Swelling in the vaginal entrance
Swelling in the vaginal entrance is a problem that many women face in the course of their lives. Many fear malicious changes. These can also be the cause of swelling, but other, diverse causes such as inflammation are much more common. However, since inflammation can also be dangerous for the body and sometimes contagious, the treating gynecologist should be consulted with every swelling.
The causes of swelling in the vaginal entrance are very diverse. Inflammation comes first. The most common here is Bartholinitis. This infection of the duct of the Bartholin gland can be triggered by various germs. A purulent inflammation develops, in which the surrounding tissue swells. The swelling is usually one-sided in the back third of the labia and can be the size of a chicken egg. It usually causes severe pain.
Further inflammation of the labia and vagina can lead to swelling. The pathogens are diverse and can be fungi, bacteria, viruses or parasites.
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Furthermore, but less often, benign and malignant changes in the labia and vagina can lead to swelling. One of the benign changes is Lichen sclerosus et atrophicus. A reduction in cells in the skin can lead to changes in the skin. Also Condylomas and Papillomas are benign. Condylomas are caused by the human papillomavirus (HPV) and cause cockcomb-shaped, pointed or flat, painless warts. Papillomas have a more cauliflower-like appearance. Malicious changes include the vulvar or vaginal intraepithelial neoplasia (VIN / VAIN)which are precursors to carcinomas in the vaginal area. Swelling may occur as the malignant cells grow.
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Depending on the cause, the swelling can develop and persist slowly or quickly. If there is inflammation, it can develop within a few days. Tumors usually grow more slowly and often remain asymptomatic for a long time. With drug therapy, the swelling usually regresses within four weeks, with surgical removal it should no longer be present after the procedure.
A gynecological examination is necessary to diagnose swelling in the vaginal area. In advance, the doctor will talk about the current symptoms. In the examination, the outer and inner vagina is examined and felt and smears are taken. To diagnose the Bartholinitis A visual diagnosis is usually sufficient, as the appearance is very clear. In the case of other inflammations, the pathogen is detected with the help of the smear. To rule out benign and malignant changes, samples are taken from the respective swollen region in order to detect a cell change.
Depending on the cause, the accompanying symptoms can also vary. Bartholinitis can lead to an abscess. This is a cavity filled with pus. In this case, other general signs of inflammation such as redness and warming of the skin appear. Inflammation in the vaginal area can lead to itching, burning, reddening, pain when urinating and / or sexual intercourse and possibly changes in the vaginal discharge. The inguinal lymph nodes may also be enlarged. Depending on the pathogen, typical symptoms such as whitish deposits with a fungal infection or blisters with a herpes virus infection can occur.
Of the Lichen sclerosus et atrophicus triggers skin changes such as whitish, shiny skin and reddening of the skin, itching, burning irritation and discomfort during sexual intercourse. Also at Papillomas and Condylomas itching, burning and additionally a sensation of wetness can occur. Malignant changes can lead to itching long before visible changes. Burning and pain can also occur. Dark skin changes and whitish mucous membranes are another sign of malignant changes.
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For bartholinitis, the therapy of choice is what is known as Marsupialization. A small incision is made in the swelling, the edges of the Bartholin glands are folded outwards and sutured to the labia. If there is an abscess, the pus is drained and, if necessary, tested for pathogens.
In the case of inflammation in the vaginal area, the therapy depends on the particular pathogen.
For herpes infections, antivirals such as Acyclovir Used locally or in severe cases in tablet form, fungal infections are treated with antimycotics such as Clotrimazole treated.
In the case of bacterial inflammation, the choice falls on antibiotics such as Metronidazole in tablet or ointment form. If necessary, the sexual partner must also be treated if it is a matter of sexually transmitted diseases.
For Lichen sclerosus et atrophicus there is no causal treatment. Symptoms such as itching can be treated topically with corticosteroid creams. Condylomas should be treated with the antiviral drug imiquimod first to reduce the extent of the warts. The skin changes can then be removed with the help of a CO2 laser, cold therapy (cryotherapy) or a sling. Since condylomas are caused by the human papillomavirus, vaccination against the most common strains can protect against the disease.
For the therapy of malignant changes, the therapy depends on the stage. In preliminary stages, removal by laser or surgery is performed. In the case of carcinomas, these are cut out as widely as possible and, depending on the location of the tumor, radio, chemotherapy or radiation therapy takes place.