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This photograph from a 24-year-old sexually-active woman with superficial dyspareunia shows a blocked Bartholin's gland duct (left side).
Bartholin's glands are paired (left and right) glands sited between the posterior part of the labia minora and the vaginal walls; their function is to secrete mucus as a lubricant during coitus. Infection of the duct and gland results in closure of the duct and formation of a Bartholin's cyst or abscess. The highest incidence occurs in women aged 20-29 years.1 The condition is often recurrent and causes pain and vulval swelling (labial oedema). Bartholinitis is readily recognised by the site and nature of the swelling.2
Infections of Bartholin's gland should be treated with appropriate antibiotics.
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Among the causitive organisms are Neisseria gonorrhoeae, Staphylococcal and Streptococcal species, gram negative enteric bacteria, and Chlamydia trachomatis.
If abscess formation has occurred, the abscess should be 'marsupialised', a procedure which involves wide incision of the mass followed by suturing of the inner edge of the incision to external mucosa. Marsupialisation reduces the risk of recurrence; it is similarly effective in the treatment of Bartholin cysts.
References
1. Blumstein H. Bartholin gland diseases. http://www.emedicine.com/emerg/topic54.htm
2. Genital tract infections. In: Essential Obstetrics and Gynaecology. E. Malcolm Symonds, Ian M. Symonds, eds. 3rd edn. Churchill-Livingstone. 1998; pp 244-246.
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