What are the other Names for this Condition? (Also known as/Synonyms)
- Squamous Epithelial Vaginal Inclusion Cysts
- Squamous Inclusion Cysts of Vagina
- Vaginal Squamous Inclusion Cysts
What is Squamous Epithelial Inclusion 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
- The most common vaginal cyst is the Squamous Epithelial Inclusion Cyst of Vagina. It is a benign cyst that is lined by stratified (non-keratinizing) squamous epithelium, when observed under a microscope by a pathologist
- There are no clearly established risk factors, but Squamous Epithelial Inclusion Cysts of Vagina are known to form due to trauma to the vaginal walls (such as due to surgery)
- Most of the cysts appear as solitary mucin-filled 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, Squamous Epithelial Inclusion Cyst of Vagina may grow to large 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 Squamous Epithelial Inclusion Cyst of Vagina is excellent with adequate treatment
Who gets Squamous Epithelial Inclusion Cysts of Vagina? (Age and Sex Distribution)
- Squamous Epithelial Inclusion 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)
- There is no known geographical, ethnic, or racial preference
What are the Risk Factors for Squamous Epithelial Inclusion Cysts of Vagina? (Predisposing Factors)
No definitive risk factors have been identified for Squamous Epithelial Inclusion 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
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 Squamous Epithelial Inclusion Cysts of Vagina? (Etiology)
- Squamous Epithelial Inclusion Cysts of Vagina are caused by displaced epithelium that occurs due to variety of factors including trauma and abnormal congenital epithelial remnants during fetal growth and development
- Surgical trauma is also an important causative factor
It is important to note that Vaginal Squamous Inclusion Cysts are not caused by any sexually transmitted disease.
What are the Signs and Symptoms of Squamous Epithelial Inclusion 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 Squamous Epithelial Inclusion Cysts of Vagina may be noted:
- Presence of a single cyst that is normally filled with fluid (usually 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 (less than 1 cm), while some may grow to large sizes (about 5 cm or more)
- 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 Squamous Epithelial Inclusion Cysts of Vagina Diagnosed?
A diagnosis of Squamous Epithelial Inclusion 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 squamous epithelial inclusion 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 Squamous Epithelial Inclusion Cysts of Vagina?
No significant complications of Squamous Epithelial Inclusion 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 Squamous Epithelial Inclusion Cysts of Vagina Treated?
Treatment measures for Squamous Epithelial Inclusion 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 squamous inclusion 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 Squamous Epithelial Inclusion Cysts of Vagina be Prevented?
- Current medical research has not established a method of preventing Squamous Epithelial Inclusion 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 Squamous Epithelial Inclusion Cysts of Vagina? (Outcomes/Resolutions)
The prognosis of Squamous Epithelial Inclusion Cysts of Vagina is excellent with surgical intervention (surgical removal through simple excision), since these are benign lesions.
Additional and Relevant Useful Information for Squamous Epithelial Inclusion Cysts of Vagina:
The following DoveMed website links are useful resources for additional information: