A Bartholin’s abscess occurs when the Bartholin’s glands, located
on either side of the opening of the vagina, become obstructed, and eventually
infected. A cyst will usually form when the gland is blocked. If the cyst
becomes infected, it can lead to a Bartholin’s abscess. The abscess can be more
than an inch in diameter and cause extreme pain. While most people with a
Bartholin’s abscess completely recover, there is a chance that the condition
will come back.
What Causes a Bartholin’s Abscess? What Are the Symptoms?
There are two Bartholin’s glands, each about the size of a pea,
with one on each side of the vaginal opening. They provide lubrication to the
vaginal membranes. Bacteria that get into the gland can cause an infection,
swelling, and an obstruction. Fluid builds up in the gland, increasing pressure
on the area. If the infection and swelling advance, the gland may abscess,
which breaks open the skin. Bartholin’s abscesses usually only appear on one
side of the vagina at a time.
It may take years for fluid to build up enough to form a cyst,
but an abscess will make itself known right away. A Bartholin’s abscess tends
to be extremely painful and the area will likely be red, swollen, and warm to the
Doctors believe that bacteria such as E. coli, or
sexually transmitted diseases (STDs) such as chlamydia or gonorrhea, may cause
the infections that lead to Bartholin’s abscesses.
How Is a Bartholin’s Abscess Diagnosed?
To determine if you have a Bartholin’s abscess, your doctor will
perform a physical exam to check for any lumps or bumps within the vagina that
would indicate an abscess. They will likely take a fluid sample from the area
to check for any STDs present that may need treatment as well.
If you are over the age of 40 or have already gone through
menopause, your doctor may want to perform a biopsy on any masses found in the
vagina to rule out other possible sources of the problem.
Treatment Options for a Bartholin’s Abscess
It’s possible to treat a Bartholin’s abscess at home using sitz baths. In a sitz bath, you fill
the tub with warm water up to hip level. It may take many days of sitz baths to
treat the abscess because the opening of the Bartholin’s gland is very small,
and it may close before drainage is complete. Soaking may not be the most
effective cure, but a sitz bath can soothe your pain and discomfort. With a
Bartholin’s abscess, you should soak in three or four sitz baths a day, for at
least 10 to 15 minutes each.
If the abscess is very large or persists despite more than a week
of conservative care, your doctor may decide it’s best to drain it surgically. This procedure
can occur in your doctor’s office under local anesthesia, but general
anesthesia in a hospital is also an option. Talk to your doctor about the best
course for you.
During the surgery, your doctor makes an incision in the abscess
and places a catheter inside to drain the fluid. The catheter may remain in
place for several weeks. Once the abscess heals, a surgeon can remove the
catheter or allow it to fall out on its own.
Since the abscess is likely the result of an infection, your
doctor may prescribe antibiotics. In most cases, antibiotics are unnecessary if
the abscess drains properly.
If you continue to develop Bartholin’s abscesses and find they
greatly impact your quality of life, your doctor may want to perform a
procedure called marsupialization. This is a surgery very similar to the
other drainage procedure. However, instead of allowing the incision to close, your
doctor will stitch the incision open to allow for maximum drainage. A catheter
is typically still used. Local anesthesia is still an option during a marsupialization,
but depending on the size and complexity of the abscess, your doctor may
perform the procedure under general anesthesia. Your doctor will treat any
infection present before the surgery.
If none of these procedures are permanently successful, your
doctor may recommend removing your Bartholin’s glands. This surgery is rare and
would require general anesthesia in a hospital setting.
Outcome and Recovery
If you develop a painful, swollen lump near the opening of your
vagina that doesn’t go away after a few days of warm sitz baths, call your
doctor. If you develop a fever or the pain starts interfering with your daily
activities, talk to your doctor about treatment. You should have no lasting
effects from the abscess once it’s treated successfully.