Concerned about painful swelling

Dear Dr Mitchell,

I have this sore lump on my outer labia that is hard and really painful. It’s got bigger, but it’s not herpes. I know this because when I was pregnant a year ago, I did a full STD panel and I was clean. How can I get rid of it and do I need to see a doctor?

The painful swelling or sore lump that you have on your outer labia is called a Bartholin’s abscess. The Bartholin’s gland is located at the posterior third of the vaginal opening at the minor fold. It provides lubrication for the vagina. There are two Bartholin’s glands, one on each side of the entrance to the vagina. The opening or duct that releases the lubrication can become blocked by infection that is sexually transmitted and this can initially form a painless swelling, which can then form an abscess which can be extremely painful.

The common sexually transmitted infections that can cause a Bartholin’s abscess includes chlamydia and gonorrhoea. Screening for other sexually transmitted infections including syphillis and human immuno-deficiency virus should be done.

A painful Bartholin’s gland swelling, especially if it is causing significant discomfort, can be temporarily relieved by the use of painkillers and sitz baths. This involves soaking at least three to four times daily in warm, salt water. This will relieve the discomfort and might even promote the drainage of the infected secretions.

Surgical drainage can be done under local anaesthesia by making a small incision in the gland and putting a small tube or catheter in or putting sutures in to keep the gland open to allow continuous drainage for up to six weeks.

The use of antibiotics to treat the infection helps to relieve the pain and discomfort and specific sexually transmitted infections should be treated. Your sexual partner should also be tested and treated to reduce the risk of recurrence and also to reduce your risk of pelvic inflammatory disease which can damage your Fallopian tubes and cause subsequent infertility.

In some cases the cyst is persistent in spite of repeated drainage and the Bartholin’s gland has to be completely removed to reduce recurrence. This has to be done in hospital with adequate pain relief, sometimes under general anaesthesia. This can be associated with a greater risk of bleeding especially if the gland is extremely large.

Consult your gynaecologist who will advise you further and determine which treatment option is best for you.

Best regards.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5 or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.

DISCLAIMER:

The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.

Dr Sharmaine Mitchell

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