Vaginal cysts are uncommon

benign Malignancy () is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous benign tumor, ''benign'' tumor in that a malig ...

cyst A cyst is a closed sac, having a distinct envelope and division compared with the nearby tissue. Hence, it is a cluster of cells that have grouped together to form a sac (like the manner in which water molecules group together to form a bubb ...

s that develop in the vaginal wall. The type of epithelial tissue lining a cyst is used to classify these growths. They can be congenital. They can present in childhood and adulthood. The most common type is the squamous inclusion cyst. It develops within vaginal tissue present at the site of an episiotomy or other vaginal surgical sites. In most instances they do not cause symptoms and present with few or no complications. A vaginal cyst can develop on the surface of the vaginal epithelium or in deeper layers. Often, they are found by the woman herself and as an

incidental finding Incidental medical findings are previously undiagnosed medical or psychiatric conditions that are discovered unintentionally and during evaluation for a medical or psychiatric condition. Such findings may occur in a variety of settings, including r ...

during a routine

pelvic examination A pelvic examination is the physical examination of the external and internal female pelvic organs. It is frequently used in gynecology for the evaluation of symptoms affecting the female reproductive and urinary tract, such as pain, bleeding, ...

. Vaginal cysts can mimic other structures that protrude from the vagina such as a

rectocele In gynecology, a rectocele ( ) or posterior vaginal wall prolapse results when the rectum bulges ( herniates) into the vagina. Two common causes of this defect are childbirth and hysterectomy. Rectocele also tends to occur with other forms of ...

and

cystocele A cystocele, also known as a prolapsed bladder, is a medical condition in which a woman's bladder bulges into her vagina. Some may have no symptoms. Others may have trouble starting urination, urinary incontinence, or frequent urination. Complic ...

. Some cysts can be distinguished visually but most will need a

biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, an interventional radiologist, or an interventional cardiology, interventional cardiologist. The process involves the extraction of sampling (medicine), sample ...

to determine the type. Vaginal cysts can vary in size and can grow as large as 7 cm. Other cysts can be present on the vaginal wall though mostly these can be differentiated. Vaginal cysts can often be

palpated Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine ...

(felt) by a clinician. Vaginal cysts are one type of vaginal mass, others include

cancers Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...

and

tumors A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

. The prevalence of vaginal cysts is uncertain since many go unreported but it is estimated that 1 out of 200 women have a vaginal cyst. Vaginal cysts may initially be discovered during pregnancy and childbirth. These are then treated to provide an unobstructed delivery of the infant. Growths that originate from the urethra and other tissue can present as cysts of the vagina.

Types

Vaginal inclusion cysts can appear as small bumps and can develop during childbirth, or after surgery. A squamous inclusion cyst can rarely be found in a newborn. Other cysts can be

Bartholin's cyst A Bartholin's cyst occurs when a Bartholin's gland within the labia becomes blocked. Small cysts may result in minimal or no symptoms. Larger cysts may result in swelling on one side of the vaginal opening, as well as pain during sex or walking. ...

Gartner's duct cyst A Gartner's duct cyst (sometimes incorrectly referred to as ''vaginal inclusion cyst'') is a benign vaginal cyst that originates from the Gartner's duct, which is a vestigial remnant of the mesonephric duct (Wolffian duct) in females. They are typ ...

mucous inclusions Mucus (, ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both serous and mucous cells. It ...

, epithelial inclusion cysts,

embryonic cysts Embryonic may refer to: *Of or relating to an embryo * ''Embryonic'' (album), a 2009 studio album by the Flaming Lips *''Embryonics ''Embryonics'' is a double-CD Compilation album, compilation of tracks by the Australian progressive metal band ...

and urothelial cysts. Less common vaginal cysts are endometrial cysts and vaginitis emphysematosa. Vaginitis emphysematosum is a group of gas-filled cysts on the vaginal wall; these are benign and self-limiting (resolve on their own). Vaginal cysts can also be congenital and associated with urinary system anomalies The most common type of vaginal cyst are Müllerian cysts. These usually develop on the anterolateral vaginal wall. This cyst can be lined with epithelium from the

cervix The cervix (: cervices) or cervix uteri is a dynamic fibromuscular sexual organ of the female reproductive system that connects the vagina with the uterine cavity. The human female cervix has been documented anatomically since at least the time ...

uterus The uterus (from Latin ''uterus'', : uteri or uteruses) or womb () is the hollow organ, organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic development, embryonic and prenatal development, f ...

and

fallopian tubes The fallopian tubes, also known as uterine tubes, oviducts or salpinges (: salpinx), are paired tubular sex organs in the human female body that stretch from the ovaries to the uterus. The fallopian tubes are part of the female reproductive sy ...

. An epithelial inclusion cyst is also referred to as epidermal inclusion cyst or squamous inclusion cyst. This type of cyst comprises 23% of all vaginal cysts and is the second most common. This cyst originates from epithelium tissue that has been 'trapped' from

surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

episiotomy Episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by an obstetrician. This is usually performed during the second stage of labor to quickly enlarge the aperture, allowing ...

, or other trauma. It is most often found on the lower posterior vaginal wall. An

epidermoid cyst An epidermoid cyst or epidermal inclusion cyst is a benign cyst usually found on the skin. The cyst develops out of ectodermal tissue. Histologically, it is made of a thin layer of squamous epithelium. Signs and symptoms The epidermoid cyst may ...

is one type of vaginal cyst. Inclusion cysts are small and located on the posterior, lower end of the vagina. Small pieces of vaginal epithelium are trapped beneath the surface due to perineal lacerations and imperfect surgical repair after an episiotomy. A

develops from a small tissue remnant of the

mesonephric duct The mesonephric duct, also known as the Wolffian duct, archinephric duct, Leydig's duct or nephric duct, is a paired organ that develops in the early stages of embryonic development in humans and other mammals. It is an important structure that pl ...

. Symptoms include:

infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...

, bladder dysfunction,

abdominal pain Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given th ...

vaginal discharge Vaginal discharge is a mixture of liquid, cells, and bacteria that lubricate and protect the vagina. This mixture is constantly produced by the cells of the vagina and cervix, and it exits the body through the vaginal opening. The composition, ...

, and

urinary incontinence Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a significant effect on quality of life. Urinary incontinence is common in older women ...

. It is often large enough to cause urinary incontinence but surgical removal provides treatment and recurrence is unlikely. Diagnosis is confirmed with

ultrasound Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply ...

imaging. The evaluation by biopsy provides the most accurate diagnosis. This cyst has a lining of epithelial tissue that varies from squamous to mucin-secreting transitional epithelium. Occasionally, a parasitic infection causes a vaginal cyst.

Signs and symptoms

In most instances, symptoms are minimal or absent. Some women may experience vaginal pressure, discomfort, swelling, painful sex, or bleeding. Cysts can also be sensitive and tender to the touch.

Diagnosis

Diagnosis is aided by the use of ultrasound, CT scan, voiding cystourethrogram, and MRI. Ultrasound findings may be the visualization of smooth margins of a fluid-filled structure. Vaginal cysts resemble other structures that protrude from the vagina such as rectocele and cystocele. Histological assessment is needed to determine the specific type of cyst. Vaginal cysts are often discovered during a routine pelvic exam or pap smear. Cysts are also discovered during a bimanual exam. Other structures that resemble vaginal cysts are connective tissue tumors,

hematocolpos Hematocolpos is a medical condition in which the vagina is pooled with menstrual blood due to multiple factors leading to the blockage of menstrual blood flow. The medical definition of hematocolpos is "an accumulation of blood within the vagina ...

, and hymenal atresia. The absence of

vaginal rugae Vaginal rugae are structures of the vagina that are transverse ridges formed out of the supporting tissues and vaginal epithelium in females. Some conditions can cause the disappearance of vaginal rugae and are usually associated with childbirth a ...

over the cyst is a clue to their presence.

Treatment

Many cysts remain small, are followed closely by a clinician, and resolve on their own. Surgery and/or drainage is performed to remove the cyst. Treatment continues after the surgical removal by scheduled followups with the medical provider who looks for changes in the cyst. Bartholin gland cysts often need to be drained. Sometimes, antibiotics are prescribed to treat them as well. Treatment for these usually includes aspiration, marsupialisation and deroofing. When cysts are treated complications are few. Vaginal cysts rarely recur. When surgically removed, the cysts usually do not return. In some cases a Bartholin cyst can develop and need further treatment. In most cases, there are no complications from the cysts themselves. A surgical removal carries a small risk of complication. The risk depends on where the cyst is located.

References

External links