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Bartholin’s abscess

Definition

Bartholin's abscess is the build-up 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. The infection is usually not caused by a sexually transmitted disease (STD). However, many types of bacteria associated with STDs, such as gonorrhea, can lead to infection.

Often the abscess appears and become very hot and swollen within 2 or 3 days. Any activity that puts pressure against the vulva, even 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.

  • Tests may be done to determine if gonorrhea is the cause.
  • Fluid drainage may be collected for lab analysis.
  • A biopsy may be recommended in older women to rule out an underlying Bartholin's gland tumor.

Treatment

Soaking in warm water 4 times a day for several days usually provides some relief. This may help bring the infection into one area and cause the abscess to open and drain on its own. However, this does not always solve the problem, because the site of rupture 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. This 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. In this procedure, a small, permanent opening is surgically created to help the gland drain.

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

Expectations (prognosis)

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

It is important to treat gonorrhea or any other infection that causes abscesses.

Complications

A chronic Bartholin's duct cyst may develop if the fluid of the abscess is scraped off from the surrounding tissue. In women over the age of 40, a swollen Bartholin's gland may mean there is a 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 develop a fever higher than 100.4 degrees Fahrenheit.

Prevention

Safer sex behaviors (especially condom use) and good personal hygiene may decrease the risk of developing a Bartholin's abscess.

Review Date:9/19/2006
Reviewed By:Audra Robertson, MD, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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