Bartholin’s abscess

Definition

Bartholin's abscess is the buildup of pus that forms a lump (swelling) in one of the Bartholin's glands, which are located on each side of the vaginal opening.

Alternative Names

Abscess - Bartholin's; Infected Bartholin's gland

Causes, incidence, and risk factors

A Bartholin's abscess forms when a small opening (duct) from the gland gets blocked. Fluid in the gland builds up and may become infected. Fluid may build up over many years before an abscess occurs.

Often the abscess appears quickly over several days and become very hot and swollen. Activity that puts pressure on the vulva, and 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. A biopsy may be recommended in older women to rule out a tumor.

Any vaginal discharge or fluid drainage will be sent to a lab for analysis.

Treatment

Soaking in warm water four times a day for several days usually provides some relief and causes the abscess to open and drain on its own. However, the opening is usually very small and closes quickly, before drainage is complete.

A small surgical cut can completely drain the abscess. This provides the greatest relief and the fastest recovery. The procedure can be done under local anesthesia in a doctor's office. A catheter (tube) may be used to continue to allow draining while the area heals.

Antibiotics may be prescribed, but they are not usually needed if the abscess is drained properly.

Women who have repeated abscesses may consider a procedure called marsupialization. The procedure involves surgically creating a small, permanent opening to help the gland drain. Women with large, persistent Bartholin's cysts may also have this procedure.

Your health care provider may recommend that the glands be removed if abscesses keep coming back.

Support Groups

Expectations (prognosis)

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

It is important to treat any vaginal infection that may be diagnosed at the same time as the abscess.

Complications

A chronic Bartholin's duct cyst may develop. In women over the age of 40, a swollen Bartholin's gland may mean there is a cancerous 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 have one of these cysts and develop a fever higher than 100.4 degrees Fahrenheit.

Prevention

Bartholin's abscess can happen without any specific cause, so there is no specific way to prevent it.

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References

Birnbaumer DM, Anderegg C. Sexually transmitted diseases. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 96.

Butler KH. Incision and drainage. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 37.