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Peri-Arousal Bartholinodynia BilateralisFrom: Marco A. Pelosi, III, MD (marcop@agoron.com)Tue Mar 27 21:37:34 2001
A 32-year-old nullipara with a history of left-sided Bartholin abscess treated by I&D 6 years ago presented with progressive severe pain within both Bartholin glands, only during arousal, for 1 year. Med/surg history is negative. Both glands are pea-sized, firm & nontender to palpation. Bilateral FNA & cultures were negative for infection. Empiric therapy with antibiotics, tub baths, and pre-coital NSAIDS was ineffective. An atropine-based asthmatic inhaler provided partial relief by reducing systemic mucus secretion, but pain is still significant. Bartholinectomy has been refused. I have considered direct injection of alcohol into the glands, but am reluctant to risk injury to critical branches of the pudendal nerves. Any ideas?
-- M.A. Pelosi, III, MD
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