What is a Bartholin Abcess?

location of cyst or abcess

If you have ever had a Bartholin Abcess, then you know it can be like being in hell. I had one twice about 10 years ago, although I have read that some people have had them over 10 times!!

If you have ever had a painful swelling of the labia and are unsure what it was, then no doubt it was one of these. They usually require a visit to the doctor because of the degree of pain they cause, so you usually know if you have had one!!!!

The Bartholin glands are located at the entrance to the vagina on the inner labia (see illustration above), one on each side and are very tiny. Their purpose is to secrete fluid on to the inner surface of the labia.

They can become infected and this is a common problem in women. Fortunately infection usually occurs in only one at a time!! (The mind boggles)

When I had it the first time, my middle daughter, Clare, was around 6 months old.

I awoke one morning with a heavy and sore feeling in the vaginal area and generally felt unwell. I knew I had to go to work so carried on, wondering why I was so sore.

After a few hours the pain had increased. Standing was very difficult and I felt faint with the pain. Sitting was even more difficult. I was worried because I was in work and could not really explain to others why I was feeling so unwell.

By the time I was due to leave work for home, the pain was severe and I was covered in a rash. My temperature was very raised and walking was almost impossible.

On arriving home I inspected the area and saw the the whole side of the labia was swollen to about the size of an orange. It was very disconcerting as the swelling reached half way down my thigh!!

The pain was unbearable and my temperature so raised that I was incoherrent and I had to be supported in walking.

I was taken to the doctor who diagnosed a Bartholin abcess and he immediately called the hospital and arranged for me to be admitted. He was shocked at the degree of swelling and to hear how much I had deteriorated over the hours since I had first complained.

I went to the hospital and was put in a room with a fan on me and waitied for the doctor. When he came, and after I was examined, he prescribed antibiotics and pain killers and after a few hours, I was sent home. I felt really ill. I had never heard of Bartholin glands, cysts or abcesses and was quite scared, especially when a nurse told me the abcesses can return with alarming regularity.

It took around 10 days for the cyst to rupture. 10 days of extreme pain, inability to walk, sleep, lie down or sit without being in agony. Painkillers did not even touch it. Sitting in the hot sitz baths were unbearable due to the amount of swelling and I needed help to get out. I was traumatised by the disfiguration of the labia and of how it could swell to such a degree and could not imagine it returning to normal ever again.

One day, I was sitting gingerly on the edge of a chair and my parents were at my home helping to care for my two young children as I could not deal with them at all.

I sneezed and felt the abcess rupture against the compression from the edge of the chair and an immediate relief of pain.

However this in itself was pretty horrific as I rushed to the toilet and spent around half an hour sitting there while loads of infected pus emptied into the toilet together with a huge ball of something indescribable, but what I can only liken to a huge eyeball!!

I was so relieved that the pain had gone and after three or four more days, I returned to work, thinking "great, no more Bartholin abcesses". How wrong could I be?

However, three months later, I felt the now familiar growing soreness in the same area and toddled off to the doctors in dread. Another Bartholin abcess was confirmed. My heart sank and to be honest, I felt near hysteria at the thought of enduring so much pain again.

The doctor was very angry to hear how I had been treated at the hospital the first time and immediately phoned the hospital proclaiming his anger at the treatment of a mother who was struggling to work with a young family!! (at that moment, I almost loved him!!)

He arranged for me to be met by a Gynae consultant in casualty.

I was to have a procedure called Marsupialization which was what he had intended to happen the first time he had sent me to hospital

This involves making an incision above the cyst and into the cyst wall which drains the abcess. The lining of the cyst wall is then sutured to the overlying skin to create a permanent drain site. In most cases this prevents the cyst recurring.

I was taken to theatre about midnight after admission and was given a general anesthetic

Fortunately for me, I have never had a repeat episode but empathise with all those who have had such experiences regularly.

What else can help?

Medical Drainage

Really, surgery (marsupialization) carried out by a Gynae surgeon is the only way to prevent recurrence of Bartholin abcesses, although your doctor can drain the abcess in their surgery. This can be an uncomfortable experience depending on how infected the area is and degree of localised swelling.

Local anesthetic is injected into the area and does not always work sufficiently to numb infected tissue. After the area is drained, the area is packed with either gauze or a small catheter. The purpose of this is to ensure the area is held open therefore promoting further drainage.

After medical drainage has been carried out, you need to return to the doctor for a follow up and for any packing to be removed. The follow up should be within 24-48 hours. In the meantime Sitz baths should be taken to promote drainage. (see below)

Medication in the form of pain killers and antibiotics will almost certainly be prescribed.

Depending on the degree of swelling and infection, IV medications for pain relief and or sedation may be arranged.

Sometimes the GP will arrange for marsupialization to be carried out some time after the drainage procedure when the abcess has "cooled off"

Personally, marsupialization seems the better option as there is no guarantee with the drainage procedure that the abcess won't keep recurring. Once you have had a Bartholin abcess, you certainly won't want a repeat performance. In chronic cases of constant recurrence, the gland can be permanently removed.

As with any operation the area will take around 6 weeks to heal after surgery. In this resprect and to prevent any infection, it is best to wait the full 6 weeks before resuming sex

What is the cause?

The cyst or abcess developes when the duct in the Bartholin gland becomes blocked. The blockage causes an accumulation of fluid causing a cyst which then can become infected producing an abcess.

The abcess can be caused by bacteria including sexually transmitted bacteria, as well as bacteria from the digestive tract.

A cyst is generally not painful and only becomes so when an abcess has developed due to infection and the pain can be significant and severe. Swelling of the labia is generally on one side only as normally only one gland becomes infected.

Discharge may also be present. Walking and sitting and even lying down can be painful, and with walking and standing, the heaviness and pressure of the swelling can make you feel light headed and trying to cope with the pain can be hard as pain relief is not normally of a level to provide complete relief.

It can swell to quite a degree, sometimes to the size of an orange and if the pain is so severe that you are unable to sit or walk, have either a fever, vomitting or abdominal pain, then emergency help should be sought.

Examination of the area is enough to confirm Bartolin cysts of abcesses but sometimes a swab is taken to check for signs of sexually transmitted diseases such as chlamydia. Whilst this will not change the treatment, additional medication may be prescribed if an additional STD is confirmed from the swab.

Sitz Baths

You can treat them at home in the absence of any symptoms such as fever or severe pain by taking something called a Sitz bath to promote drainage. This will involve sitting in a few inches of very warm to hot water several times a day. The water should be bearable and not so hot so as to burn. Salt can be added in small amounts. You need to soak the area for around 15 minutes, 3 to 4 times a day and this can often be all that is needed if the swelling is only at the cyst stage and is not causing pain. If it has reached the abcess stage then medical intervention is needed to prevent further distress.

However Batholin abcesses can still require further drainage even after they have "popped" at home as infected fluid may still be lurking.

Reinfection can occur if complete drainage has not taken place and then you really need to consult a doctor to either drain the fluid or request the marsupialization procedure.

Prevention

If you notice a swelling, Sitz baths may prevent it becoming a full blown Bartholin abcess so prompt treatment is needed.

Safe sex practices are imperative if the abcess has been caused by bacteria caused by STD's.

Personal hygeine is of utmost importance if you are a sufferer and prone to regular flare up's. Use an unscented organic vegetable based soap as perfumed products are not recommended.

The hygeine of your partner is important too. Clean fingers and cleanliness of "male anatomy parts" is very important as well as sexual health.

Most of all, make sure your doctor takes notice. Many brush you off with a course of antibiotics. Believe me, this is not enough and marsupialization is the only way to ensure that reinfection does not occur or by destroying the gland completely by removal. Male doctors have never had to suffer the pain of a Bartholin abcess, so make sure they listen!!

Regular taking of products to boost your immune system and reduce inflammation in the body may also help reduce or even eliminate attack

Please click here to read about more conditions helped by Serrapeptase and also see Detox your World's website for plenty of information.



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