The Bartholin gland: An overview of anatomy, physiology and disease
The Bartholin’s glands are located bilaterally at the posterior portion of the vestibule, distal to the hymenal remnants and are secretory in function. Although not solely so, they are responsible for the natural lubrication of the vagina and vulva and are normally not palpable or visible on examination of the pelvis.
Symptomatic Bartholin duct masses are a common presenting complaint in women presenting acutely to a gynaecological department and can present a therapeutic dilemma. Symptoms most often arise when an abscess forms in an obstructed duct, and unless this is draining spontaneously, it may require a degree of surgical intervention. Incision and drainage has proved to have a high recurrence rate and should thus be supplemented with the insertion of a Word catheter or the placement of sutures securing the ductal wall to the perineal epithelium, known as marsupialisation. Other methods of treatment have proved less effective.
Less often malignancies can arise from the Bartholin structures and occur most frequently in women aged 40 to 70 years. It is thus mandatory to biopsy the ductal and or gland wall in women of this age presenting with a suspicious enlargement of this area of the vulva on the first visit as primary neoplasms of this origin, although rare, are highly metastatic and may require extensive surgical intervention.
Keywords: Bartholin’s gland; Bartholin’s duct; Disease