Cyst of bartolinovy gland
Cyst of bartolinovy gland – the osumkovanny congestion of a secret in vagina threshold iron caused by obstruction of its output channel. The cyst of bartolinovy gland is shown by a swelling in the basis of vulvar lips, discomfort when walking, physiological departures, sexual intercourse. At infection of a cyst the clinic of abscess of bartolinovy gland develops. Diagnostics is based on data of survey, detection of the accompanying urogenital infections. Treatment can include a marsupialization of a cyst of bartolinovy gland, the Word installation of a catheter, an extirpation of bartolinovy gland, opening of abscess of gland.
Cyst of bartolinovy gland
Bartolinovy glands – the pair glands of a threshold located in the thickness of vulvar lips at an entrance to a vagina. The main function of bartolinovy glands consists in development of the viscous grayish secret serving for moistening of a mucous vulva at sexual excitement. The size of bartolinovy glands does not exceed 0,5 cm; assignment of a secret from glands happens on the output channels opening from a vagina threshold.
At partial or full impassability of an output channel outflow of the secret allocated by gland stops, and he begins to crowd in a gleam of the obturirovanny channel, stretching it and forming a cyst of bartolinovy gland. A cyst of bartolinovy gland look as opukholevidny formation of a vulvar lip of 3-5-8 cm in size. Under adverse conditions (secondary infection, immunity easing) there is cyst suppuration to development of abscess of bartolinovy gland.
Reasons of formation of a cyst of bartolinovy gland
Formation of a cyst of bartolinovy gland usually happens against the background of chronically proceeding bartolinit – an inflammation of gland of a threshold and its channels. The inflammation of gland can be connected with STD (gonorrhea, trichomoniasis, mycoplasmosis, candidiasis, ureaplasmosis, clamidiosis, etc.), hit in fabric of gland of nonspecific opportunistic microorganisms (stafilokokk, colibacillus, streptococci) and the general decrease in resistance of an organism.
Infection of fabrics of gland is quite often promoted by non-compliance with intimate hygiene, traumatizing an integument in the course of an epilation of deep bikini, mechanical irritation of skin of genitals close linen etc. The hematogenic way of penetration of an infection is noted in the presence of the centers of a chronic inflammation in an organism - tonsillitis, caries, antritis, pyelonephritis, etc.
Sometimes development of a bartolinit or a cyst of bartolinovy gland is preceded by surgical termination of pregnancy, other gynecologic interventions and manipulations. Education or increase in a cyst of bartolinovy gland of the patient is frequent connect with recent sexual intercourse as in its process gland develops bigger quantity of a secret.
Symptoms of a cyst of bartolinovy gland
The uncomplicated cyst of bartolinovy gland represents roundish, almost painless swelling in the lower segment of a big vulvar lip. The size of a cyst of bartolinovy gland can vary from the pea sizes to goose egg. Small educations proceed asymptomatically and can come to light the gynecologist in the course of planned survey. In case of growth of a cyst of bartolinovy gland to the considerable sizes inconveniences at the movement are noted, morbidity at sexual intercourse.
At suppuration of a cyst of bartolinovy gland and formation of abscess the febrilny temperature (38-39 °C), intoxication, sharp deterioration in health appears. Increase in the amount of education up to 10-12 cm, feelings of a raspiraniye and the sharp pulsing pain in a crotch is locally noted. Any movement (walking, sitting, etc.) strengthen pain. Abscess of bartolinovy gland can spontaneously be opened with allocation outside of pus. As the abstsedirovaniye of a cyst of bartolinovy gland is quite often connected with sexually transmitted infections, existence of clinical symptomatology of a colpitis, uretrit, endotservitsit is possible (hypostasis and hyperaemia mucous, an itch, bleach).
Diagnosis of a cyst of bartolinovy gland
At gynecologic inspection of the patient unilateral hypostasis of a vulvar lip, asymmetry of a sexual crack decides on a cyst of bartolinovy gland. If the cyst of bartolinovy gland is not inflamed, the integument over it keeps usual coloring. At a palpation the gynecologist defines poorly painful cystous formation of an elastichesky consistence in the thickness of a big vulvar lip. At abscess of bartolinovy gland morbidity, hypostasis, hyperaemia of fabrics, fluctuation, sometimes – dribble of purulent contents comes to light.
The microscopic research of dab and bacteriological crops allow to reveal the microbic agents who served as the reason of a bartolinit and a cyst of bartolinovy gland. In some cases examination on causative agents of sexually transmitted infections is conducted by the IFA and PTsR methods.
Treatment of a cyst of bartolinovy gland
To treatment of small and asymptomatic cysts of bartolinovy gland of strict indications does not exist. Most often in gynecology resort to their removal at the request of the patient in connection with a recidivous current or the disturbing cosmetic shortcoming. At increase in a cyst of bartolinovy gland and discomfortable feelings the surgical tactics directed to restoration of outflow of contents from gland is shown.
Simple opening and depletion of a cavity of a cyst of bartolinovy gland, as a rule, happens insufficiently: in this case after a while there is almost always a cyst recurrence. This results from the fact that the cut fabrics stick together again and block a way for outflow of a secret of gland. Therefore the operational gynecology uses the methods allowing to create a new output channel from gland.
As traditional way of treatment of retentsionny formation of a threshold serves the marsupialization of a cyst of bartolinovy gland – opening of a cavity, evacuation of the accumulated secret, podshivany cysts of walls to edges of an operational wound with formation of the mouth of a new output channel. Marsupialization cysts allows to keep both bartolinovy gland, and its function.
Rather new technique is treatment of a cyst of bartolinovy gland with the help Word of a catheter. Through small (3-5 mm) a section over a pole of education evacuate contents and sanify a cyst cavity; then in it establish a thin silicone catheter with the small cylinder inflated on the end. Word a catheter is left in a cyst cavity for 4-5 weeks during which there is a formation and an epitelization of a new output channel. After removal Word of a catheter of a wall of the output channel do not grow together with each other any more. If the cyst of bartolinovy gland comes to light at the patient in the course of conducting pregnancy, punktsionny aspiration of its contents is carried out.
Unfortunately, neither the marsupialization, nor the Word installation of a catheter guarantee against emergence of a recurrence of a cyst of bartolinovy gland. At a recurrence of obstruction of an output opening the extirpation - removal of a cyst of bartolinovy gland together with gland and a channel is made. In case of suppuration of a cyst of bartolinovy gland opening of abscess and its drainage is carried out. In the post-operational period the physical therapy (UVCh, magnetotherapy, Ural federal district), treatment of the revealed sexually transmitted infection, immunocorrection is carried out.
Prevention of formation of a cyst of bartolinovy gland
Refer immunity strengthening, timely treatment of chronic sexually transmitted and ekstragenitalny infections, respect for intimate hygiene, an exception of casual sexual communications to measures of the prevention of development of a cyst of bartolinovy gland.