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

• Mucous Cyst of Vulva
• Paramesonephric Mucinous Cyst of Vulva
• Vulvar Mucinous Cyst

What is Mucinous Cyst of Vulva? (Definition/Background Information)

• Mucinous Cyst of Vulva is a type of vulvar cyst that is filled with mucin (a type of mucous). It occurs due to blockage of a vulvar gland duct and is typically seen in adult women
• Mucinous Cysts of Vulva are benign and common cysts that may involve the mesonephric duct (or Gartner ducts) remnants, Bartholin glands, or the Skene’s glands. They can also originate from the urogenital sinus remnants
• A majority of these cysts are small and present no symptoms, while some may grow larger causing pain and discomfort. In some cases, the cysts may get infected resulting in abscess formation
• Treatment course includes observation of the lesions in asymptomatic cases and surgical management, if necessary. In general, the prognosis of Mucinous Cysts of Vulva is excellent, since it is a benign condition

Who gets Mucinous Cyst of Vulva? (Age and Sex Distribution)

• Mucinous Cysts of Vulva are mostly observed in adult women; particularly in women of childbearing age
• There is no known geographical, ethnic, or racial preference

What are the Risk Factors for Mucinous Cyst of Vulva? (Predisposing Factors)

• No specific risk factors have been identified for Mucinous Cysts of Vulva. However, a majority of the cysts are observed in women of reproductive age (between the 20s and 30s)

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 Mucinous Cyst of Vulva? (Etiology)

• Mucinous Cysts of Vulva are caused by obstruction of gland ducts in the vulva (the area around the external vaginal opening), followed by an accumulation of fluid or mucin
• The glands that are involved may include the vestibular glands (Bartholin’s and Skene’s glands) and the Gartner ducts
• Study reports also indicate that such mucinous cysts may arise from the urogenital sinus-derived epithelium; glands lined by mucinous epithelium become obstructed and collect mucin

It is important to note that Vulvar Mucinous Cysts are not caused by any sexually transmitted disease.

What are the Signs and Symptoms of Mucinous Cyst of Vulva?

A majority of the cysts may be asymptomatic, presenting no significant signs and symptoms. In some cases, the following signs and symptoms of Mucinous Cysts of Vulva may be noted:

• Presence of numerous cysts filled with fluid (mucin)
• The cysts may be present in any region of the vulva, but are especially concentrated near the vestibular glands
• A collection of cysts may appear like a mucin-filled mass; larger masses may appear pedunculated (suspended from a bag-like structure)
• An area of redness and inflammation may be observed; there may be an absence of pain
• Large sizes may cause discomfort and pain; some cysts may grow to 3 cm in size
• Pain or discomfort while using a tampon, or during sex
• Discomfort while walking or sitting

How is Mucinous Cyst of Vulva Diagnosed?

A diagnosis of Mucinous Cysts of Vulva may involve the following steps:

• Evaluation of the individual’s medical history and a thorough physical (pelvic) examination. A pelvic (visual) exam is normally sufficient to diagnose the condition
• Tests to rule out sexually-transmitted infections (if necessary)
• Biopsy of the mass: It is the process of removing tissue for examination. In the case of mucinous cysts, 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: If the cysts are present in middle-aged and older women (over 40 years of age), additional tests to rule out certain cancerous conditions may be recommended by the healthcare provider.

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 Mucinous Cyst of Vulva?

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

• Higher risk for abscess formation resulting in infections (especially bacterial infections due to Gonorrhea and Chlamydia); this may result in associated signs and symptoms
• Severe pain during sex, if the cysts are infected and painful
• 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

How is Mucinous Cyst of Vulva Treated?

If there are no symptoms, then the healthcare provider may advise a ‘wait and watch’ approach, following the diagnosis of mucinous cysts. An analysis of risk versus benefit for a ‘wait and watch’ approach will be considered on a case-by-case basis by the healthcare provider.

Treatment measures for Mucinous Cysts of Vulva may include the following:

• Some cysts may subside and spontaneously regress on their own
• 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 to drain out 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
• Application of topical creams and gels, to bring relief from the symptoms and to provide a measure of comfort
• Stopping the usage of soaps and body creams that have harsh chemicals in them; use of milder alternatives
• Use of clean cotton underwear; avoiding synthetic and tight-fitting clothes for a period of time
• Maintain proper personal hygiene, especially in the genital region
• 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
• Bartholin gland and Skene’s gland cysts may be treated through marsupialization surgical procedure
• 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 Mucinous Cyst of Vulva be Prevented?

Current medical research has not established a method of preventing Mucinous Cysts of Vulva.

• In case of a secondary infection it is better to avoid sex, as it may aggravate the condition
• After bowel movement, clean or wipe from front to back and avoid spread of pathogens from the rectum to vagina
• Ensure good genital hygiene
• Avoid tight-fitting dress that trap moisture between the legs

Medical screening at regular intervals with scans and physical examinations are advised.

What is the Prognosis of Mucinous Cyst of Vulva? (Outcomes/Resolutions)

• Mucinous Cysts of Vulva is a common and benign condition that occurs in adult women. Typically, the cysts are benign and the cysts may not be any clinical significance
• If necessary, treatment (including surgery) may be provided; with adequate treatment, the prognosis of Vulvar Mucinous Cysts is excellent. However, if the cysts are infected, then it may adversely affect the prognosis

Additional and Relevant Useful Information for Mucinous Cyst of Vulva:

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/