Bartholinitis
Introduction
Introduction to vestibular gland inflammation The vestibular glandular inflammation (bartholinitis) is inflammation of the vestibular gland. The vestibular gland is located in the lower third of the labia majora on both sides, and its diameter is about 0.5-1.Ocm. Their outlet glands are about 1,5-2. .Ocm, the opening of the gland is located near the inside of the labia minora. Under the stimulation of sexual intercourse, mucus is secreted for smoothing. Due to the particularity of the anatomical location, pathogens are prone to invade causing vestibular gland inflammation. Most of the pathogens are Staphylococcus, Escherichia coli, Streptococcus and Enterococcus. With the increase of the incidence of sexually transmitted diseases, Neisseria gonorrhoeae and Chlamydia trachomatis have become the most common pathogens. If not treated promptly, acute suppurative inflammation will become a vestibular gland abscess, which is more common in women of childbearing age. basic knowledge The proportion of sickness: 0.25%, more common in women of childbearing age Susceptible people: women Mode of infection: non-infectious Complications: abscess
Cause
Causes of vestibular gland inflammation
Pathogen (50%):
Most of the pathogens are Staphylococcus, Escherichia coli, Streptococcus and Enterococcus. With the increase of the incidence of sexually transmitted diseases, Neisseria gonorrhoeae and Chlamydia trachomatis have become the most common pathogens.
Anaerobic bacteria (30%):
In addition, there are anaerobic bacteria, among which Bacteroides is the most common, because Bacteroides is a normal vaginal resident, and there are more chances of infection. This disease is often a mixed infection, which occurs mostly during the growth period.
Pathogenesis:
The disease is often mixed infection, pathogens are complex, the main pathogens are endogenous pathogens and pathogens of sexually transmitted diseases, mostly staphylococcus, streptococcus, Escherichia coli, gonococcus, etc., foreign and domestic individual areas of Neisseria gonorrhoeae Mainly, it can also be caused by anaerobic bacteria (including Bacteroides).
Prevention
Vestibular gland inflammation prevention
Keeping the vulva clean is the main method to prevent vestibular gland inflammation. Clean the vulva daily, wear sweat-absorbent and breathable underwear, preferably cotton products, timely treatment when suffering from vulvitis, to prevent vestibular gland inflammation to a certain extent. happened.
1, pay attention to personal hygiene, keep the vulva clean, clean the vulva 1-2 times a day.
2, menstrual period menstrual blood pollution genital area is more prone to infection, so the menstrual period should also clean the vulva once a night, but be careful not to let water into the vagina.
3, avoid sexual intercourse during the menstrual period.
Complication
Vestibular gland inflammation Complications
If the abscess is not treated in time, it can be spread to the posterior side to form an abscess around the rectum, sometimes even to the rectum.
After the abscess is cut open, most of the abscess can be completely closed and healed, but even the fistula can be formed, and a small amount of secretions are continuously discharged. When palpation, a small and hard induration can be found, with slight tenderness, sometimes when squeezed. The pus can be discharged from the mouth of the mouth. Sometimes the mouth is closed or narrowed by itself, and the pus can be accumulated to form an abscess again. It may also be repeated and will not heal for a long time.
Symptom
Vestibular gland inflammation symptoms Common symptoms Vulvar burning stimulation genital swelling swelling urination pain vulva skin swelling vulvar pain vulvitis itching inguinal lymphadenopathy
At the beginning of the labia majora, red and swollen lumps were found, pain, burning sensation, obvious tenderness, painful urination, difficulty walking, sometimes difficulty in urinary and bladder, mostly unilateral, occasional bilateral disease, after the surface of the mass Thinning, edema around the tissue, fluctuations, development to abscess, the size of the tumor is different, mostly egg size, often accompanied by inguinal lymphadenopathy, severe cases may have fever, headache and other systemic symptoms, if not treated, abscess can be After ulceration, the local pain is relieved after the pus flows out, the congestion and edema are relieved, and the systemic symptoms can disappear. When the pressure inside the abscess increases, the surface skin becomes thinner, and the abscess collapses on its own. If the hole is large, it can drain itself. If it breaks down and healed, if the mouth is small, the pus can not be completely drained, the lesion can be recurrent, and the local skin redness, fever, tenderness, and sometimes body temperature rise, white blood cell increase and other systemic symptoms, if gonorrhea Neisseria infection, local extrusion can flow out thin, pale yellow pus, when the abscess is formed, the pain is intensified, and the fluctuation can be touched. In severe cases, the abscess can reach 5~ 6cm, the patient developed systemic symptoms such as fever, and the inguinal lymph nodes may increase in different degrees.
Examine
Examination of vestibular gland inflammation
Due to severe pain, vaginal speculum examination is impossible. If it is not necessary, it can not be carried out temporarily. Generally, the secretions should be taken for smear in the vestibular gland opening and urethral opening. The vestibular gland inflammation showed fever, and the examination showed that the skin color of the tumor was red, swollen and painful, and there was a sense of fluctuation. When the pressure was applied, pus overflow was observed at the opening of the gland.
Diagnosis
Diagnosis and differentiation of vestibular gland inflammation
diagnosis
According to the medical history and local appearance and finger diagnosis, it is generally not difficult to diagnose, but at the same time, attention should be paid to the abnormality of the urethral opening and the paraurethral glands. Due to severe pain, vaginal speculum examination is impossible. If it is not necessary, it may not be carried out. Generally, the secretions of the vestibular gland and the urethra and the urethral glands should be taken for smear to check the pathogen.
Differential diagnosis
Mainly differentiated from vestibular gland cysts: the common feature is that there are lumps in the vestibular gland, but the vestibular gland inflammation shows fever. The skin color of the lumps is red, swollen and painful, and there is a sense of fluctuation. During the pressurization, pus overflow can be seen at the opening of the gland, while the color of the vestibular gland cyst is unchanged, the cyst is cystic, no tenderness, no pus overflow during pressurization, and no systemic symptoms such as fever.
