BARTHOLINS

ABSCESS
By :
Nova Rukmala Dewi (110 208 0096)
ADVISOR:
dr. Suci Nugraeni
SUPERVISOR:
dr. Widya Widita Sp.KK M.Kes

DEFENITION
Bartholins Abscess glands is abscess that
happens when bartholin glands are obstructed.
Bartholins glands can be obstructed because of
some reasons, such us infection, inflammation
or long term irritation.

Bartholins Abscess

EPIDEMIOLOGI
Disease that attacks bartholini glands usually
happen to women around 20 - 30 years old.
Swelling Bartolini glands of patient more than
40 years old are seldom to be found, and need
to be consultated to gynecologist so can be
done a biopsy.

ETIOPATOGENESIS
Cause of abnormality Bartholins glands is obstructed
part of distal from ductus glands that cause retention
from secretion, ductus dilatation happens and forms
cyst.If these glands get infection for long time can
effects formed bartholins cyst and than grows to
become abscess. Bartholins abscess is not only
because of cyst which gets infection, but also because
of direct infection on bartholins glands. Microbe which
often infects bartolins gland is Neisseria gonorrhoeae.

CLINICAL INDICATION
Painful
Painful when
when walking
walking
and
and sitting,
sitting, Painful
Painful
which
which suddenly
suddenly
abated
abated

Extreme
Extreme painful
painful which
which
follows
follows swelling
swelling
unilateral
unilateral labial
labial

Dispareunia
Dispareunia

Discharge
Discharge
appearance
appearance (( very
very
possible
possible indicates
indicates
there
there is
is spontaneus
spontaneus
ruptur
ruptur from
from abscess)
abscess)

DIAGNOSIS

ANAMNESIS AND PHYSICAL CHECK

Diagnosis begins from anamnesis and physical check,

manifestation of clinic from
bartolinis abscess
includes extreme painful. System around ( connection
between middle side and down side of labia minora)
gets inflamation and edema. In physical check,
introitus of vagina usually changed looks there is
fluctuation mass in palpation check. Very seldom
sistemic indication and presents infection be reported.

SUPPORT CHECK

In
Bartolins
abscess
In
Bartolins
abscess
probably
probably also
also be
be required
required
smear
smear check
check (pap
(pap smear)
smear) or
or
culture
check
for
culture
check
for
bacteryology
check
bacteryology
check
specificly.
specificly. However
However as
as long
long
as
as indication
indication which
which be
be found
found
in
in anamnesys
anamnesys and
and physical
physical
check,
check, culture
culture check
check is
is
seldom
seldom to
to be
be done.
done.

IfIf patient
patient in
in health
health condition,
condition,
blood
blood laboratory
laboratory check
check is
is
not
not be
be required
required to
to evaluate
evaluate
cyst
cyst or
or abscess.
abscess. IfIf itit has
has
been
been abscess,
abscess, bacterial
bacterial
culture
culture can
can be
be useful
useful to
to
determine
microbe
and
determine
microbe
and
appropriate
appropriate treatment.
treatment.

COMPARISON
DIAGNOSIS

Epiderm
al
inclusio
n cyst
Mukosa
vestibuli
cyst

Location:
Location: usually
usually on
on labia
labia mayora.
mayora.
Characteristics:
Characteristics: Benign,
Benign, mobile,
mobile,
nontender,
nontender, cause
cause of
of trauma
trauma or
or
obstruction
obstruction from
from polisabaseus
polisabaseus duct.
duct.
getting
getting infection,
infection, be
be inquired
inquired insition
insition
and
and simple
simple drainage
drainage ..

Location:
Location: labia
labia minora,
minora, vestibuli,
vestibuli,
periclitoral
periclitoral area
area
Characteristics:
Characteristics: Soft
Soft consistence,
consistence,
diameter
diameter is
is less
less than
than 22 cm,
cm, flat
flat surface,
surface,
located
located in
in superfisial,
superfisial, soliter
soliter or
or multiple,
multiple,
usually
usually asimptomatic.
asimptomatic.

Hidradenom
Hidradenom
aa
papilliferum
papilliferum

Location: between majora labium and minora

labium.
Characteristics: Transparant, slow growth,
small nodules (2 mm - 3cm), grows from
apocrin sweat glands. Need be concidered to
be done a biopsy if blooding happens and
removed it if there is indication.

Skenes
Skenes
duct
duct cyst
cyst

Location: Near from meatus urethrae in

vestibuli.
Characteristics: Transparant. Asimptomatik, if
getting bigger will cause obstruction in
urethra and happens urine retention.

MANAGEMENT OF
IMPLEMENTATION
Treatment of

bartholins cyst and bartholins

abscess one of them is surgery treatment ,
includes insition and drainage, marsupialization.

WORD CATHETER
Word catheter was found first time in 1960s. its

a small catheter with ballon which can be bloated

up with saline on the end of distal. usually its
used to threat cyst and bartholins abscess.

MARSUPIALIZATION

Marsupialization from bartholins gland commonly is

done if there is big abscess which causes difficult
operation of gland excition . In this surgical operation,
surgeon will open widely abscess membranes so that
enable to bring out
purulent exudate. Abscess
membranes be sewn to mucosal of vagina and skin on
introitus vagina for granulation effect and reepitelisation
from bottom wound to top of abscess. Purpose of
bartholins glands marsupialization is to remove abscess
such that will happen epitheliasation on the bottom.

EXCISON

Excision from Bartholins gland can be considered to

patient who does not response drainage, however
this procedure must be done when there is no active
infection.

DRUG TREATMENT

Antibiotic as empirical therapy to treat

sexual
transmitted disease is used to treat gonococcal
infection and chlamydia. Ideally, antibiotic must be
given before incision and drain be done.

COMPLICATION

Some cases Bartholinis abscess usually relapses.

Blooding especially for koagulopati patient.

scarring system rises.

PROGNOSIS
If abscess with
drainage treatment and avoid
recurrence, the prognosis is well. Level of
relapsemostly be reported under 20%.

THANK YOU