Bartolini's Glands - Functions and Disorders

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These glands are located in the posterolateral portion of the vaginal orifice, at the level of the lower end of the skin folds (or lips) of the vulva.
The function of Bartolini's glands is closely linked to sexual activity: in the arousal phase of the woman, these structures are responsible for secreting a clear and viscous liquid, which acts as a lubricant for the vaginal canal.
Bartholin's glands can be affected by inflammatory processes (Bartholinitis), during which they increase in volume and become painful. When the channels from which the lubricating fluid flows are blocked, however, the formation of cysts can result. The latter can remain asymptomatic for a long time, but if they become infected, they evolve into abscesses (sack-like formations containing pus).
The pathological conditions affecting the Bartolini's glands require the evaluation of the gynecologist, who can carry out the correct diagnostic classification and indicate the most appropriate treatment for the case.

, on the surface of the vulva. More precisely, Bartolini's ducts open at the level of the sulcus formed by the labia minora laterally and by the hymen (or its residues) medially.

Image taken from: https://en.wikipedia.org/wiki/Vulva

which contributes to the maintenance of vaginal canal lubrication when a woman is sexually aroused.
During intercourse, a small amount of this thick, viscous, clear liquid can help moisten the opening of the vagina, making intercourse more comfortable.
Bartholin's glands change their structure with age: in young girls, they have small dimensions (since they are not yet functional in this period), while in sexually active adult women they reach their maximum volume. These structures then meet. to a "progressive involution and, after menopause, are atrophic.

Bartholin's glands are also called major vestibular glands, to distinguish them from other smaller glandular structures that are scattered throughout the lower tract of the female genital tract. Among these are the Skene's glands, located near the distal urethra, in the area above the vaginal intake.

Like Bartholin's glands, in a state of sexual arousal, Skene's glands begin to secrete a fluid that appears to contribute to vaginal lubrication during copulation.

, have protected sexual intercourse and consult your doctor when you notice nodules and inflammation in the genital area. The goal of any treatment is to preserve the gland and its function whenever possible.

acute, redness and tension of the overlying skin. Other often related symptoms are a feeling of weight in the lower abdomen and local itching.
Bartholinitis is usually caused by a vaginal infection (vaginitis). Predisposing factors for inflammation of the Bartholin glands include poor hygiene, sexual intercourse, inability to wash for a long time and excessive use of synthetic underwear. or tight-fitting clothing that causes chafing.
Simple inflammation of the Bartholin's glands can be transient and resolves within 3-5 days. In several cases, however, the pathological process can result in the formation of a cyst.
Once it is ascertained that it is bartholinitis, therefore, the doctor can prescribe a pharmacological treatment based on anti-inflammatories (to counteract the acute inflammatory process in progress) and, possibly antibiotics, both orally and through the use of ointments to be used locally. If the inflammation recurs two or three times in the course of a year, however, surgical removal of the Bartolini glands involved may be indicated.

they represent the most common vulvar cystic formations: this affection affects about 2% of women, usually between 20-30 years of age. With the advancement of time (menopause), however, the disease manifests itself with less probability.
The disorder occurs as a result of an obstruction of the Bartolini's duct, which causes the gland to swell due to the stagnation of mucus, which results in the formation of a cyst. The reason why the fluid produced by the glands fails to flow normally is not always known; rarely, cysts result from an "ongoing infection, a sexually transmitted disease (such as gonorrhea and chlamydia), or from congenitally abnormal development of genital tract tissues.
Frequently, cystic formations are asymptomatic; however, larger cysts can cause an uncomfortable sensation, especially during walking and sexual intercourse. The more voluminous lesions can also be associated with tenderness, vulvar irritation and dyspareunia.
Most Bartholin's cysts are unilateral and palpable near the vaginal orifice; when large, these formations stretch the labia majora on the affected side and cause vulvar asymmetry. Furthermore, if the cysts are affected by an infectious process, very intense pain and fever can occur.
The evaluation of the disease requires a specialist medical examination. The differential diagnosis is made with other cystic and solid lesions of the vulva, such as epidermal inclusion cysts (round and asymptomatic swellings localized in the labia majora), papillary hydroadenoma (benign neoplasm that derives from the sweat glands, located above all at the level of the labia minora), the fibroid and the lipoma.
Generally, Bartholin's gland cysts do not need treatment when they are modest in size, do not cause discomfort and are not subject to infection. However, if the lesion becomes symptomatic or abscesses, drainage (incision of the gland) may be necessary, with or without complete enucleation of the gland (bartolinectomy).
The prevention of complications affecting Bartholin's cysts involves baths in hot water, to be performed several times a day, immersing oneself up to the pelvis.

). This becomes very bulky (can reach the size of a walnut), as well as causing intense pain around the gland and secretions (usually, yellowish in color). In some cases, a few lines of fever may also be present.
Abscesses affecting Bartholin's gland are often polymicrobial; the most frequently isolated pathogens are Escherichia coli, Neisseria gonorrhoeae And Chlamydia trachomatis.
This pathology makes it necessary to resort to the antibiotics prescribed by the doctor and to drainage to favor the escape of the purulent material. This approach allows for a sudden improvement in vulvar pain.
In case of relapses, marsupialization may be indicated, ie the gland is incised and left open to allow continuous drainage and prevent the liquid from stagnating inside; after the operation, the walls of the abscessed cyst retract, leaving a new orifice for secretions. Alternatively, it is possible to proceed with the surgical removal of the infected cyst by bartolinectomy.

primitive arises in postmenopausal women, due to the neoplastic transformation of the epithelial components of the gland. However, the tumor pathology of the Bartholin's glands can occur in young women, being sometimes related to human papillomavirus infection.

Other risk factors include vulvar intraepithelial neoplasia (VIN), genital lichen sclerosus, squamous hyperplasia, carcinoma of the vagina, and chronic granulomatous disease.
Bartholin's gland tumor usually presents as an irregular, nodular, persistently indurated palpable vulvar growth. Late, clinical signs such as abrasions, pain and itching appear. The lesion may become necrotic or ulcerated, sometimes causing bleeding or watery vaginal discharge.
Considering that the Bartolini's glands undergo an involution in menopausal or peri-menopausal women, the appearance of a vulvar mass makes it necessary to perform an excisional biopsy to exclude the presence of a malignant process.
Therapy involves surgical excision of the local tumor and dissection of the inguinal and femoral lymph nodes. These approaches are sometimes associated with postoperative radiotherapy and chemotherapy.

: therefore, it is necessary to pay attention to an accurate and daily local cleaning and, especially in summer, to change underwear frequently.

Another good habit to reduce the risk of incurring genital infections is to avoid the abuse of sanitary towels and panty liners for the whole day, if not necessary, since they do not allow the correct skin transpiration. For the same reason, it is The use of synthetic clothing and particularly tight underwear is not recommended: the continuous rubbing of the fabric on the skin can cause local irritation.

Practicing safe sex - especially using a condom every time you have intercourse - can help reduce the chances of developing a cyst infection and the formation of a Bartholin gland abscess.