Vaginal Cysts

Introduction

• Description: Cystic masses in the vaginal wall are uncommon and may arise from either congenital (Gartner duct cysts) or acquired (epithelial inclusion cysts) processes.

• Prevalence: 1/200 women.

• Predominant Age: Generally from adolescence to middle reproductive years.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Congenital (Gartner duct cyst or remnant, generally found in the anterior lateral vaginal wall), structural (urethral diverticulum, loss of vaginal wall support), acquired (inclusion cyst; >50% of cysts).

• Risk Factors: Episiotomy or obstetric laceration, gynecologic surgery.

Signs and Symptoms

• Asymptomatic

• May be associated with a sense of fullness

• Dyspareunia (uncommon)

• Difficulty with tampon insertion or retention

• Cystic mass lesion (1–5 cm) generally found in the lateral vaginal wall (congenital) or in midline posteriorly (acquired)

Diagnostic Approach