Gartner Duct Cysts of Vagina

Gartner Duct Cysts of Vagina

Article
Sexual Health
Women's Health
+2
Contributed byKrish Tangella MD, MBASep 16, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Mesonephric Cysts of Vagina
  • Vaginal Mesonephric Cysts
  • Vaginal Wolffian Duct Cysts

What is Gartner Duct Cysts of Vagina? (Definition/Background Information)

  • Vaginal cysts are rare, benign, and usually fluid-filled lesions that form on the vaginal walls in adult women. A majority of these cysts are small and present no symptoms, while some may grow to large sizes resulting in pain and discomfort
  • The following different types of vaginal cysts have been identified:
    • Squamous Epithelial Inclusion Cysts of Vagina
    • Müllerian Cysts of Vagina
    • Gartner Duct Cysts of Vagina
    • Urothelial Cysts of Vagina
    • Bartholin’s Gland Cysts of Vagina
  • Gartner Duct Cysts of Vagina are types of vaginal cyst. It is a benign cyst that is lined by non-secretory cuboidal/columnar epithelial cells, when observed under a microscope by a pathologist. These are also known as Mesonephric Cysts of Vagina
  • There are no clearly established risk factors. Gartner ducts are known to form in pregnant women and they tend to disappear following delivery of the child. However, in case they do not regress, it may result in the formation of Gartner duct cysts
  • Most of the cysts appear as solitary lesions and are painless. Frequently, these cysts are discovered incidentally while the individual is being examined for other medical conditions
  • No significant signs and symptoms or complications are typically noted. However, in some cases, Gartner Duct Cyst of Vagina may grow to larger sizes resulting in discomfort and pain
  • Treatment course includes close observation of the tumor in asymptomatic cases and surgical management, if necessary. In general, the prognosis of Gartner Duct Cyst of Vagina is excellent with adequate treatment

Who gets Gartner Duct Cysts of Vagina? (Age and Sex Distribution)

  • Gartner Duct Cysts of Vagina are mostly observed in adult women
  • In general, vaginal cysts are seen between the ages 20-75 years; a peak age range is observed in the 4th decade (30-40 years)
  • The Gartner duct cysts account for nearly 12% of all vaginal cysts
  • There is no known geographical, ethnic, or racial preference

What are the Risk Factors for Gartner Duct Cysts of Vagina? (Predisposing Factors)

No definitive risk factors have been identified for Gartner Duct Cysts of Vagina. However, they may occur due to the following factors:

  • Trauma to the vagina during childbirth
  • Presence of other benign vaginal tumors
  • Invasive procedures involving the female genital tract, such as colposcopic exam, endocervical curetting, episiotomy, colporrhaphy, and laser therapy, that are performed for various reasons

The Vaginal Gartner Duct Cysts may be also associated with the following conditions:

  • Cross-fused ectopia
  • Herlyn-Werner-Wunderlich syndrome
  • Ipsilateral renal dysplasia
  • Renal agenesis

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Gartner Duct Cysts of Vagina? (Etiology)

  • During fetal growth and development, the formation of Gartner ducts or mesonephric ducts on the vaginal walls take place. These ducts are generally known to disappear after childbirth
  • However, in case they are present following delivery of the child, some of them tend to accumulate fluid or pus and result in Gartner Duct Cysts of Vagina
  • The Gartner/mesonephric cysts form from Gartner/mesonephric ducts when they expand or stretch

It is important to note that Vaginal Gartner Duct Cysts are not caused by any sexually transmitted disease.

What are the Signs and Symptoms of Gartner Duct Cysts of Vagina?

A majority of the cysts may be asymptomatic, presenting no significant signs and symptoms (about 75% of the vaginal cysts). In some cases, the following signs and symptoms of Gartner Duct Cysts of Vagina may be noted:

  • Presence of a single cyst that is normally filled with fluid (usually not with mucin); the cysts may be also sometimes filled with pus, air, or other cell remnants
  • The cyst is soft and usually well-defined; it may occur as a polyp on the vaginal wall
  • The cysts may be of varying sizes; most cysts are small (1 cm in size), while some may grow to large sizes (5-14 cm have been noted)
  • Presence of a noticeable lump within the vagina
  • Large sizes may cause discomfort and pain from pressure to the region (mass effect)
  • Pain or discomfort while using a tampon
  • Discomfort while walking or sitting
  • It may also cause itching, painful urination, and pelvic pain

How is Gartner Duct Cysts of Vagina Diagnosed?

A diagnosis of Gartner Duct Cysts of Vagina may involve the following steps:

  • Evaluation of the individual’s medical history and a thorough physical (pelvic) examination
  • Tests to rule out sexually-transmitted infections (if necessary)
  • In many cases, no radiological studies are necessary. However, if the tumor is of a large size, then the following radiological tests may be considered:
    • Ultrasound scan of the abdomen
    • Transvaginal ultrasound of the uterus can provide an image of the vagina and surrounding pelvic organs
    • CT or CAT scan with contrast of the abdomen and pelvis may show a well-defined mass. This radiological procedure creates detailed 3-dimensional images of structures inside the body
    • MRI scans of the abdomen and pelvis: Magnetic resonance imaging (MRI) uses a magnetic field to create high-quality pictures of certain parts of the body, such as tissues, muscles, nerves, and bones. These high-quality pictures may reveal the presence of the tumor
  • Vaginal biopsy of the mass: It is the process of removing tissue for examination. In the case of Gartner duct cyst, a complete excision and removal of the lesion can help in the process of a biopsy, as well as be a means for treating the condition
  • Occasionally, since the cyst is fluctuant (due to accumulation of fluid), a fine needle aspiration of the cyst contents may be performed
    • Fine needle aspiration (FNA) biopsy: A very fine and hollow needle is inserted where the cyst is noticed; the fluid contained within the cyst is withdrawn. The extracted sample is sent for further pathological examination
    • If the healthcare provider suspects an infection process, then culture studies on the cyst aspirate may be performed

Note: Many vaginal cysts are discovered incidentally on radiological studies, while the individual is being examined for other medical conditions.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Gartner Duct Cysts of Vagina?

No significant complications of Gartner Duct Cysts of Vagina are noted, because it is a benign condition. However, the following may be observed in some cases:

  • Stress due to a concern for vaginal cancer
  • Abscess formation resulting in infections; this may result in associated signs and symptoms including fever
  • Pain during sex, if the cysts are infected and painful
  • The cysts may rupture and bleed resulting in secondary infections
  • In some rare cases, large cysts may cause additional complications during pregnancy; it may even necessitate a C-section delivery of the child
  • Damage to the muscles, vital nerves, and blood vessels, during surgery
  • Post-surgical infection at the wound site is a potential complication
  • Recurrence of the cyst following surgery is not known to occur

How is Gartner Duct Cysts of Vagina Treated?

Treatment measures for Gartner Duct Cysts of Vagina may include the following:

  • Some cysts are known to subside and spontaneously regress on their own
  • If there are no symptoms, then the healthcare provider may advise a ‘wait and watch’ approach, following the diagnosis of a Gartner duct cyst
  • Sitz bath: Immersing oneself several times in a tub filled with warm water for a period of 3-4 days may cause the cyst to break and the fluid will drain on its own. This therapy may not be effective for all individuals. The healthcare provider will advise if the therapy is appropriate for the individual
  • In some cases, the cysts may get secondarily infected. If bacteria is the cause of infection, it may be treated through antibiotics
  • If the antibiotics does not clear the infection, then an abscess drainage through a surgical procedure may be performed
  • Surgical intervention with complete excision can result in a complete cure
  • During pregnancy, large tumors can either be drained through aspiration or surgically removed to facilitate easy delivery. In case, this is not possible, then a C-section delivery may be considered
  • Post-operative care is important: Minimum activity level is to be ensured until the surgical wound heals
  • Follow-up care with regular screening and check-ups are important

How can Gartner Duct Cysts of Vagina be Prevented?

  • Current medical research has not established a method of preventing Gartner Duct Cysts of Vagina
  • In case of a secondary infection it is better to avoid sex, as it may aggravate the condition
  • However, medical screening at regular intervals with scans and physical examinations are advised

What is the Prognosis of Gartner Duct Cysts of Vagina? (Outcomes/Resolutions)

The prognosis of Gartner Duct Cysts of Vagina is excellent with surgical intervention (surgical removal through simple excision), since these are benign lesions.

Additional and Relevant Useful Information for Gartner Duct Cysts of Vagina:

The following DoveMed website links are useful resources for additional information:

http://www.dovemed.com/healthy-living/womens-health/

http://www.dovemed.com/diseases-conditions/cancer/

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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