What are the other Names for this Condition? (Also known as/Synonyms)
- Cysts of Vagina
What is Vaginal Cysts? (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: It is the most common Vaginal Cyst. It is lined by stratified (non-keratinizing) squamous epithelium, when observed under a microscope by a pathologist
- Müllerian Cysts of Vagina: It is a common type of Vaginal Cyst that is lined by columnar endocervical and tubo-endometrial type cells, resembling lining of the endocervix and fallopian tube, when observed under a microscope by a pathologist
- Gartner Duct Cysts of Vagina: 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. Gartner ducts are known to form in pregnant women
- Urothelial Cysts of Vagina: It is a very rare type of Vaginal Cyst. The benign cyst are lined by transitional epithelium, when observed under a microscope by a pathologist
- Bartholin’s Gland Cysts of Vagina: Bartholin glands are glands that are present normally on either side of the women’s vagina. When the duct of the bartholin glands gets blocked, the fluid gets accumulated and causes the gland to swell and form a cyst
- Sebaceous Gland Cysts of Vagina: It is a type of benign vaginal cyst that forms when the sebaceous glands (oil glands) that lubricate the skin and hair get obstructed due to various reasons. They may also be known as Epidermal Inclusion Cysts of Vagina
- There are no clearly established risk factors, but some Vaginal Cysts 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, the Vaginal Cysts may cause secondary infections and pain during sex
- Treatment course includes close observation of the tumor in asymptomatic cases and surgical management, if necessary. In general, the prognosis of Vaginal Cysts is excellent with adequate treatment
Who gets Vaginal Cysts? (Age and Sex Distribution)
- Vaginal Cysts are commonly seen between the ages 20-75 years; a peak age range is observed in the 4th decade (30-40 years)
- Sebaceous cysts may be seen in a wide age range of females
- Urothelial cysts have also been reported in infant children
- There is no known geographical, ethnic, or racial preference
What are the Risk Factors for Vaginal Cysts? (Predisposing Factors)
No definitive risk factors have been identified for Vaginal Cysts. However, some 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
Additionally, the Vaginal Gartner Duct Cysts may be 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 Vaginal Cysts? (Etiology)
- Vaginal Cysts (the squamous epithelial inclusion, Müllerian, and urothelial cysts) 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
- Some scientists believe that Müllerian cystic tumors form from abnormal embryological tissue remnants (paramesonephric remnant or Müllerian remnant) during the fetal growth and development stage
- Some reports indicate that the Urothelial Cysts of Vagina may form due to an abnormal expansion of the paraurethral glands and ducts; they are believed to arise from periurethral or Skene’s glands
- The Sebaceous Gland Cysts of Vagina occur due to obstruction of the oil glands or sebaceous glands causing it to dilate and get swollen
However, in the case of Gartner Duct Cysts of Vagina, the following may be noted:
- Pregnancy leads to the formation of Gartner ducts or mesonephric ducts on the vaginal walls. 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 expand or stretch and accumulate fluid or pus, resulting in Gartner duct cysts
It is important to note that Vaginal Cysts are not caused by any sexually transmitted disease.
What are the Signs and Symptoms of Vaginal Cysts?
A majority of the Vaginal Cysts may be asymptomatic, presenting no significant signs and symptoms (in about 75% of the cases). In some cases, the following signs and symptoms may be noted:
- Presence of a single cyst that is normally filled with fluid; 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
- Sebaceous gland cysts may appear as tiny bumps on the surface
How is Vaginal Cysts Diagnosed?
A diagnosis of Vaginal Cysts 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 a Vaginal 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 Vaginal Cysts?
No significant complications of Vaginal Cysts 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. However, in case of a Bartholin gland cyst, a continuous and chronic occurrence of the cyst is noted
How is Vaginal Cysts Treated?
Treatment measures for Vaginal Cysts 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 Vaginal 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
- Sebaceous cysts may be treated through vaginal topical creams, maintaining good hygiene, and avoidance of harsh cosmetics and soaps
- 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 Vaginal Cysts be Prevented?
Current medical research has not established a method of preventing Vaginal Cysts.
- 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
- However, medical screening at regular intervals with scans and physical examinations are advised
What is the Prognosis of Vaginal Cysts? (Outcomes/Resolutions)
The prognosis of Vaginal Cysts is excellent with surgical intervention (surgical removal through simple excision), since these are benign lesions.
Additional and Relevant Useful Information for Vaginal Cysts:
The following DoveMed website links are useful resources for additional information:
What are some Useful Resources for Additional Information?
American Congress of Obstetricians and Gynecologists (ACOG)
409 12th Street SW, Washington, DC 20024-2188
Phone: (202) 638-5577
Toll-Free: (800) 673-8444
American Cancer Society (ACS)
1599 Clifton Road, NE Atlanta, GA 30329-4251
Toll-Free: (800) 227-2345
TTY: (866) 228-4327
References and Information Sources used for the Article:
WHO Classification of Tumours of Female Reproductive Organs; Edited by Robert J. Kurman, Maria Luisa Carcangui, C. Simon Herrington, Robert H. Young; 4th Ed., IARC Press, Lyon, 2014
http://www.healthline.com/health/vaginal-cysts#Overview1 (accessed on 10/20/2016)
https://radiopaedia.org/cases/vaginal-wall-cysts (accessed on 10/20/2016)
https://medlineplus.gov/ency/article/001509.htm (accessed on 10/20/2016)
Helpful Peer-Reviewed Medical Articles:
Eubanks, A. A., & Gonzalez, H. M. (2016). Congenital Megaureter Presenting in an Adult as a Vaginal Wall Cyst. Obstetrics & Gynecology, 127(5), 859-861.
Raz, S. (2015). Vaginal Cysts and Masses. In Atlas of Vaginal Reconstructive Surgery (pp. 261-284). Springer New York.
Shobeiri, S. A., Rostaminia, G., White, D., Quiroz, L. H., & Nihira, M. A. (2013). Evaluation of vaginal cysts and masses by 3-dimensional endovaginal and endoanal sonography. Journal of Ultrasound in Medicine, 32(8), 1499-1507.
Samal, S., Mahapatro, A., & Poorkodi, B. (2015). Posterior vaginal wall cyst of Mullerian origin: a case report. Int J Reprod Contracept Obstet Gynecol, 4(1), 245-6.
Heller, D. S. (2012). Vaginal cysts: a pathology review. Journal of lower genital tract disease, 16(2), 140-144.
Lallar, M., Nandal, R., Sharma, D., & Shastri, S. (2015). Large posterior vaginal cyst in pregnancy. BMJ case reports, 2015, bcr2014208874.
Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Nov. 4, 2016
Last updated: Nov. 4, 2016
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