Thursday, June 13, 2013

The Bartholin Gland

The Unknown Gland

So what is a Bartholin Gland anyhow? Most women do not even know that this gland exists, mainly because it remains silent and typically does not cause any problems. The Bartholin gland (also known as greater vestibular glands), are located just a smidge below and to the left and right of the vaginal opening in women and though small is not visible to the naked eye however it may be detected as a divot on the skins surface. Males too have a similar gland; however it is located deeper in the perineal pouch and is called a bulbourethral gland. The Bartholin Glands, under normal circumstances, main function is to secrete mucus to aid in vaginal lubrication. The Bartholin gland, typically before orgasm will excrete 1-2 drops of mucus to lubricate the vaginal opening, while interior lubrication occurs deeper within the vagina.
Bartholin Glands will Sometimes say "Hello"
As stated before, most women go their entire lives without ever realizing that there are two little glands in that area. However the Bartholin Gland can rear its ugly face and make its presence well known. Although unusual, the Bartholin Gland can become irritated or infected, causing extreme swelling and discomfort. Typically if the gland(s) become inflamed and form a cyst, the cyst is not painful, only uncomfortable and more of an annoyance, but often time a cyst leads to infection and the area will become even more inflamed, the surrounding areas will be tender, warm and may throb any firm pressure applied is sure to add to ones discomfort making almost impossible for one to sit down. When this happens, the gland is then referred to as a Bartholin Cyst that has abscessed.
Bartholin Abscess: a Painful experience
If you have ever had the unfortunate chance to experience one of these buggers, then you know all to well just how bothersome and debilitating they can be. In most cases, only one gland is affected at a time, and for some unknown reason can bounce back and forth between glands (For example, the left one is abscessed then heals, a little while later the right one forms a cyst and abscesses). The way Bartholin Cysts form are when for some reason the duct exiting the gland become blocked causing fluid to accumulate, swell and form a cyst. A Bartholin Cyst can lead to an abscess when a formed cyst becomes infected. An infection can occur for multiple reasons such as : bacterial infections, sexually transmitted diseases such as Chlamydia and gonorrhea, and even some bacteria's found in the intestines like E. Coli and it is very common for these abscesses to have one or more of these causing factors.
Symptoms Simplified (Cyst):
·         Swelling of Labia and surrounding tissue
·         Not very much pain associated with it (unless it is large)
Symptoms Simplified (Abscess):
·         Significant pain near labia and vaginal opening
·         Tender to the touch
·         Swollen
·         Reddish skin covering affected area
·         Inability to find any comfy spot
Is it time for the Doctor?
If at any point, you feel that the gland is continuing to swell and grow, and shows no sign of improvement within 3-4 days, then it’s time to go see your doctor or gynecologist. If a lump developed and begins to be painful, this is indicative of an abscess and chances are it will NOT go away on its own, it is infection-infections get worse without medical intervention and the lump needs to be drained. Especially if you are experiences other symptoms as well such as: fever, vomiting, abnormally colored vaginal discharge or abdominal pain (the latter is not a normal symptom) it time to go to the doctor or ER. If you are experiencing extreme pain, and cannot sit down or wear your normal pants get to the doctor immediately.
What’s Going to Happen at the Doctors?
There is no testing to confirm a Bartholin cyst or abscess; it is simply diagnosed by a physician through examination. In many cases, especially if the issue is a returning or repeating one, the doctor may collect a culture to determine a bacterial strain so that the best medication can be prescribed and you will be checked for related STD's such as gonorrhea and Chlamydia. The culture is typically collected from the drainage of the cyst or abscess and only sometimes the cervix, test results are usually back within 48 hrs. When you to the doctor, you will depending on the severity and the difference between cyst and abscess be given pain killers like Hydrocordone or Morphine. Once the pain killers have kicked in a local anesthetic is applied to the affected area, and the doctor will make an incision. The relief is immediate; all the pressure simply goes away. The doctor will then, either pack the gland with a special gauze or use a balloon catheter. As a special note, if it has been decided that the Bartholin gland needs to be lanced, local anesthetics do not work well in areas where there is inflamed tissue, so be sure, if you are in pain to discuss your options for pain relief prior to surgery--you can be sedated if necessary--all you need to do is ask.
Occasionally, though no longer as common as it was a few years ago Marsupialization was a procedure that created a permanent drainage site, to prevent cyst and/or abscess reoccurrence. The doctor would generously make the recommendation, and arrange for a time to do it. Many doctors today still believe that there is some benefit in performing this procedure in individuals that suffer from this problem on a frequent basis, however it has come to light, that this invasive, permanent change may not be as beneficial as once thought. While marsupialization does provide drainage, it appears that at least 60 percent of those who have had this procedure see reoccurrences despite it often the problem that was once isolated to one side, after the procedure has a tendency of jumping to the other gland.
After Surgery Care:
Once you have had the cyst or abscess drained, you probably feel a whole lot better. Proper at home care is imperative to prevent re-infection and sooth any pain of discomfort. If you can spare $20.00 or so, a shower head with an extendable neck or hose will make regular cleaning much easier and more comfortable as you can adjust the pressure and the wound is not entirely submerged. Try not to pull on or mess with either the packing or the word catheter. (and as a fore note: if you can opt for the word catheter you should is is less irritating, you can sit down than with packing which btw is excruciating to have removed, so if you have it get pain killer prior to removal) as they easily can become dislodged or fall out. If your word catheter fall out within 24 hours, the balloon was not inflated correctly (which often happens) and needs to be replaced, however if you drop the catheter a few days afterwards you should be alright, continue using a sitz bath to keep it clean. Remember that if your doctor prescribed you some antibiotics, you must finish them out, even if everything feels better, finish every last pill. In addition to any medication, ask your doctor for prescription strength Ibuprophine or hydrocordone, you will be in pain post surgery for 2-3 days. Most doctors prescribe clyndomyacin as the antibiotic in varying doses in accordance with the severity of the infection, if this is the medication you are given, please don’t forget I told you this, it WILL my you intolerably nauseous, so ask for anti-nausea pills!
At Home Prevention:
Yes you can help prevent these nasty buggers from coming back. My experience has shown me that when one comes, several follow in a row, generally sticking to one side, or occasionally bouncing back and forth between the right and left sides. As mentioned before, regular use of a warm bath will help break up any blockage that may exist or be forming. Occasional addition of Epson salt to a bath increases your ability to prevent a blockage from forming, but be careful that you not over do it with the Epsom salt as it has the ability to cause dryness, which will lead to chaffing in the genital area. Keep strong cleansers and body washes away, instead opt for fragrance and dye free soaps that boast gentle cleaning such as Very Private (brand) Body wash available online. If you feel some swelling coming on, get to a hot bath immediately if you can, and if possible create a current by moving your hands to help move water around the affected area. Repeat this up to 5 times a day (each bath lasting 10 minutes). Wear loose fitting pants and non constricting underwear, during sleep wear a simple a t-shirt to bed or very loose bottoms. Make use of heating pads to sooth and bring comfort as well and encourage the gland to expel the buildup of fluids. Drink a lot of water and fruit juices, stay away from dairy products (dairy increases mucus production) to help flush your system. Get plenty of rest to help you body fight the imbalance. If you smoke, try to cut down during this period as it could aggravate the area by increasing the blood flow. Avoid applying pressure to the area, this increases the swelling. For at home pain management, a cold pack (NOT ICE PACK in this region of your body solid ice can act very quickly, damaging the tissues by freezing them), stick to gel packs, or in a desperate pinch take a spoon and place it in the freezer for 15 min, remove, wrap with a paper towel and apply to the surface of the swollen gland until spoon is no longer cold or you have achieved some relief. But be warned to not over do it with the cold treatments, which cause tissue to contract--the opposite of what you want it to do. Heat is your very best friend! Avoid crossing your legs if swelling is severe, and consider sitting on a pillow instead of harder surfaces such as kitchen chairs which can be aggravating.
Medical Outlook:
While there is little study or research currently about the Bartholin Gland, a recent (within the last 10yrs) a outcry from suffering women is encouraging health care professionals to take a second look at this ongoing condition. Unfortunately, we still do not know entirely how these little glands work, or why for some individuals become chronically infected, swollen or in pain. As I find new, relevant information pertinent to this medical condition I will update this blog to bring you the best knowledge out there, all together in one place!

Here I am

Location of bartholin gland
Location of bartholin gland
 To the right, the image gives a clear view of where the bartholin gland is located. When the gland is irritated, it can swell to well over 5X its size, making it nearly impossible to sit down.
I am doing an extensive series concerning Bartholin Glands and the problems associated with them. There are an overwhelming amount of women (and men though fewer) who struggle with this condition. There is little no information available online and where there is, it is very broad spectrum and does not offer a solutional approach nor the voice of one who deals with this condition. Below you will find a list of other Bartholin related topic I have composed for benefit and i encourage you to educate yourself and read them!