KISTA BARTOLINI

Anatomy and Physiology of Bartholiny

Glands
• The bartholin glands
are paired glands
approximately 0,5 cm in
diameter
• Homologues of the
Cowpers glands
(bulbourethral gland) in
males
• Located bilaterally at
the base of the labia
minora
• Typically, they are
nonpalpable
• Drain through 2-2.5 cm-
long ducts that empty
into the vestibule at
about the 4 o’clock and
8 o’clock positions
• Their function is to
maintain the moisture
of the vaginal mucosa’s
vestibular surface.
• Folashade Omole,M.D., Barbara J.Simmons,M.D., Yolanda Hacker,M.D. Management of Bartholiln’s Ducts Cyst and Gland Abscess. American Family
Physician, Vol.68, No.1. Morehouse School of Medicine, Atlanta,Georgia. 1st July 2003
• Antonia Quinn,DO. Bartholin Gland Diseases. https://emedicine.medscape.com/article/777112-overview#a1 diakses tanggal 13th July 2018
• Tjokorde Istri Nindya Vaniary, Sunarko Martodihardjo. Studi Retrospektif: Kista dan Abses Bartholin. Artikel Berkala Kesehatan Kulit dan Kelamin Vol.
29/No.1/April 2017. Fakultas Kedokteran Universitas Airlangga
 Definition
• Bartholin Cyst is obstruction of distal gland
ducts of fluid-filled enlargement and having a
swollen sac-like structure.
• Bartholin abcess is infected bartholin cysts

• Folashade Omole,M.D., Barbara J.Simmons,M.D., Yolanda Hacker,M.D. Management of Bartholiln’s Ducts Cyst and Gland Abscess. American Family
Physician, Vol.68, No.1. Morehouse School of Medicine, Atlanta,Georgia. 1st July 2003
• Antonia Quinn,DO. Bartholin Gland Diseases. https://emedicine.medscape.com/article/777112-overview#a1 diakses tanggal 13th July 2018
• Tjokorde Istri Nindya Vaniary, Sunarko Martodihardjo. Studi Retrospektif: Kista dan Abses Bartholin. Artikel Berkala Kesehatan Kulit dan Kelamin Vol.
29/No.1/April 2017. Fakultas Kedokteran Universitas Airlangga
 Epidemiology
• The most common cystic growths in the vulva,
occur in the labia majora
• Approximately 2% of woman of reproductive age
will experience swelling of one or both Bartholin
glands
• 20-30 y.o
• Bartholin gland enlargement in patients older
than 40 years is rare and should be referred to a
gynecologist for possible biopsy
• Folashade Omole,M.D., Barbara J.Simmons,M.D., Yolanda Hacker,M.D. Management of Bartholiln’s Ducts Cyst and Gland Abscess. American Family
Physician, Vol.68, No.1. Morehouse School of Medicine, Atlanta,Georgia. 1st July 2003
• Antonia Quinn,DO. Bartholin Gland Diseases. https://emedicine.medscape.com/article/777112-overview#a1 diakses tanggal 13th July 2018
• Tjokorde Istri Nindya Vaniary, Sunarko Martodihardjo. Studi Retrospektif: Kista dan Abses Bartholin. Artikel Berkala Kesehatan Kulit dan Kelamin Vol.
29/No.1/April 2017. Fakultas Kedokteran Universitas Airlangga
 Etiology
• Although Neisseria gonorrhoeae
is the predominant aerobic
isolate, anaerobes are the most
common pathogens
• Chlamydia trachomatis also may
be a causative organism.
• Bartholin’s duct cysts and gland
abscesses are no longer
considered to be exclusively the
result of sexually transmitted
infections
• Vulvovaginal surgery is an
uncommon cause of these cysts
and abscesses

• Folashade Omole,M.D., Barbara J.Simmons,M.D., Yolanda Hacker,M.D. Management of

Bartholiln’s Ducts Cyst and Gland Abscess. American Family Physician, Vol.68, No.1.
Morehouse School of Medicine, Atlanta,Georgia. 1st July 2003
 PATOFISIOLOGI
SECONDARY INFECTION

OUTLET BLOCKAGE OF BARTHOLINE GLAND DUCT

DUCTAL REGION ORIFICES OBSTRUCTED

CYST DILATATION OF THE

THE GLAND PRODUCE
DUCT AND CYST
BUILD UP OF MUCUS
FORMATION

INFECTION

BARTHOLIN’S GLANDS
DIRECT INFECTION

BARTHOLIN’S GLANDS
ABSCESS
Lee MY, Dalpiaz A, Schwamb R, et all. Clinical Pathology of Bartholin’s Glands : a Review of the
Literature. New York: SUNY school of Medicine Stony Brook University. 2015 May 20;8:22-25
 Penyebab Obstruksi Kelenjar Bartholini
Infeksi, peradangan, atau iritasi jangka panjang
IMS seperti gonorrhoea & chlamydia (rare)
faktor mucus atau trauma, edema yg kompresi ductus
Kista bartholine banyak terjadi pada wanita :
 Muda & aktif seksual
 Belum pernah hamil
 Hanya pernah sekali hamil

Mekanisme : apabila saluran kelenjar ini mengalami

infeksi maka saluran kelenjar ini akan melekat satu
sama lain dan menyebabkan timbulnya sumbatan.

Hasnawati, Saragih SW, Abses Bartolini

Reccurent Infection

Lee MY, Dalpiaz A, Schwamb R, et all. Clinical Pathology of Bartholin’s Glands : a Review of the
Literature. New York: SUNY school of Medicine Stony Brook University. 2015 May 20;8:22-25
 Manifestasi klinis
• Kista Bartholine
 Asimptomatikjika kista kecil dan tidak inflamasi
 Terlihat massa menonjol secara medial dalam introitus posterior pada regio yang
duktusnya berakhir pada vestibulatidak nyeri disertai kemerahan/pembengkakan
biasa unilateral
 Apabila kista membesar akan menimbulkan rasa kurang nyaman saat beraktivitas
 Jika kista tidak ada komplikasidisharge mukus nonpurulen
• Abses Bartholine
 Jika akut, nyeri dengan pembengkakan biasanya unilateral
 Dispareunia
 Nyeri ketika beraktivitas seperti berjalan, duduk
 Dapat terjadi skin rupture & spontaneous drainnyeri diikuti keluarnya discharge
 Massa pada labium akan berfluktuasi disertai dengan eritema dan edema
 Cellulitis
 Demam tidak khas
 Jika terinfeksi IMSdemam disertai pembesaran kelenjar limfe & inguinal
 Sekret d vagina4-5 hari setelah pembengkakan

Lee MY, Dalpiaz A, Schwamb R, et all. Clinical Pathology of Bartholin’s Glands : a Review of the
Literature. New York: SUNY school of Medicine Stony Brook University. 2015 May 20;8:22-25
 DIAGNOSIS
• Anamnesis
• Pemfis
Pemeriksaan ginekologi : unilateral,nyeri, fluktuasi dan
pembengkakan eritem pada posisi jam 4 dan 8 pada
labium minus posterior
• Pemeriksaan penunjang
Kultur jaringanbakteri penyebab abses & IMS seperti
gonorrhea & chlamydia
Histological examination untuk menyingkirkan
keganasan pada kelenjar bartholine (disarankan untuk
wanita post menopause)
 Anamnesis
• Keluhan Utama • Riwayat penyakit kulit
• Sejak kapan dalam keluarga
• Berapa lama • Riwayat keluarga
• Faktor yang memperberat mengidap kanker kelamin
• Riwayat berganti • Riwayat penyakit lain
pasangan seks • Riwayat pengobatan
• Keluhan saat • Riwayat operasi vulvo-
berhubungan vaginal
• Riwayat IMS
 DIAGNOSIS BANDING
• Bartholin gland • Hidradenoma
malignancy • Lipoma
• Chancroid • Sebaceous cysts
• Emergent • Skene duct cyst
management of • Syphilis
Gonorrhea
• Vaginitis
• Endometriosis
• Vestibular mucous
• Genital warts cysts
• Hematoma • Vulvar malignancy