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Vaginal cysts

  • Definition
    • A cyst is a closed pocket or pouch of tissue. It can be filled with air, fluid, pus, or other material. A vaginal cyst occurs on or under the vaginal lining.

  • Alternative Names
    • Inclusion cyst; Gartner duct cyst

  • Causes
    • There are several types of vaginal cysts.

      • Vaginal inclusion cysts are the most common. These may form as a result of injury to the vaginal walls during birth process or after surgery.
      • Gartner duct cysts develop on the side walls of the vagina. This duct is present while a baby is developing in the womb but will most often disappear after birth. If parts of the duct remain, they may collect fluid and develop into a vaginal wall cyst later in life.
      • Bartholin cyst or abscess is the buildup of fluid for pus that forms a lump in one of the glands found on each side of the vaginal opening.
      • Pieces of endometriosis may appear as small cysts in the vagina.
      • Benign tumors of the vagina are uncommon. They are most often composed of cysts.
      • Cystoceles and rectoceles are bulges in the vaginal wall from the underlying bladder or rectum. These are not really cysts, but can look and feel like cystic masses in the vagina.
  • Symptoms
    • Most vaginal cysts usually do not cause symptoms. In some cases, a soft lump can be felt in the vaginal wall or protruding from the vagina. Cysts range in size from the size of a pea to that of an orange.

      However, Bartholin cysts can commonly become infected, swollen and painful.

      Some women with vaginal cysts may have discomfort during sex or trouble inserting a tampon.

      Women with cystoceles or rectoceles may feel a protruding bulge, pelvic pressure or have difficulty with urination or defecation.

  • Exams and Tests
    • Physical exam is essential to determine what type of cyst or mass you may have.

      A mass or bulge of the vaginal wall may be seen during a pelvic exam. You may need a biopsy to rule out vaginal cancer, especially if the mass appears to be solid.

      If the cyst is located under the bladder or urethra, x-rays may be needed to see if the cyst extends into these organs.

  • Treatment
    • Routine exams to check the size of the cyst and look for any changes may be the only treatment needed.

      Biopsies or minor surgeries to remove the cysts or drain them are typically simple to perform and resolve the issue.

      Bartholin gland cysts often need to be drained. Sometimes, antibiotics are prescribed to treat them as well.

  • Outlook (Prognosis)
    • Most of the time, the outcome is good. Cysts often remain small and do not need treatment. When surgically removed, the cysts usually do not return.

      Bartholin cysts can sometimes recur and need ongoing treatment.

  • Possible Complications
    • In most cases, there are no complications from the cysts themselves. A surgical removal carries a small risk of complication. The risk depends on where the cyst is located.

  • When to Contact a Medical Professional
    • Call your health care provider if a lump is felt inside the vagina or is protruding from the vagina. It is important to contact your provider for an exam for any cyst or mass you notice.

  • References
    • Baggish MS. Benign lesions of the vaginal wall. In: Baggish MS, Karram MM, eds. Atlas of Pelvic Anatomy and Gynecologic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2016:chap 61.

      Katz VL. Benign gynecologic lesions. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 18.