patient.With timely, appropriate treatment and subsequent compliance with the patient simple measures to prevent inflammatory disease of the external genitalia can be cured completely.
Inflammation of the large gland vestibule develops after penetrating into the representatives of conditionally pathogenic microbial flora (staphylococcus, streptococcus, E. coli, etc.), or specific pathogens of sexual infections (gonococcus and trichomonas).
should be noted that non-specific origin bartholinitis rarer others.The reasons for its development is a microbial association, while at the specific disease process is called only one agent.
secondary infection occurs when flowing downward by abnormal vaginal discharge in the area of the vulva.Then pathogenic microbes through a narrow opening ductless fall deep into the prostate, where they begin to actively proliferate, causing inflammatory purulent process.
presence of genital infections not all patients leads to the development bartholinitis.In normal operation of the immune system are minimal chances of bartholinitis as any inflammation will be extinguished due to internal reserves.
addition to violations of the proper functioning of the immune system increases the risk of bartholinitis:
- Ignoring the rules of hygiene intimate area (especially during menstruation).The skin and mucous membranes of the external genitalia is a huge number of different microorganisms.In normal conditions, the quantitative ratios are involved in the maintenance of local protective mechanisms.If the number of unwanted microflora begins to rise significantly, the proper balance is disrupted, and developed inflammation.Hygiene external genitalia prevents the development of such a scenario.
- Close underwear made of synthetic fibers.Continued use of the laundry increases the secretion of glands vestibule and does not allow the skin of the external genitalia to "breathe."As a result of an excessive accumulation of glandular secretions creates favorable conditions for the development of inflammatory disorders and outflows content Bartholin glands.
- promiscuity.Genital infections (gonorrhea, and trichomoniasis) very often contribute to the emergence of symptoms of acute bartholinitis.
- Chronic diseases of the genitourinary system, in which the infection gets into the descending through the mucous vestibule and can trigger the development of bartholinitis.
- Traumatic injuries of the vulva and vagina tissue during surgery or abortion.
- extragenital pathology associated with decreased immune defense: diabetes, metabolic diseases, infectious diseases and immunodeficiency.
Any hotbed of chronic infection in the body can contribute to getting infections in the tissue of the vulva hematogenous (through the blood) or lymphogenous way.
- hypothermia, stress and beriberi.
Pregnant women bartholinitis diagnosed less frequently because, as a rule, expectant mothers are comprehensive, regular inspection and receive timely preventive treatment.
bartholinitis usually develops during pregnancy according to the physiological predisposing factors: a change in the normal composition of microflora in the direction of increasing its opportunistic component and reduced immune defense.The immediate causes of bartholinitis in pregnant women do not differ from those of other patients.
clinic disease does not depend on its causes, but can be supplemented with symptoms of the disease, which is accompanied by the formation of bartholinitis.
Symptoms and signs bartholinitis
In most cases, the infection process at Bartolini develops on one side.Bilateral inflammation characteristic of gonorrhea.
The disease begins with the infiltration of ductless Bartholin gland.Its lumen narrows sharply (and then disappears), the outflow of the contents of the gland is disrupted, it accumulates in the gland.In response to these changes in the size of the prostate begins to gradually increase on the surface of the affected labia appears rounded protrusion surrounded by a zone of hyperemia and edema.
bartholinitis The clinical picture depends on what part of the cancer is localized focus of infectious inflammation.Often, it is changing with the spread of inflammation and characterized by successive stages of the infection process.
initial stage of the disease is almost always takes the form of canalicular bartholinitis.Kanalikulit - an inflammation of the ductless glands.The wall of the duct thickens due to inflammation, duct lumen narrows sharply, but does not close completely, so the pressure on the affected area can be allocated a small amount of pus.
At this stage, there is no striking clinical symptoms, so starting the inflammation can be detected by chance during a woman hygiene.In the area of one of the labia detectable inflammatory small roller.Subjective feelings are absent more often.Sometimes in the affected labia may appear discomfort and palpation - a slight soreness.If at this stage bartholinitis patient goes to a doctor, when external examination revealed slight inflammation in the background of a small roller redness.Palpation seal is accompanied by a small amount of pus-like content that is collected for subsequent bacteriological examination.
Independent medical procedures without adequate prior consultation of a doctor at an early stage undesirable.It is especially dangerous to squeeze out the contents of the self-sealing.Because the Bartholin's glands are surrounded by loose tissue with good blood and lymphatic system, the infection can easily penetrate into the bloodstream and cause general blood poisoning - sepsis.Heat treatments may likewise contribute to the generalization of purulent process.
As the disease progresses the external opening of ductless Bartholin gland is completely blocked, flow begins to increase in size because of the accumulating secret, and formed a false abscess Bartholin gland.So begins the second stage of the disease.Abscess called false because iron is not destroyed, but is squeezed and pushed to the periphery stretched excretory duct.At this stage of the disease a woman concerned about pain on the affected side, worse while walking, contact with tight clothing and intercourse, there is a fever.Inflammatory "tumor" on the progression of the infection reaches a considerable size and can partially block the entrance to the vagina.On examination of the labia lips on the affected side is increased due to pronounced edema and hyperemia.On the inner surface of the labia determined circular protrusion of considerable size, tenderness.
often false abscess opened independently, is an allocation of a considerable amount of pus, and all the symptoms of inflammation disappear.Mistakenly believing that the disease is passed on their own, some women are not in a hurry to ask for help.Often, however, a short period of time, the disease returns, since the spontaneous opening of the abscess complete emptying does not occur, and the disease becomes chronic.
Sometimes patients say that they happened autopsy bartholinitis instead of the correct "opening the abscess."Bartolini - an inflammatory disease of Bartholin's gland, and Bartholin gland abscess - a cavity filled with liquid, which may reveal their own or forced by surgery.Such procedures like opening bartholinitis simply does not exist.
Recurrent chronic bartholinitis proceeds without striking clinical symptoms and discomfort and limited to the small size of the inflammatory pain-free seal.If chronic bartholinitis there long enough in the oral cancer gradually accumulated liquid contents formed a painless education - Bartholin gland cyst.
If pathogens penetrate into the tissue of the gland, causing it to purulent fusion, developing a true abscess.It is a capsule filled with purulent content.Clinic this stage of the disease meets all the signs of acute purulent inflammation: high fever, general health deterioration, intolerable pain in the formation of an abscess pulsating character.During the external examination on the affected side are rendered swollen, reddened labia (large and small), a significant increase in size.Sex gap sharply narrowed or completely blocked by tissue inflammation.An abscess is visualized in the form of a large inflammatory tumors.Often the largest it can resemble a hen's egg.Any touch to the affected tissues causes a sharp pain.
When abscess formation underlying tissues become dense and immobile, so palpation skin in the abscess is stationary.Inguinal lymph nodes are increased.From false true abscess different constant severe pain pulsing character, pronounced swelling of the labia, high fever and immobility of the skin over the abscess.
Bartholinitis often develops on the background of marked infectious inflammation of the vulva and vagina, so the clinical picture can be supplemented with symptoms of genital infections - secretions from the genital tract, the feeling of itching, burning sensation in the vulva and vagina, urinary disorders and so on.
Bartholin gland cyst must be differentiated from cysts gartnerova channel, purulent processes in the interior of the labia majora (abscess, boil, and so on) and "wandering abscess" in tuberculosis.External similarity manifestations of these diseases confirms the inadmissibility of self-diagnosis and self-treatment.
Diagnostics bartholinitis in a women's clinic does not cause much difficulty.The diagnosis is usually placed during gynecological examinations based on the characteristic appearance of pathological changes in the external genitalia.
Laboratory diagnosis allows to establish a true "culprit" of the infectious process.In order to identify the causative agent appointed:
- normal vaginal swab contents;
- a study on the presence of the main pathogens of sexual infections (PCR diagnostics): gonorrhea, trichomoniasis, human papillomavirus, chlamydia, and so on;
- crop discharge from the vagina for a more detailed study of the composition of the vaginal microflora and identification of its sensitivity to antibiotics;
- bacteriological examination of pus obtained after spontaneous opening of the abscess or after very careful pressure on the excretory duct cancer.
also prescribed to patients blood count, immunogram, blood tests for HIV and RW.If you suspect a urogenital infections conducted additional research.
bartholinitis Negative impacts are most often associated with delayed treatment of the patient's medical care or improper attempts to self-medication.