Skene’s gland cyst excision: A Case Report

Background and Aim : Skene’s (paraurethral) glands are are the female homolog of male prostate(1).Skene’s gland lie within the submucosa of distal urethra and are located laterally on each side of themeatus (2,3). It can became cystic when the ducts becomes obstructed, most often due to an infection (1).A skene’s gland cyst can present as a painful, erythematous , fluctuant mass inferolateral to the urethra (3).The standard treatment protocol for Skene’s gland remains undetermined, as such cysts are rare (4,5).Although antibiotic treatment can resolve a skene’s gland cyst abscess, surgical methods such as partialexcision, marspialization (incision of cyst and suturing of its edges), and complete excision can producecomplete resolution (3,4,6).Methods : A 34 year old woman, G1P1L1, who complained of bulge at anterior vesicovaginal wall. Wedetected a large, non tender, mobile, fluctuant mass seeming to have origin on the anterior vaginal wall,independent from bowel or bladder. We carried a transvaginal and abdominal ultrasound. We found a singlecystic, low level echo, avascular area of approximately 6cm on anterior vaginal wall, probably gartner cyst.No abnormality were found in renovesical ultrasound. Surgical removal was performed. The patient wasproposed for surgery- drainage of dark color fluid and dissection of the cyst wall- which was performedwithout any complications. The pathologic report revealed paraurethral skene gland cyst.Results : Although skene’s gland cysts are rare, it is important to distinguish them from other periurethralmasses so that the lesion can be properly treated (3). Surgical excision , whether partial or complete ,prevails as the definitive treatment. Partial excision and/or marsupialization of skene’s gland cysts havehad favorable results , with minimal recurrences and complications (4-6).Conclusion : Complete excision offers a definitive approach but carries the risk of distal urethral-wallinjury, which could result in incontinence, urethrovaginal fistula , or urethral stricture (4).

Keywords:

skene’s gland , fistula