Bartholin's gland inflammation

　　This disease is often a mixed infection. During an acute inflammatory attack, bacteria first invade the gland duct, and the duct opening may become swollen or blocked due to inflammation or the coagulation of exudate, so that pus cannot be excreted externally. Gradually accumulating, it can form an abscess called the vestibular gland abscess (also known as the Bartholin gland abscess).

　　The etiology of Bartholin gland inflammation is mainly bacterial infection. Chinese research has found that the pathogen is mostly Staphylococcus, Streptococcus, Escherichia coli, gonococcus, etc., while in foreign countries, gonococcus is more common. In addition, there are anaerobic bacteria. Some scholars have cultured the pus of the Bartholin gland abscess and found anaerobic bacteria, among which Bacteroides is more common. With the increasing incidence of sexually transmitted diseases, Neisseria gonorrhoeae and Chlamydia trachomatis have become common pathogens.

　　The main cause of Bartholin gland inflammation is also the entry of pathogenic bacteria into the gland. The entry of bacteria into the gland is related to the following factors: one is unclean sexual intercourse. If the male has gonorrhea and has not been completely cured, he has sexual relations with his partner, the淋球菌 on the glans penis can enter the gland through the opening of the duct of the vestibular gland at the vaginal opening; sexual intercourse during menstruation can also push the pathogenic bacteria in the menstrual blood into the duct opening and enter the deep part of the gland. Childbirth can also cause Bartholin gland inflammation. If there is a vaginal surgical delivery, bacteria can enter the gland through the wound.

　　Another factor is not paying attention to the cleanliness of the vulva. For example, using dirty hands to touch the vulva, not washing the vulva every day, and not changing underwear frequently can all allow bacteria to reproduce and increase at the vaginal opening, enter the gland through the gland duct opening, which is more common in unmarried girls.

　　What complications can Bartholin gland inflammation lead to, which is also a problem we need to pay further attention to.

　　If the abscess is not treated in time, it may occasionally spread to the posterior direction, forming a perirectal abscess, and sometimes even溃破 into the rectum. After the abscess is incised and the pus is drained, most of the abscess cavities can close completely and heal, but occasionally a fistula may form, with a continuous discharge of a small amount of secretion. A small and hard nodule can be palpated during palpation, with slight tenderness, and pus may sometimes be discharged from the fistula when pressed. Sometimes the fistula may close spontaneously or become narrow, and pus may accumulate again, forming an abscess, which may also recur and not heal for a long time.

　　This disease often occurs on one side, initially manifested as swelling, pain, and burning sensation in the vulva. Sometimes the pain is very severe, even causing difficulty in urination and defecation, pain during urination, and difficulty in walking. Examination of the vulva shows that the skin on the affected side is red and swollen, hot, and painful to the touch. Sometimes, a small white dot can be seen at the opening of the Bartholin gland on the affected side. When an abscess forms, the pain can become significantly worse, with the diameter of the abscess ranging from 3 to 150px, or even larger, and a palpable fluctuation can be felt locally. Sometimes, it may also be accompanied by systemic symptoms such as fever, and the lymph nodes in the inguinal area can become swollen to varying degrees. When the pressure inside the abscess increases, the surface skin becomes thin, and the abscess may burst spontaneously. If the opening is large, the pus will flow out spontaneously after the pus, and the inflammation often subsides quickly and heals. If the opening is small, the pus cannot be drained smoothly, and the inflammation persists, and symptoms may recur even if they are reduced.

　　Severe cases may have systemic symptoms such as fever and headache. If not treated, the abscess can break on its own. After the pus is discharged, local pain will subside, congestion and edema will decrease, and systemic symptoms will disappear. When the pressure inside the abscess increases, the skin surface becomes thin, and the abscess breaks on its own. If the orifice is large, it can drain itself, and the inflammation will subside and heal quickly. If the orifice is small, the pus cannot be completely drained, and the lesion may recur. Examination shows local skin redness, fever, and marked tenderness. Sometimes there may be fever and increased white blood cells. If it is due to Neisseria gonorrhoeae infection, squeezing the local area may produce thin, pale yellow pus. When the abscess forms, the pain increases, and it can be felt to have a fluctuation. In severe cases, the diameter of the abscess can reach 5 to 6 cm, and the patient may have systemic symptoms such as fever. The inguinal lymph nodes may increase to varying degrees.

　　When taking measures to prevent bartholin gland inflammation, attention should be paid to the following issues:

　　Bartholin gland inflammation is mainly caused by bacterial infection of the Bartholin gland, leading to poor drainage at the opening of the gland duct, causing inflammation. Therefore,

　　1. Keeping the vulva clean is the main method of preventing infection. Wash the vulva daily and do not wear nylon underwear.

　　2. Treat vulvitis promptly when it occurs, pay attention to the cleanliness and dryness of the vulva in daily life, wear cotton underwear, and do not wear synthetic underwear.

　　3. Try to reduce the use of sanitary napkins or sanitary pads during non-menstrual periods, maintain the breathability of the vulva, and wear moderately loose pants.

　　4. Pay attention to sexual hygiene. To some extent, it can prevent the occurrence of bartholin gland inflammation.

　　5. Seek medical treatment as soon as possible once symptoms occur.

　　What laboratory tests are needed for bartholin gland inflammation? Due to severe pain, vaginal speculum examination is not possible, and it can be temporarily not performed if not necessary. Generally, secretion should be taken from the opening of the bartholin gland, the urethral orifice, and the paraurethral glands for smear examination to detect pathogens.

　　Specific process: Use a sterile long cotton swab to take a small amount of vaginal secretion from the posterior fornix, place it on a glass slide containing 1 to 2 drops of physiological saline, and immediately perform a microscopic examination. Vaginal secretion smear examination is to scrape vaginal cells for smearing, and observe under a microscope. It mainly determines whether there is trichomonal vaginitis and candidal vaginitis. No vaginal cleanliness grade I, trichomonas, or mold were seen.

　　Abnormal results: The grade II vaginal cleanliness does not indicate that the patient is already ill, but rather that there is an excessive amount of unclean secretions, which is easy to cause illness. It should be alert and pay attention to vaginal cleanliness.

　　A positive mold result indicates the presence of mold visible under a microscope, confirming the diagnosis of candidal vaginitis.

　　People who need to be checked include those with vulvar itching or burning discomfort, lower abdominal or lumbar sacral pain, which worsens during sexual intercourse, menstruation, and defecation. Some may also experience symptoms such as weak lower limbs, bitter taste, nausea, and yellowish urine.

　　What is good for the body when suffering from bartholin gland inflammation?

　　1. Eat light and nutritious, easy-to-digest foods, such as fish and chicken.

　　2. Eat more fresh fruits and vegetables.

　　3. Eat more foods that can increase immunity, such as mushrooms, mushrooms, tremella, and silver ear.

　　2. What foods should not be eaten best during Bartholinitis?

　　1. Patients with Bartholinitis should not eat some spicy, stimulating, and greasy foods, as these foods will trigger the condition and make the condition worse. Eating these foods during treatment will affect the treatment and make the treatment ineffective or less effective.

　　2. Abstain from smoking and drinking.

　　3. Eat less drinks and snacks containing chemicals, preservatives, and additives.

　　Medication is a relatively effective method, so the conventional method of Western medicine for treating bartholinitis is to use antibiotics, and if an abscess forms, surgical incision and drainage can be considered. If there are other complications, attention should be paid to improving the overall condition of the body.

　　1. General Treatment:During the acute stage, bed rest should be noted, and attention should be paid to keeping the vulva clean, and cold compresses can be applied locally. If there is fever, more fluids should be supplemented.

　　2. Anti-inflammatory Treatment:According to the nature of the pathogen, appropriate antibiotics should be selected. Penicillin 8 million units can be administered intravenously once a day, and 250ml of 0.2% metronidazole can be added to the intravenous infusion. For example, penicillin can be injected intramuscularly, or cephalosporin antibiotics can be taken orally, as they often have anaerobic infections, and broad-spectrum antibiotics such as quinolones can be used directly, or cephalosporin antibiotics can be used with antibiotics against anaerobic bacteria. If there is no abscess, oral medication is effective and symptoms gradually improve and absorb. In addition, heat compresses or sitz baths with local heat application of清热、解毒 Chinese medicine can be used, or 1:5000 diluted potassium permanganate solution can be used for sitz baths.

　　3. Local Treatment:If an abscess has formed, it should be incised and drained immediately, and an ostomy should be created. The incision should be made at the thinnest part of the skin, on the inner side of the labia majora, to drain pus. Change the dressing regularly until recovery. Alternatively, after thoroughly disinfecting the vulva, use a larger needle to puncture the abscess cavity from the mucosal side, aspirate the pus, and then inject 200,000 to 320,000 units of Gentamicin or 200,000 to 400,000 units of Penicillin. During the acute stage, try to rest in bed as much as possible, and keep the vulva clean and dry locally. At the same time, antibiotic treatment should be given, and it is best to guide medication based on the culture results of the secretion. Generally, empirical treatment is adopted.