扬州大学：《妇产科学》课程教学课件（PPT讲稿）30 女性生殖道感染 GENITAL TRACT INFECTION 1/3

GENITAL TRACTINFECTION

1 GENITAL TRACT INFECTION

Bartholin's gland cysts and abscessBartholin's glandmucus secreting glandlocated in the lower pole of the labium majusopen just external to the hymeneal ringlubricatethevestibuleApproximately 2% of women ofreproductive agewill experienceswellingofoneorbothBartholinglands

2 Bartholin’s gland cysts and abscess Bartholin’s gland ❖ mucus secreting gland ❖ located in the lower pole of the labium majus ❖ open just external to the hymeneal ring ❖ lubricate the vestibule. ❖Approximately 2% of women of reproductive agewill experience swelling of one or both Bartholin glands

CausesUncomplicated Bartholin cysts are filled with nonpurulent mucous.Several studies have aimed to identify the most common bacterialpathogens responsible for Bartholin abscess formation. Studies from the1970-1980s named Neisseria gonorrhoeae and Chlamydia trachomatis ascommon pathogens.More recent studies report the predominance ofopportunistic bacteria such as Staphylococcus species, Streptococcusspecies, and, most commonly, Escherichia coli

3 Causes Uncomplicated Bartholin cysts are filled with nonpurulent mucous. Several studies have aimed to identify the most common bacterial pathogens responsible for Bartholin abscess formation. Studies from the 1970-1980s named Neisseria gonorrhoeae and Chlamydia trachomatis as common pathogens . More recent studies report the predominance of opportunistic bacteria such as Staphylococcus species, Streptococcus species, and, most commonly, Escherichia coli

Barholinitisand Bartholin's gland abscessCAUSEObstruction of the eases of the ductTrauma*InfectionEpithelial hyperplasia

4 Barholinitis and Bartholin’s gland abscess CAUSE Obstruction of the eases of the duct ❖ Trauma ❖ Infection ❖ Epithelial hyperplasia

Bartholin'sgland cysts andabscessBartholin gland diseases are rarely complicated by systemic infection.sepsis, and bleeding secondary to surgical treatment. Missed diagnosis ofmalignancy mayresultinpooreroutcome forthosepatientsThese diseases typically occur in women between the ages of 20 and 30years. Bartholin gland enlargement in patients older than 40 years is rare andshould be referred toa gynecologist for possible biopsy

5 Bartholin’s gland cysts and abscess Bartholin gland diseases are rarely complicated by systemic infection, sepsis, and bleeding secondary to surgical treatment. Missed diagnosis of malignancy may result in poorer outcome for those patients. These diseases typically occur in women between the ages of 20 and 30 years. Bartholin gland enlargement in patients older than 40 years is rare and should be referred to a gynecologist for possible biopsy

Bartholin'sglandcysts andabscessTheBartholin glands are paired glands approximately 0.5 cmindiameterand are foundinthelabiaminorain the 4-and 8-o'clockpositions.Typically, they are nonpalpable.Each gland secretes mucusinto a 2.5 cm duct.Thesetwo ducts emerge onto the vestibule at eitherside of thevaginal orifice, inferior to the hymen.Their function is tomaintain the moisture ofthe vaginalmucosa'svestibular surface

6 Bartholin’s gland cysts and abscess The Bartholin glands are paired glands approximately 0.5 cm in diameter and are found in the labia minora in the 4- and 8-o’clock positions.Typically, they are nonpalpable. Each gland secretes mucus into a 2.5 cm duct. These two ducts emerge onto the vestibule at either side of the vaginal orifice, inferior to the hymen. Their function is to maintain the moisture of the vaginal mucosa's vestibular surface

Bartholin abscess.福

7 Bartholin abscess

Patients typically have an exquisitely tender, fluctuant labial mass withsurrounding erythema and edema.Patients may have a painless,unilateral labial mass without signs of surrounding cellulitis.Bartholinabscesses are very rarely caused by sexually transmitted pathogensABartholin abscess is generally painful, and, thus, usually requiresincision and drainage.Patients with an abscess oftenfeelimmediatepain relief after the drainage procedure; however, they may require oralanalgesiaforseveral days aftertheprocedure

8 Patients typically have an exquisitely tender, fluctuant labial mass with surrounding erythema and edema. Patients may have a painless, unilateral labial mass without signs of surrounding cellulitis. Bartholin abscesses are very rarely caused by sexually transmitted pathogens. A Bartholin abscess is generally painful, and, thus, usually requires incision and drainage. Patients with an abscess often feel immediate pain relief after the drainage procedure; however, they may require oral analgesia for several days after the procedure

Clinical manifestationAcute onset of painSwellingTendernessAssociated cellulitis of vulvaDyspureuniaDifficulty walking

9 Clinical manifestation ❖ Acute onset of pain ❖ Swelling ❖ Tenderness ❖ Associated cellulitis of vulva ❖ Dyspureunia ❖ Difficulty walking

TreatmentDrainageAntibiotic therapyWarm sitaz bath

10 Treatment ❖ Drainage ❖ Antibiotic therapy ❖ Warm sitaz bath