Medicine an Surgery notes

Apr 24th, 2015
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DISORDERS OF BARTHOLIN'S GLANDIntroduction The two Bartholin's glands secrete mucus to provide moisture for the vulva; they are the homologue of the bulbourethral glands in the male. These glands are located bilaterally in the vulvovaginal area at approximately the four and eight o'clock positions on the posterior-lateral aspect of the vaginal orifice Each gland is approximately one-half centimeter (cm) in size and drains into a duct 2.5 cm long. The ducts emerge onto the vestibule, one at each side of the vaginal orifice, just below the hymenal ring. A normal Bartholin's gland is not palpable, except possibly in very thin women. Cysts and abscesses are the most common disorders of the Bartholin's glands, occurring in 2 percent of women; carcinoma is rare However, many vaginal and vulvar lesions mimic Bartholin's gland disorders and should be considered in the differential diagnosis of a vulvovaginal mass Bartholin's gland cysts Chronic inflammation can obstruct the orifice of the Bartholin's gland duct. This leads to cystic dilatation of the duct, but not the gland, proximal to the obstruction. Clinical manifestations and diagnosis Bartholin's cysts average from 1 to 3 cm in size and are usually asymptomatic. Larger cysts may be associated with vulvar pain, discomfort during sexual intercourse, or difficulty sitting or ambulating. The diagnosis is clinical and based upon findings of a soft, painless mass in the medial labia majora or lower vestibular ar

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