Exxcellence pearls: vaginal cysts Flashcards
What is the differential diagnosis for a cystic mass at the vaginal apex?
Inclusion cyst possibly related to vaginal laceration repair or Gartner’s duct cyst. Cystocele or enterocele.
What is the differential diagnosis for a cystic mass in the midline of the anterior vagina?
Urethral diverticulum, inclusion cyst, abscess or cyst of the Skene’s gland
What is a Gartner’s duct cyst?
How would a Gartner’s duct cyst causing dyspareunia be managed?
Vestigial remnant of a mesonephric duct.
Surgical excision.
What historical features suggest a urethral diverticulum?
Dysuria, urgency, frequency, and post-void dribbling
How can urethral diverticula be diagnosed on physical exam?
Palpation of the mass with milking of the urethra leading to urethral discharge.
How is urethral diverticulum surgically managed?
Excision or marsupialization (Spence) procedure
How should a suspected urethral diverticulum be confirmed?
What other lab testing is recommended?
Cystourethrogram or urethrogram with contrast. Ultrasound, MRI, and CT have also been reported.
Urine culture to rule out concomitant infection.
