Skene's Duct Cyst

Skene's Duct Cyst

Article
Sexual Health
Women's Health
+3
Contributed byKrish Tangella MD, MBAAug 13, 2019

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

  • Cyst of Skene’s Duct
  • Cyst of Skene’s Glands
  • Skene Duct Cyst

What is Skene's Duct Cyst? (Definition/Background Information)

  • Skene’s glands are known as the lesser or minor vestibule glands and are located just below the urethra, near the vaginal opening. Hence, they are also known as paraurethral glands
  • When the duct of the Skene’s glands gets blocked, fluid gets accumulated and causes the gland to swell and form a cyst. This medical condition is termed as a Skene’s Duct Cyst
  • It is a painless enlargement or swelling of the Skene gland, which could form into a painful abscess following infection of the gland. Skene’s Duct Cyst usually forms in adult women
  • While most of the cysts are small, it can also appear as a lump in the vaginal area and cause discomfort while walking or having sex, which are the most common symptoms of Skene’s Duct Cyst
  • Only symptomatic cysts may require treatment, and this usually involves a surgical drainage of the fluid. The prognosis of Skene Gland Cyst is excellent with appropriate treatment

Who gets Skene's Duct Cyst? (Age and Sex Distribution)

  • Typically, Skene Duct Cyst affects adult women (young, middle-age, or older women)
  • In rare cases, the condition has been observed in infant children too
  • The condition is observed worldwide; all racial and ethnic groups may be affected

What are the Risk Factors for Skene's Duct Cyst? (Predisposing Factors)

  • Currently, no specific risk factors for Skene’s Duct Cyst formation have been identified

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 Skene's Duct Cyst? (Etiology)

  • A Skene’s Duct Cyst forms when the Skene gland gets blocked and fluid gets accumulated. This causes the gland to in size and form a cyst
  • If the cyst gets infected by bacteria or other pathogens, then it may result in the formation of a Skene gland abscess
  • The Skene’s gland have a role to play during sex, with respect to lubrication and female ejaculation

What are the Signs and Symptoms of Skene's Duct Cyst?

The common signs and symptoms of Skene’s Duct Cyst may include:

  • A lump or a mass near the vaginal opening, which may be tender and painless
  • The size of the cyst may be about 1 cm, while some are larger
  • In case of an abscess formation, then pain, redness, inflammation, and ulceration may be noticed
  • Pain and discomfort while walking or sitting, or during sex
  • Fever, especially when the gland is infected to form an abscess
  • Large cysts are known to obstruct the urethra and cause pain or irritation during urination, or urination difficulties

In a majority of cases, other than the presence of a mass, no other signs and symptoms are noted.

How is Skene's Duct Cyst Diagnosed?

The diagnosis of Skene’s Duct Cyst may involve:

  • A thorough examination of the genital area and complete evaluation of medical history. Usually a physical examination of the genital area is sufficient to make a diagnosis of Skene Duct Cyst
  • 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
  • Biopsy of the mass: It is the process of removing tissue for examination. In the case of Skene 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. A biopsy of the cyst may be recommended in women of age more than 40 years, to check for the presence of cancerous cells

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 Skene's Duct Cyst?

Skene’s Duct Cyst may lead to the following complications:

  • Anxiety and stress due to concern for a sexual infection
  • Continuous and chronic occurrence of the cyst
  • Recurrence of abscesses that will need to be treated on a continuous basis
  • Damage to the muscles, vital nerves, and blood vessels, during surgery
  • Post-surgical infection at the wound site is a potential complication

How is Skene's Duct Cyst Treated?

Women with Skene’s Duct Cyst with small-sized cysts showing no symptoms may not require treatment for the condition. In others, the treatment may depend on the following factors:

  • The size of the cyst
  • Level of discomfort the women is experiencing
  • If the cyst is infected (resulting in a Skene’s gland abscess)

Various treatment methods for the condition may include:

  • 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
  • Surgical drainage:
    • Surgical drainage of abscess is undertaken for larger cysts
    • A small incision is made on the cyst and the fluid accumulated inside it is allowed to drain
  • Antibiotics: If the cyst is infected with abscess formation due to bacteria
  • Marsupialization surgical procedure:
    • Recurring cysts are treated using this procedure
    • Stitches are placed on each side of the drainage incision so that a permanent opening is made
    • Through this opening a catheter is placed to drain the fluid for a few days so that it does not recur
  • 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 Skene's Duct Cyst be Prevented?

There are no specific methods to prevent the occurrence of Skene’s Duct Cyst. However, by adopting certain measures, the risk for further complications may be reduced:

  • Practicing safe sex (such as using condoms)
  • Always maintaining good personal hygiene
  • Drink plenty of water and other fluids (such as fruit juices)
  • Medical screening at regular intervals with scans and physical examinations are advised (as recommended by the healthcare provider)

What is the Prognosis of Skene's Duct Cyst? (Outcomes/Resolutions)

  • The prognosis of Skene’s Duct Cyst is generally good with proper treatment. Most women feel a measure of relief after the abscess drainage has taken place
  • In very rare cases, women may have recurring cysts and abscesses, which may require to be treated through marsupialization surgical procedure

Additional and Relevant Useful Information for Skene's Duct Cyst:

  • The Bartholin glands are glands that are present on either side of a woman’s vagina. They are also known as the greater vestibular glands
  • A Bartholin gland abscess drainage procedure involves removal of the cyst and drainage of the abscess that is a result of blockage in the Bartholin gland

The following article link will help you understand Bartholin gland abscess drainage procedure:

http://www.dovemed.com/common-procedures/procedures-surgical/bartholins-gland-abscess-drainage/

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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