Gartner's duct cyst

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Gartner's duct cyst
Gartner Duct Cyst (4800250022).jpg
Gross pathology of Gartner's duct cyst
Specialty Gynecology

A Gartner's duct cyst (sometimes incorrectly referred to as vaginal inclusion cyst) is a benign vaginal cyst that originates from the Gartner's duct, which is a vestigial remnant of the mesonephric duct (Wolffian duct) in females. [1] [2] Persistent Wolffian duct syndrome (PWDS) in individuals with XX chromosomes is the inverse disorder of Persistent Müllerian duct syndrome (PMDS) in individuals with XY chromosomes. They are typically small asymptomatic cysts that occur along the lateral walls of the vagina, following the course of the duct. They can present in adolescence with painful menstruation (dysmenorrhea) or difficulty inserting a tampon. They can also enlarge to substantial proportions and be mistaken for urethral diverticulum or cystocele. [3] [4] In some rare instances, they can be congenital. [2]

There is a small association between Gartner's duct cysts and metanephric urinary anomalies, such as ectopic ureter and ipsilateral renal hypoplasia. [5] Symptoms of a Gartner's duct cyst include: infections, bladder dysfunction, abdominal pain, vaginal discharge, and urinary incontinence. [6]

The size of the cyst is usually less than 2 cm. On T2-weighted imaging, it manifests as hyperintense signal as most of its contents are fluid in nature. If the contents of the cyst are blood or protenanous, it will show high T1 signal and low T2 signal. [7]

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The urethra is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both female and male mammals. In female humans and other primates, the urethra connects to the urinary meatus above the vagina.

<span class="mw-page-title-main">Urinary system</span> Human anatomical system consisting of the kidneys, ureters, urinary bladder, and the urethra

The urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, control levels of electrolytes and metabolites, and regulate blood pH. The urinary tract is the body's drainage system for the eventual removal of urine. The kidneys have an extensive blood supply via the renal arteries which leave the kidneys via the renal vein. Each kidney consists of functional units called nephrons. Following filtration of blood and further processing, wastes exit the kidney via the ureters, tubes made of smooth muscle fibres that propel urine towards the urinary bladder, where it is stored and subsequently expelled from the body by urination. The female and male urinary system are very similar, differing only in the length of the urethra.

<span class="mw-page-title-main">Cyst</span> Closed sac growth on the body

A cyst, also traditionally known from Old English as a wen, is a closed sac, having a distinct envelope and division compared with the nearby tissue. Hence, it is a cluster of cells that have grouped together to form a sac ; however, the distinguishing aspect of a cyst is that the cells forming the "shell" of such a sac are distinctly abnormal when compared with all surrounding cells for that given location. A cyst may contain air, fluids, or semi-solid material. A collection of pus is called an abscess, not a cyst. Once formed, a cyst may resolve on its own. When a cyst fails to resolve, it may need to be removed surgically, but that would depend upon its type and location.

<span class="mw-page-title-main">Ureter</span> Tubes used in the urinary system in most animals

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<span class="mw-page-title-main">Duplicated ureter</span>

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Müllerian duct anomalies are those structural anomalies caused by errors in Müllerian duct development during embryonic morphogenesis. Factors that precipitate include genetics, and maternal exposure to teratogens.

A urethral diverticulum is a condition where the urethra or the periurethral glands push into the connective tissue layers (fascia) that surround it.

<span class="mw-page-title-main">OHVIRA</span> Medical condition

Herlyn-Werner-Wunderlich syndrome, also known as OHVIRA is an extremely rare syndrome characterized by a congenital birth defect of the lower abdominal and pelvic organs. It is a type of abnormality of the Müllerian ducts.

A urogenital fistula is an abnormal tract that exists between the urinary tract and bladder, ureters, or urethra. A urogenital fistula can occur between any of the organs and structures of the pelvic region. A fistula allows urine to continually exit through and out the urogenital tract. This can result in significant disability, interference with sexual activity, and other physical health issues, the effects of which may in turn have a negative impact on mental or emotional state, including an increase in social isolation. Urogenital fistulas vary in etiology. Fistulas are usually caused by injury or surgery, but they can also result from malignancy, infection, prolonged and obstructed labor and deliver in childbirth, hysterectomy, radiation therapy or inflammation. Of the fistulas that develop from difficult childbirth, 97 percent occur in developing countries. Congenital urogenital fistulas are rare; only ten cases have been documented. Abnormal passageways can also exist between the vagina and the organs of the gastrointestinal system, and these may also be termed fistulas.

<span class="mw-page-title-main">Vaginal anomalies</span> Congenital defect; abnormal or absent vagina

Vaginal anomalies are abnormal structures that are formed during the prenatal development of the female reproductive system and are rare congenital defects that result in an abnormal or absent vagina.

<span class="mw-page-title-main">Vaginal cysts</span> Benign growths of the vaginal epithelium

Vaginal cysts are uncommon benign cysts that develop in the vaginal wall. The type of epithelial tissue lining a cyst is used to classify these growths. They can be congenital. They can present in childhood and adulthood. The most common type is the squamous inclusion cyst. It develops within vaginal tissue present at the site of an episiotomy or other vaginal surgical sites. In most instances they do not cause symptoms and present with few or no complications. A vaginal cyst can develop on the surface of the vaginal epithelium or in deeper layers. Often, they are found by the woman herself and as an incidental finding during a routine pelvic examination. Vaginal cysts can mimic other structures that protrude from the vagina such as a rectocele and cystocele. Some cysts can be distinguished visually but most will need a biopsy to determine the type. Vaginal cysts can vary in size and can grow as large as 7 cm. Other cysts can be present on the vaginal wall though mostly these can be differentiated. Vaginal cysts can often be palpated (felt) by a clinician. Vaginal cysts are one type of vaginal mass, others include cancers and tumors. The prevalence of vaginal cysts is uncertain since many go unreported but it is estimated that 1 out of 200 women have a vaginal cyst. Vaginal cysts may initially be discovered during pregnancy and childbirth. These are then treated to provide an unobstructed delivery of the infant. Growths that originate from the urethra and other tissue can present as cysts of the vagina.

References

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  2. 1 2 Tiwari C, Shah H, Desale J, Waghmare M (2017). "Neonatal Gartner Duct Cyst: Two Case Reports and Literature Review". Developmental Period Medicine. 21 (1): 35–37. PMC   8522989 . PMID   28551690.
  3. Eilber KS, Raz S (September 2003). "Benign cystic lesions of the vagina: a literature review". The Journal of Urology. 170 (3): 717–22. doi:10.1097/01.ju.0000062543.99821.a2. PMID   12913681.
  4. Arumugam A, Kumar G, Si L, Vijayananthan A (October 2007). "Gartner duct cyst in pregnancy presenting as a prolapsing pelvic mass". Biomedical Imaging and Intervention Journal. 3 (4): e46. doi:10.2349/biij.3.4.e46. PMC   3097688 . PMID   21614298.
  5. Currarino G (November 1982). "Single vaginal ectopic ureter and Gartner's duct cyst with ipsilateral renal hypoplasia and dysplasia (or agenesis)". The Journal of Urology. 128 (5): 988–93. doi:10.1016/S0022-5347(17)53311-X. PMID   7176066.
  6. Rios SS, Pereira LC, Santos CB, Chen AC, Chen JR, de Fátima B, Vogt M (June 2016). "Conservative treatment and follow-up of vaginal Gartner's duct cysts: a case series". Journal of Medical Case Reports. 10 (1): 147. doi: 10.1186/s13256-016-0936-1 . PMC   4890494 . PMID   27256294.
  7. Chaudhari VV, Patel MK, Douek M, Raman SS (November 2010). "MR imaging and US of female urethral and periurethral disease". Radiographics. 30 (7): 1857–74. doi:10.1148/rg.307105054. PMID   21057124.