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

• Ectopic Prostatic Tissue of Vagina
• Skene Duct Cyst of Vagina
• Vaginal Tubulosquamous Polyp

What is Tubulosquamous Polyp of Vagina? (Definition/Background Information)

• Tubulosquamous Polyp of Vagina is an infrequently occurring benign tumor of squamous epithelium that is mostly known to occur in women over 40 years of age
• Tubulosquamous Polyps of Vagina may be of 2 types that are more or less equally distributed (incident rate). These include:
  • Cystic type of tubulosquamous polyp
  • Polypoid type of tubulosquamous polyp
• The cystic type is seen in women before menopause, while the polypoid type is commonly present in women following menopause
• There are no clearly established risk factors for Tubulosquamous Polyp of Vagina and the cause of tumor formation is also unknown. It is thought to arise from certain abnormal embryological remnants during the fetal growth and development stage
• The tumors appear as a polyp nearer to the cervix, in the upper vaginal tact; while the cystic type is frequently present in the lower vaginal tract. No significant signs and symptoms or complications are noted. However, occasionally, Tubulosquamous Polyp of Vagina is associated with certain types of adenocarcinomas
• Treatment course includes close observation of the tumor in asymptomatic cases and surgical management, if necessary. In general, the prognosis of Tubulosquamous Polyp of Vagina is excellent with suitable treatment

Who gets Tubulosquamous Polyp of Vagina? (Age and Sex Distribution)

• Tubulosquamous Polyp of Vagina is a rare tumor that is observed in adult women (mostly middle-aged women). The age range for this tumor is between 39-78 years
• There is no known ethnic or racial preference

What are the Risk Factors for Tubulosquamous Polyp of Vagina? (Predisposing Factors)

• No definitive risk factors have been presently identified for Tubulosquamous Polyp of Vagina

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's 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 Tubulosquamous Polyp of Vagina? (Etiology)

• Currently, the exact cause and mechanism of formation of Tubulosquamous Polyp of Vagina is unknown
• Some believe these tumors are due to abnormal congenital embryological remnants (misplaced Skene glands) during fetal development

It is important to note that Vaginal Tubulosquamous Polyp is not a sexually-transmitted condition.

What are the Signs and Symptoms of Tubulosquamous Polyp of Vagina?

The signs and symptoms of Tubulosquamous Polyp of Vagina may include:

• Small tumors usually do not cause any symptoms. But, occasionally they may become painful, if they compress surrounding structure
• Some tumors can appear as a polyp or as a cystic mass
• The polyps are observed in the upper vagina (nearer to the uterine cervix), while the cysts are seen in the lower vagina (nearer to the urethra)
• The size of the tumor can range from 1-3 cm
• Abnormal discharge from the vagina
• Large tumors may cause a feeling of fullness in the abdomen or pain in the pelvic region
• Frequent urination due to compression/pressure of the tumor

How is Tubulosquamous Polyp of Vagina Diagnosed?

A diagnosis of Tubulosquamous Polyp of Vagina may involve the following steps:

• Evaluation of the individual’s medical history and a thorough physical (pelvic) examination
• Colposcopy:
  • The cervix (including the vulva and vagina) is examined with an instrument, called a colposcope. This helps the physician get a magnified view of the cervix
  • In order for this procedure to be performed, the individual has to lie on a table, as for a pelvic exam. An instrument, called the speculum, is placed in the vagina to keep the opening apart, in order to help the physician visualize the cervix. The colposcope is then used to get a magnified view of the inside

Although the above modalities can be used to make an initial diagnosis, a tissue biopsy of the tumor is necessary to make a definitive diagnosis to begin treatment. The tissue for diagnosis can be procured in multiple different ways which include: 

• Fine needle aspiration (FNA) biopsy of the tumor: A FNA biopsy may not be helpful, because one may not be able to visualize the different morphological areas of the tumor. Hence, a FNA biopsy as a diagnostic tool has certain limitations, and an open surgical biopsy is preferred
• Core biopsy of the tumor
• Open biopsy of the tumor

Tissue biopsy:

• A tissue biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
• Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
• Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis

In rare cases of adenocarcinoma being suspected, the following additional tests may be performed:

• Ultrasound scan of the abdomen
• 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

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 Tubulosquamous Polyp of Vagina?

Significant complications from Tubulosquamous Polyp of Vagina are generally not noted, because it is a benign tumor. However, the following may be observed in some cases:

• Stress due to a concern for vaginal cancer
• Rare cases of association with adenocarcinoma of the Skene gland, or prostatic-type adenocarcinoma has been noted
• Damage to the muscles, vital nerves, and blood vessels, during surgery
• Post-surgical infection at the wound site is a potential complication

How is Tubulosquamous Polyp of Vagina Treated?

Treatment measures for Tubulosquamous Polyp of Vagina may include the following:

• If there are no symptoms, then the healthcare provider may advise a ‘wait and watch’ approach, following a diagnosis of tubulosquamous polyp
• Pain medications, in case of tumors causing pain
• Surgical intervention with complete excision can result in a complete cure. It can also help reduce the chances of tumor recurrence
• Radiation therapy and chemotherapy are not usually required
• Some women may require reassurance and support to help with stress and anxiety. The healthcare professional may dispel fears that the condition is not due to a sexually-transmitted infection
• 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 Tubulosquamous Polyp of Vagina be Prevented?

• Current medical research has not established a way of preventing Tubulosquamous Polyp of Vagina
• Medical screening at regular intervals with scans and physical examinations are advised

What is the Prognosis of Tubulosquamous Polyp of Vagina? (Outcomes/Resolutions)

The prognosis of Tubulosquamous Polyp of Vagina is excellent with surgical intervention and complete removal, since it is a benign tumor.

Additional and Relevant Useful Information for Tubulosquamous Polyp 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/