What is the best way to diagnose Bartholinitis?

Bartholin's gland cyst is caused by inflammation of the Bartholin's glands, which leads to blockage of the opening and inability to discharge secretions. After the acute inflammation subsides, the pus gradually turns into clear mucus. It can also be caused by vaginal and vulvar damage during childbirth, which damages the Bartholin's gland ducts and causes them to become blocked. So, what is a good way to diagnose Bartholin's gland inflammation?

The diagnostic criteria for Bartholin's gland cyst are as follows:

1. History of onset

Most patients have a history of acute Bartholinitis, or a history of perineal laceration and episiotomy during delivery.

2. Clinical manifestations

(1) When the cyst is small, the patient usually has no subjective symptoms and it is often discovered during a gynecological examination. When the tumor grows larger, the patient may feel a swelling sensation in the vulva or discomfort during sexual intercourse, and can touch the tumor on one side of the vulva.

(ii) During the examination, the affected side of the vulva is swollen and a cystic mass can be felt. It is usually oval and adheres to the skin. The labia minora on that side is flattened and the vaginal opening is pushed toward the healthy side. Repeated infection can cause the cyst to enlarge.

(III) Bartholin's gland cysts vary in size, and most of them gradually increase in size, and some can remain unchanged for several years. If the cyst is small and not infected, the patient may have no symptoms; if the cyst is large, the patient may feel a sense of heaviness in the vulva or discomfort during sexual intercourse. Examination shows that the cysts are mostly unilateral or bilateral, and are mostly oval in shape.

3. Diagnostic examination

Acute Bartholinitis first invades the gland duct, presenting as acute suppurative inflammatory changes, with local redness, swelling, heat, and pain. Sometimes there is a feeling of heaviness and difficulty in urination and defecation, as well as systemic symptoms such as increased body temperature and increased white blood cell count. The gland duct opening is often blocked due to swelling or coagulation of exudate, and the pus cannot flow out to form an abscess, which is called Bartholin's gland abscess. There may be a sense of fluctuation locally, and when the pressure in the abscess cavity increases due to swollen inguinal lymph nodes, it may rupture on its own. If the rupture is large and the drainage is unobstructed, the inflammation may subside and heal quickly. If the rupture is small and the drainage is not smooth, it may recur, often making the patient restless when walking or lying down. When the acute inflammation disappears, the gland duct opening is blocked, the gland secretion fluid cannot be discharged, or the pus gradually turns into mucus to form a cyst, which is called Bartholin's gland cyst.

Based on the medical history, local appearance and digital examination, it is generally not difficult to diagnose. However, attention should also be paid to whether there are any abnormalities in the urethral opening and paraurethral glands. Due to severe pain, vaginal speculum examination is no longer possible. If it is not necessary, it can be temporarily suspended. Generally, secretions should be taken from the opening of the Bartholin's glands, the urethral opening, and the paraurethral glands for smear examination of pathogens.

Warm Tips: It should be distinguished from labia majora inguinal hernia. The latter has an impulse feeling with inguinal mass, and the mass swells slightly when the air is released downwards. The percussion sound is tympanic. It usually appears suddenly after excessive force. According to these characteristics, the identification is generally not difficult. It should be distinguished from labia majora inguinal hernia. The latter has an impulse feeling with inguinal mass, and the mass swells slightly when the air is released downwards. The percussion sound is tympanic. It usually appears suddenly after excessive force.