Bartholin's Gland Research Articles

The development of the external genitals in female human embryos and foetuses. Part 2: Vaginal vestibule, anal canal, perineal raphe and perineal cutaneous muscles.

Concomitant with the rupture of the cloacal membrane, the perineal skin epithelium thickens (see accompanying article). In this study, we establish in female embryos and foetuses that the thick skin area divides into ventral and dorsal areas at ~14 weeks and gradually becomes restricted to the vaginal vestibule and anal canal thereafter. The dense mesenchymal core of the labia minora, which forms at ~8 weeks, extends dorsally to the anal canal as a midline reinforcement. The skin epithelium overlying this reinforcement is much thinner than the flanking 'thick skin', and is supported by an interrupted basement membrane, which implies epithelial-mesenchymal transformation of the thin midline epithelium and the subsequent establishment of the perineal raphe by the merging of the adjacent thick epithelium. Meanwhile, the anogenital distance in the perineum increases rapidly in length. Perhaps as a consequence, the labia minora cover only the ventral third of the vaginal vestibule at 20 weeks. The endodermal ducts of Bartholin's glands are identifiable at 7 weeks, while acini form at ~12 weeks. The vestibular bulbs become identifiable at ~10 weeks and form vascular networks after ~14.5 weeks. After the rupture of the cloacal membrane, the diameter of the junction of the dorsal cloaca with the anal canal is just a pinhole but widens dorsoventrally after the 7th week. The cutaneous muscles of the perineal area form as a ventrally open U-shaped mesenchymal mass, from which the anal sphincter and bulbospongiosus muscle develop. In conclusion, our findings show that thick skin epithelium persists in the vaginal vestibule and anal canal.

Endometriosis of the Bartholin gland in a patient with deep endometriosis

Endometriosis of the Bartholin gland in a patient with deep endometriosis

Chemoradiation Therapy as the Treatment of the Adenoide Cystic Cancer of the Bartholin Gland : About One Case Report and Review of the Literature

Adenoid cystic carcinoma (ACC) of the Bartholin's gland is a rare yet clinically significant malignancy Originating from the Bartholin's gland, situated in the vulvar region, ACC exhibits unique histopathological features and clinical behaviors. In our article, we describe a clinical case involving a 28-year-old female patient who initially presented with a painful swelling on the left labia majora. Initially misdiagnosed as simple Bartholin's gland inflammation, biopsy revealed cystic adenoid carcinoma of the Bartholin gland upon histopathological examination. Radiological evaluation revealed a locally advanced left vulvar lesion with no evidence of distant metastasis. Given the impracticability of surgical intervention, concurrent chemoradiation therapy was administered, resulting in favorable outcomes. ACC has been a diagnostic therapeutic challenge, there is currently no established therapeutic standard. Despite its infrequent occurrence, ACC warrants attention due to its potential for aggressive local invasion, distant metastasis, and propensity for recurrence.

Case series on the management and outcomes of Bartholin gland carcinoma

ObjectiveTo evaluate the management and outcomes of Bartholin gland cancer at a single tertiary institution. Study DesignA single institution retrospective review of 9 cases of BGC between 2004 and 2022 was conducted. Demographics, pathological characteristics, treatment, follow up and oncologic outcomes were extracted from clinical records. Data are summarised using descriptive statistics and survival probabilities are presented with Kaplan Meier graphs. ResultsTen cases of BGC were identified at our institution over a period of 18 years. Nine out of ten clinical records were available for analysis. Eight patients presented with vulval swelling and four were treated initially for Bartholin cyst or abscess. One patient had a histological diagnosis of adenoid cystic carcinoma while the remaining were squamous cell carcinomas. With the exception of stage I disease chemoradiation was the primary mode of treatment. Adverse events included skin desquamation (4/9), venous thrombo-embolism (2/9), gastro-intestinal (1/9) and neurotoxicity (1/9). Median follow up was 60 months with a 5-year recurrence free and overall survival at 76 % and 64 % respectively. ConclusionBGC may present after a long duration of symptoms and at advanced stages. Primary chemoradiation appears to be a feasible treatment option in advanced disease with the benefit of decreased morbidity.

Socio-demographic, obstetric characteristics and molecular confirmation of <i>Trichomonas vaginalis</i> detected from pregnant women attending Kawo General Hospital, Kaduna, Nigeria

Trichomoniasis is a widespread Sexually Transmitted Infections (STIs) that can have detrimental consequences, including infection of the skin, endometrium, Bartholin glands, and fallopian tubes and ovaries (the adnexa of the uterus). This study was conducted to assess the prevalence of Trichomonas vaginalis (T. vaginalis) and T. vaginalis from vaginal swabs of pregnant patients attending Kawo general hospital in Kaduna state. A total of 250 high vaginal swab samples were randomly taken from consenting pregnant women attending antenatal. Structured questionnaires were used to collect participant demographic and medical data. Samples were analysed by wet mount preparation and T. vaginalis positive samples were confirmed using Polymerase Chains Reaction (PCR). Out of the 250 pregnant women that were examined, 24 (9.6%) were positive for T. vaginalis infection. T. vaginalis was detected more in age group 20-25 (9.4%), and among women of third trimester stage (11.4%). T. vaginalis infection was significantly associated with age, gravidation, education and occupation. Among the 24 pregnant women that tested positive for T. vaginalis infection, only 2 (8.0%) were without symptoms associated with vaginal trichomoniasis, while the remaining 22 (92.0%) presented symptoms such as vaginal odour (20%), itching and discomfort (32%) and greenish yellow vaginal discharge (92%). Molecular analysis confirmed 1 positive case out of the 5 samples randomly analysed. Trichomoniasis transmission to newborn infants could be avoided with better personal cleanliness, screening, and treatment for pregnant women who are affected.

Bartholin's Gland is an Important Part of the Female Reproductive System

Bartholin's Gland is an Important Part of the Female Reproductive System

Human Papillomavirus-Associated Multiphenotypic Carcinoma: First Description of a Vulval Case.

Human papillomavirus (HPV)-associated multiphenotypic sinonasal carcinoma is a rare and recently described epithelial neoplasm exhibiting myoepithelial differentiation and morphological overlap with salivary gland neoplasms, especially adenoid cystic carcinoma; it is commonly associated with HPV, especially type 33. It has mainly been reported in the nasal cavity and paranasal sinuses with a single case reported in the breast. Herein, we report the first vulval example in a 47-year-old patient who presented with a large craggy mass in the region of the Bartholin gland. The histologic features were of a high-grade carcinoma composed of basaloid cells arranged in sheets and nests, with occasional ductal formations, surrounded by densely hyalinised basement membrane-type material. There was diffuse block-type immunoreactivity with p16 and HPV genotyping revealed high-risk HPV type 16. In reporting this case, we highlight the propensity for "salivary gland-type" neoplasms to arise in the vulva, especially in the Bartholin gland, and stress that pathologists should consider salivary-type neoplasms when faced with a morphologically unusual vulval tumor.

Chistul de glandă Bartholin – abordări terapeutice actuale şi prezentare de caz

Bartholin gland cysts account for 2% of all gynecologic visits per year. Although the treatments for Bartholin gland cysts seem apparently simple, recurrent cysts as well as the differential diagnosis between simple cyst, abscess or malignant pathology can complicate the management for this apparent common problem. Bartholin gland disorders, such as cysts and abscesses, can significantly impact a woman’s quality of life, necessitating effective and lasting interventions. Starting from the standard conduct of authors in Bartholin gland cyst, the article aims to review the current therapeutic techniques and to present a case report of an approach based on the excision of the gland.

Knowledge and Practice Regarding Abnormal Vaginal Discharge Among Adolescent Females in Riyadh City: An Observational Study.

Introduction Vaginal discharge (VD) is a common condition that affects women during their childbearing years and often requires medical attention. It results from the physiological secretion of cervical and Bartholin's glands, as well as the shedding of vaginal epithelial cells caused by bacterial action in the vagina, which alters the acidic environment of the vagina.Experiencing vaginal symptoms is a common reason for seeking medical attention, especially among women during their reproductive years. This often leads to a visit to an obstetrician or a gynecologist. Accordingly,addressing such issues becomes even more crucial. The aim of this study is to assess the knowledge and practice regarding abnormal VD (AVD) among adolescent females in Riyadh City, Saudi Arabia. Methods The present study utilized a correlational cross-sectional survey methodology conducted in Riyadh City. The questionnaire was employed as thedata collection instrument from November 2022 to November 2023. Eligibility for inclusion was limited to adolescent femalesand students living in Riyadh City, aged from 14 to 20 years. Electronic consent was obtained from participants aged 18 years and above, while consent from guardians was sought for those below 18 years. This sample size was determined with a minimum requirement of 500 participants, and 824 were involved. The questionnaire encompassed several sections, including demographic characteristics (gender, age, education, and menstruation history), history of AVD, knowledge regarding VD, and students' practices and behaviors related to VD. Cronbach's alpha values for all the sections were more than 0.7. Data analysis was performed using statistical software, employing descriptive analysis, chi-square tests, and t-tests. Results A total of 824 girls were included, and their ages ranged from 14 to 20 years, with a mean age of (16 years ± 5) years old. Exactly 697 (84.6%) were high school students. Most of the study students (85.1%; 701) complained of an AVD at any point in their lives. Only 97 (11.8%) of the study students had a good knowledge level of VD. Higher age, marriage, late menarche, and seeking medical care for complaints of VD were the factors associated with a high knowledge level about VD (P<0.05). Additionally, 44.2% of school-age females sought medical care when experiencing AVD, with reasons including worsening symptoms over time and fear of serious diseases. However, a significant portion of participants opted for self-treatment using herbal remedies, medication from pharmacies, or leaving VD untreated, citing reasons such as perceiving it as a simple condition or fearing examination and disclosure. Conclusion In summary, the current study revealed that adolescent femalesdemonstrate a sub-optimal level of knowledge regarding AVD. These findings are primarily observed among adolescent girls and individuals who exhibit a reluctance to seek appropriate medical intervention when having AVD.

Vulvar Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology.

Vulvar cancer is annually diagnosed in an estimated 6,470 individuals and the vast majority are histologically squamous cell carcinomas. Vulvar cancer accounts for 5% to 8% of gynecologic malignancies. Known risk factors for vulvar cancer include increasing age, infection with human papillomavirus, cigarette smoking, inflammatory conditions affecting the vulva, and immunodeficiency. Most vulvar neoplasias are diagnosed at early stages. Rarer histologies exist and include melanoma, extramammary Paget's disease, Bartholin gland adenocarcinoma, verrucous carcinoma, basal cell carcinoma, and sarcoma. This manuscript discusses recommendations outlined in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for treatments, surveillance, systemic therapy options, and gynecologic survivorship.

Benign Vulvar Conditions: Comprehensive Overview

Benign ailments of organs surround a large spectrum of non-diseased environments that influence the genitalia of outdoor girls. These environments can cause pain, aches, and misery for the damaged objects. This review supports a concise survey of mild vulvar ailments and their dispassionate presentations, sickness, and management. Lichen sclerosis (LS) is a non-meansfinishing angering condition characterized by tingling, pain, and atrophic adjustments. Early acknowledgments and the state of affairs are sent via email to save you from never-ending confusion. Lichen planus provides accompanying mauve, polygonal papules, and erosions, and its management involves syndrome aid and immunosuppressive remedies, which are unavoidable. Vulvar dermatoses, together with touch rash and rash, frequently present with pruritus and call for identification and removal of determinants. Vulvar intraepithelial neoplasia (VIN) is characterized by pre-malignant changes in the vulvar skin. Welltimed disease and invasion are essential for the development of vulvar tumors. Bartholin gland cysts and abscesses can result in pain, lumps, seepage, and marsupialization. Vestibulodynia and vulvodynia are caused by incessant vulvar pain, making it essential to use multidisciplinary techniques for efficient management. Understanding favorable vulvar illnesses and their distinct dispassionate visages is vital for proper disease management and tailored treatment plans. This records healthcare thought providers to determine appropriate care, relieve signs, and upgrade the reputation of the boom for stirred people.

GIANT BARTHOLIN CYST CASE REPORT

Bartholin gland cysts are common masses in the vulvar region that can range from asymptomatic to large and infected, requiring treatment [1]. In this case report, we wanted to discuss a case of a large Bartholin gland cyst that presented with painful genital swelling to our clinic and its treatment. A woman in perimenopausal age presented with a large mass in the vulva, and physical examination revealed an 18x10 cm mass originating from the left labia minora. MRI confirmed the mass, and the initial diagnosis was Bartholin gland cyst. The cyst was surgically excised totally under the operating room conditions and sent for histopathological examination. Although Bartholin gland cysts can present in various sizes and clinical features, cysts of this size are rare and can be confused with malignant masses.

AYURVEDIC APPROACH TO YONI KANDA WITH RESPECT TO BARTHOLIN’S CYST-A SINGLE CASE STUDY

Bartholin’s cyst is a condition of Bartholin's glands which are located deep to posterior aspect of labia majora on either side. Bartholin’s cyst form when duct becomes obstructed with fluid. Further when the cyst becomes in-fected and if untreated, it develops in abscess. This causes irritation and pain during walking, sitting and during intercourse. According to Ayurveda it can be correlated to Yonikanda (Bartholin’s cyst), which was mentioned in Madhavanidana, where Yonikanda is described as disease of vagina presenting with protuberant mass like struc-ture which resembles Nikucha or Lakucha (Monkey jack fruit) shape. In present case study, A female aged 22 years, unmarried, occupation by student, came to OPD of Dr. BRKR GOVT AYURVEDIC HOSPITAL, complaining of swelling and mild pain in right labia majora since 10days. For this condition she took allopathy medicine for 5days but no relief. She has a previous history of the same complaints on left side of labia 1year ago, which was treated surgically. Considering all the factors this condition can be correlated with Yonikanda and managed by Aushada (Drug) which are Vata-kapha hara, Shotha ha-ra(Anti-inflammatory), Raktha shodaka(Blood purifier), Shula hara(Analgesic),Janthugna (Anti-microbial) properties. Sthanika chikitsa like Yonidhavana (Vaginal douche), Yoni lepa(Vaginal anointment), Yoni dhu-pa(Vaginal fumigation), Ahara(Diet), Vihara(Conduct). In contemporary sciences, antibiotics, surgical draining, marsupialization, removal of Bartholin glands is only the line of treatment, whereas in Ayurveda it can be man-aged through Aushada, Sthanika chikitsa, Ahara, Vihara, Dinacharya (Daily regimen). The patient got relieved completely after 15days of treatment.

Bartholin Duct Cyst and Nodular Hyperplasia: A Clinicopathological Study of 32 Patients.

Background: Inflammatory lesions and cysts are the most common Bartholin glands pathologic diagnoses. There have been very few reports of benign solid lesions of Bartholin glands such as nodular hyperplasia. Materials and methods: Thirty-two lesions diagnosed as Bartholin duct cyst in the gynecologic specialized institute were reviewed by two expert gynecological pathologists. Results: Using specific criteria, 7 qualified as nodular hyperplasia, 25 as Bartholin duct cyst. The average age of the patients with nodular hyperplasia was 31 years (range, 24 to 43). These lesions were solid, solid and cystic or purely cystic, had a mean maximal dimension of 3.3 cm, and were frequently thought to be Bartholin cysts on clinical examination. Four lesions were diagnosed as Bartholin duct cysts, while in the review they were considered as nodular hyperplasia. Conclusion: Nodular hyperplasia of Bartholin gland may be more common than is reported in the literature. This study showed that the diagnosis of nodular hyperplasia has been overlooked due to limited literature sources.

A Metastasis of Ovarian Cancer in the Bartholin Gland: A Case Report with Systematic Literature Review

The metastasis of a gynecological malignancy to the Bartholin gland is rare. We report the case of a 62-year-old patient who had undergone extensive treatment of metastatic ovarian cancer that involved the liver, spleen, and peritoneum. She presented with painful swelling of the left vulva. Clinical and sonographic examinations showed a solid tumor in loco typico of the Bartholin gland. Surgical excision was performed. The patient died 3 months after the diagnosis of this metastasis. We performed a systematic search of PubMed, which yielded 453 entries. We selected those with at least an abstract available in English that described metastatic lesions on the Bartholin gland (n = 5). The review showed that a variety of primary cancers (colorectal, medullary thyroid, breast cancer, and endometrial cancers) metastasize to this location. Some patients showed signs of visceral metastasis. Bartholin gland metastases appeared as initial and metachronous manifestations. Most patients were symptomatic, with painful swelling or abscess. Genetic alterations were mentioned in some cases. The main pathways of metastasis discussed were lymphatic, but the mechanism of such metastasis remains unclear. Surgical resection was the preferred treatment option. The literature review indicated that Bartholin gland metastasis of ovarian cancer is rare and associated with poor prognosis. Oncological reasons for vulvar pathologies should be taken into consideration in patients with metastases.

(031) Bartholin Cysts Can Be Treatable Causes of Female Sexual Dysfunction: Four Year Review of Diagnosis and Treatment Principles

Abstract Introduction Bartholin glands are major vestibular androgen dependent glands that release mucus secretions during sexual arousal through a 2.5 cm duct that drains at the 5 o'clock and 7 o'clock positions of the vestibule. Bartholin's glands are innervated by a branch of the pudendal nerve; mucous secretion is activated by the efferent pelvic nerve. Unilateral or bilateral obstruction of the Bartholin's ducts may occur (e.g. from trauma, infection, surgery, or idiopathic), however as long as innervation is intact, Bartholin glands continue to produce mucus despite outlet ductal occlusion. This leads to dilation of the duct with subsequent cyst formation that can result in Bartholin cyst-associated sexual dysfunction symptoms. Objectives To review patient records of women presenting to a sexual medicine clinic over a four-year period diagnosed with and surgically treated for Bartholin cyst-associated sexual dysfunction. Methods Grayscale ultrasound was performed (see figure) using the Aixplorer and cyst dimensions were measured after visual sexual stimulation in the office. Vulvoscopy was performed with the Wallach Zoomscope. Bartholin cyst anesthesia testing was performed using benzocaine 20%, lidocaine 8% and tetracaine 6%. Marsupialization surgery was performed as an out-patient. Results We identified 11 patients (mean age 26 +/− 6 years) diagnosed with Bartholin cyst-associated sexual dysfunction between January 2019 and November. 2010 who met inclusion criteria and were surgically treated by marsupialization for unilateral (4) and bilateral (7) Bartholin cysts. Their symptoms of Bartholin cyst-associated sexual dysfunction included dryness with sexual arousal (73%), pain with sexual arousal (82%), pain with orgasm (36%), spontaneous drainage (18%), and a mass at the introitus interfering with penetration (45%). 55% had been treated previously at other facilities unsuccessfully, including cyst aspiration, Word catheter placement, and marsupialization. The mean cyst size on ultrasound was 2.9 +/− 1.5 cm. Bartholin cyst anesthesia testing was positive in all (4/4) that underwent this test. Surgical principles to encourage post-op mucin drainage through the Bartholin duct included visualization of the duct at surgery (see figure) and direct anastomosis of the duct to the inferior portion of the incision at 5 and/or 7 o’clock locations (see figure). Post-operative daily arousal was encouraged and mucin secretion through the marsupialized ducts was documented by placement of gauze in the introitus and observing the mucous (see figure). At the time of this review, with an average follow-up of 8 months, 15 of 18 (83%) cysts are still draining and 9/11 patients are somewhat better, much better and very much better with resolution of Bartholin cyst-associated sexual dysfunction symptoms. Conclusions Bartholin cysts are a sexual dysfunction that can be successfully treated. Diagnosis involves an ultrasound after sexual arousal and a positive Bartholin cyst anesthesia test. Treatment involves marsupialization with visualization and anastomosis of the Bartholin duct to the inferior portion of the incision at the 5:00 and 7:00 locations. Post-operative daily arousal is encouraged with documentation of mucinous drainage detected. Disclosure No.

(032) A Large Retroperitoneal Schwannoma Masquerading as Genito-Urinary Syndrome of Menopause

Abstract Introduction Retroperitoneal schwannomas are extremely rare, slow growing, benign, neurogenic tumors. Their diagnosis is challenging and often incidentally found upon evaluation of vague symptoms. Extrinsic compression to nearby organs or nerves may cause pain and paresthesia. Vulvar pain as a presenting symptom of a retroperitoneal schwannoma is reported in the literature in a case with pudendal nerve involvement. Here we present a case report of a patient who presented with vulvar burning and lower urinary tract irritative symptoms which was found to have a large infra-hepatic retroperitoneal schwannoma. Objectives In this report we show case how performing a detailed neurological evaluation and having a good understanding of the vulvar, perineal, and lower extremity dermatomal innervation have assisted in early diagnosis and treatment of a large retroperitoneal schwannoma. Methods A 65-year-old menopausal woman presented to her primary provider for a 3-month-history of worsening vulvar burning sensation associated with urinary burning, frequency, and nocturia. The pain is worse at night and when sitting for more than an hour. The patient endorsed low back pain that radiated like pins down her anterior thighs. The patient underwent evaluation by her referring provider to rule out a urinary tract infections and vaginitis. She was treated with vaginal estrogen tablets with partial relief for a working diagnosis of Urogenital Syndrome of Menopause. Patient was then referred to Gynecology due to inadequate relief. A detailed pelvic examination revealed normal labia majora and minora with no erythema or swelling. The Vestibule, Bartholin and Skene glands were non tender. Q-tip testing provoked burning sensation in the left and right labia minora on the medial and lateral aspect as well as the labia majora. Pelvic Floor evaluation elicited left pelvic floor tenderness and bilateral ischial spine pain concerning for Pudendal neuralgia. Also, noted paresthesia overlying the left lower extremity at the L3 and L4 distribution at the medial thigh (Figure-1) The patient underwent a bilateral pudendal block with total resolution of her vulvar pain for 24 hours and hence, lumbar and pelvic nerve entrapment was suspected. Magnetic Resonance Imaging was requested. Evaluation revealed a 3.3x4.4cm left ovarian mass and uterine fibroids that could potentially explain L2-L5 radiculopathy. The Lumbar MRI noted a cystic mass in the right mid abdomen for which further evaluation with CT scan was recommended. (Image-1). Referral to Surgical Oncology and Gyn oncology was sought. Epithelial ovarian cancer tumor markers were normal. Catecholamine studies were nonrevealing except for unexplained increase in dopamine levels. Results Surgical excision of the retroperitoneal and ovarian tumor revealed a left ovarian Fibroma and Schwannoma with Cystic Degeneration, confirmed with Immuno-peroxidase studies for S100 and SOX10. The patient had an uncomplicated post-operative course and remains asymptomatic with total resolution of her urinary and vulvar burning symptoms. Conclusions This a case report of vulvar and urethral paresthesia caused by an exceedingly rare tumor located high in the retroperitoneum. Diagnosis was aided by detailed history, comprehensive gynecological, and neurodermatomal evaluation. Appropriate imaging and timely referral led to early diagnosis and treatment, resulting in symptom resolution. Disclosure No.

Adenosquamous carcinoma of the Bartholin gland treated with surgery and radiotherapy.

Adenosquamous carcinoma of the Bartholin gland treated with surgery and radiotherapy.

Vulvar Leiomyosarcoma Masquerading as a Bartholin Gland Cyst

Vulvar Leiomyosarcoma Masquerading as a Bartholin Gland Cyst

Adenoid Cystic Carcinoma (ACC) of the Bartholin's gland misdiagnosed for three times: a case report

BackgroundAdenoid cystic carcinoma (ACC) in Bartholin’s gland is an uncommon malignant tumor. These tumors have a vague clinical feature, so they are diagnosed late and discovered at a high-level stage. Our case presented Three Recurrences and Three times Misdiagnosis of Adenoid Cystic Carcinoma (ACC).Case presentationWe report a case of adenoid cystic carcinoma arising in Bartholin's gland of a 64-year-old female patient that appeared after three previous vulvar tumors were excised. The patient underwent bilateral radiotherapy which was performed on the perineum.ConclusionACC of the vulvar sweat glands is prone to misdiagnosis and delay in both diagnosis and treatment. As seen in our case, it was misdiagnosed three times as Chondroid Syringoma. Further studies need to be conducted to better understand the tumor prognosis, and its optimal treatment options.