An accumulation of purulent fluid that forms a lump ( swelling ) in one of the mucus producing Bartholin's glands which are located on each side of the vaginal opening at the inner-most part of the labia. This swelling is hot, sensitive, and painful.

Alternative Names

Abscess - Bartholin's; Infected Bartholin's gland

Causes, incidence, and risk factors

Bartholin's abscesses form when ducts (small drainage openings) to the Bartholin's glands get blocked. Secretions in the glands build up and may become infected. Many different types of bacteria can cause the infection, including the bacteria that cause gonorrhea. However, these infected glands are usually not caused by a sexually transmitted infection. Often the abscess can appear and become full-blown within 2 or 3 days. Any pressure against the vulva may cause such excruciating pain that even walking and sitting seem almost impossible.

Signs and tests

A pelvic examination reveals an enlarged and tender Bartholin's gland.

Treatment

Soaking in warm water, 4 times a day for several days usually provides some relief. This may help localize infection and precipitate spontaneous drainage. However, it does not always solve the problem because the site of rupture is usually very small and closes quickly so drainage isn't complete. Surgical incision, which results in complete drainage of the abscess , provides the greatest relief and the fastest recovery. This procedure can be done under local anesthesia in a doctor's office. Placement of an iodoform gauze wick or a small rubber catheter during surgery allows the abscess to continue draining while facilitating healing. Antibiotics may be prescribed to combat the infection, but they are not usually needed if the abscess is drained properly. Women who have recurrent abscesses may consider the marsupialization procedure. A small, permanent opening is surgically created to facilitate drainage. Occasionally, the glands will be completely excised if the abscesses continue to recur.

Expectations (prognosis)

The chance of full recovery is excellent. About 10% of time the abscess will recur in the future. It is important to treat gonorrhea if it is the cause.

Complications

A chronic Bartholin's duct cyst may develop if the purulent fluid of the abscess is "walled off" from the surrounding tissue. In women over the age of 40, an enlarged Bartholin's gland may signal an underlying 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 it does not improve with 2-3 days of home treatment, or if pain is severe and interferes with normal activity. Call the health care provider if a fever above 100.4 degrees Fahrenheit develops.

Prevention

Safer sex behaviors (especially condom use) and good personal hygiene may decrease the risk.