Vulval cysts | DermNet

Authors: Dr Yi Jia Lee, Resident Medical Officer, Sir Charles Gairdner Hospital, Perth, WA, Australia; Dr Varitsara Mangkorntongsakul, Senior Medical Officer, Central Coast Local Health District, Gosford, NSW, Australia. Copy edited by Gus Mitchell. November 2020

What is a vulval cyst?

A vulval cyst is an encapsulated lesion that contains fluid or semi-fluid material occurring on the external female genitalia. Vulval cysts can develop from any of the structures normally found in this complex area.

Who gets vulval cysts?

Females of any age can present with a vulval cyst; however, a particular type of cyst may be more common in a specific age group.

What causes vulval cysts?

Vulval cysts can be developmental, genetic, post-traumatic, or spontaneous.

What are the clinical features of vulval cysts?

Vulval cysts are dome-shaped, firm or fluctuant, discrete lesions which may be asymptomatic and noticed incidentally, or present due to pain or dyspareunia which may be cyclic, intermittent, or persistent. The location or distribution of the cysts can be characteristic for a particular type of cyst.

See Vulval cyst images.

Common cutaneous cysts on the vulva

Milium

Vulval milia are 1–2 mm, white cysts very commonly seen on examination of the labia of older women. The patient may be aware of the multiple small lumps, but typically they are asymptomatic and an incidental finding.

Epidermoid cyst

Epidermoid cysts are commonly found on the cutaneous aspect of the labia majora of middle-aged and elderly women. The cysts may be solitary or multiple, spontaneous or post-surgical, usually presenting as a painless lump up to a centimetre in diameter. Giant epidermoid cyst of the vulva has been described.

Cysts specific to the vulval area

Bartholin and Skene duct cysts

Cysts of the Bartholin gland or Skene duct contain clear mucoid fluid. Bartholin glands are located towards the back and side of the introitus at the 4 o’clock and 8 o’clock positions. Skene glands are adjacent to the distal urethra. Cysts may present as a lump, or as painful swelling if the cyst has become infected and an abscess has formed. Bartholin duct cysts are reported to affect 2% of adult women at some time in their life. Skene duct cysts can also present in neonates. Diagnosis is usually made by the anatomic location of the cyst.

Vestibular mucinous cyst

Mucinous cysts develop from minor vestibular glands found on the inner labia minora along Hart lines. Cysts may be found incidentally, present as a palpable lump noticed by the patient, or cause pain should the cyst become inflamed. Vestibular mucinous cysts typically develop between puberty and the fourth decade.

Cyst of the canal of Nuck

A cyst of the canal of Nuck is a developmental anomaly due to incomplete closure of the round ligament and is the equivalent of a spermatic cord hydrocele in males. It presents as a skin-coloured, asymptomatic swelling located in the inguinal area and labium majorum, resembling an inguinal hernia. It is usually detected by five years of age.

Gartner cyst

A Gartner, or mesonephric, cyst develops in remnants of an incompletely regressed mesonephric duct. The mesonephric duct forms the male sexual organs, so should regress completely in the female fetus. Persistent mesonephric duct remnants in a female are usually associated with congenital abnormalities of the metanephric urinary system such as an ectopic ureter, unilateral renal agenesis or hypoplasia. A Gartner cyst is a small solitary unilateral cyst on the front vaginal wall towards one side, which may bulge to present as an interlabial mass in late adolescence.

Ciliated cyst of the vulva

At the ninth week of gestation, the paramesonephric duct develops into the fallopian tube. Remnants of this duct can form a ciliated, or paramesonephric, cyst found incidentally on the labium majorum during pregnancy, puberty, or with other hormonal influences. The lesion is usually a single cyst cavity, 1–3 cm in diameter, and drains clear or amber-coloured fluid if ruptured.

Cutaneous cysts that may occur on the vulva

Eruptive vellus hair cysts

Eruptive vellus hair cysts present as multiple small yellow-brown papules usually on the front of the trunk but have been rarely reported on the labia majora.

Steatocystoma

Steatocystoma is an autosomal dominant skin condition resulting in an abnormal proliferation of the pilosebaceous duct junction. The resultant skin papules drain an oily fluid when punctured. Involvement localised to the vulva has been rarely reported as a late-onset sporadic condition.

Pilonidal cyst

Pilonidal disease is usually found at the upper end of the gluteal cleft, but has been reported as a painless papule or nodule on the vulva, particularly in the area around the clitoris, due to an ingrown hair forming a dermoid cyst.

Endometriosis

Cutaneous endometriosis can rarely occur on the vulva at the site of previous obstetric or surgical trauma. It presents as nodules, patches, or cysts filled with fresh or clotted blood.

What are the complications of vulval cysts?

• Cyst rupture
• Inflammation and infection
• Pressure effects
• Dyspareunia (painful sexual intercourse)

How is a vulval cyst diagnosed?

Diagnosis of a vulval cyst is usually clinical based on the age at presentation, location, and appearance. Ultrasound examination or histology of a skin biopsy or excision specimen may sometimes be required.

What is the differential diagnosis for a vulval cyst?

• Vascular lesions — cherry angioma, angiokeratoma, haemangioma, varicosities
• Infections — viral wart, herpes simplex virus, bullous impetigo
• Inflammatory conditions — sebaceous adenitis, hidradenitis suppurativa, bullous fixed drug eruption
• Vulval cancer

What is the treatment for a vulval cyst?

The majority of vulval cysts do not require treatment once the diagnosis has been made. Cysts may be drained, marsupialised, extracted, or excised.

What is the outcome for a vulval cyst?

Vulval cysts are generally benign. Some may resolve or rupture spontaneously. Recurrence can follow surgical intervention particularly if the entire cyst wall has not been removed.

Pictures of What They Look Like

Medically Reviewed by Stephanie S. Gardner, MD on November 22, 2022

It’s a lump of fluid, air, or something else. Cysts are very common, and most aren’t cancer. You may need tests (like a CT scan, ultrasound, or biopsy) to confirm that it’s a cyst. They do not go away, but often, cysts don’t need treatment. Your doctor can let you know if yours does. You can get cysts in many different parts of your body, and you may not even know that they’re there.

You get acne when oil and dead skin block a pore. This often causes a small growth, or “pimple,” that goes away on its own or with over-the-counter drugs. If it’s more serious or a pimple gets very irritated, you might get a larger squishy growth called a cyst. (Hard growths are called nodules.) Talk to your doctor about treatment including antibiotics and other medications for your cysts.

A soft, fluid-filled lump can form at the back of your knee if you injure the joint because of arthritis, inflammation, a torn ligament, or other causes. You might mistake it for a blood clot. Rest with your leg raised up and ice the area for 15 minutes at a time. Anti-inflammatory drugs could also help. In some cases your doctor may suggest surgery or use a needle to drain it or inject steroids to lessen swelling.

The tiny Bartholin glands are deep under the skin on either side of the vagina opening. Their job seems to be to make fluids for sex. If something blocks a duct in one of these glands, it fills with mucus and gets bigger. It could even get infected and form a sore called an abscess. Tub soaks can help. In serious cases, your doctor might do surgery to create a permanent drain or remove the cyst.

You might notice one or more smooth lumps with clear edges on your breast, but you can’t always feel them. They may hurt in the days just before your period starts or when you have lots of caffeine. They’re very common and more likely right before menopause, or afterward, if you take replacement hormones. You don’t usually need to treat them, but see your doctor about any breast lump because it may be something more serious than a cyst.

In the womb, a baby’s bladder connects to its belly button through a channel called the urachus in the abdominal wall gut. If it doesn’t close by the time you’re born, a small lump of tissue and fluid (a cyst) can grow there. If it gets infected, you could have belly button pain, fever, and bloody urine. Your doctor may give you antibiotics, drain or remove the cyst, and possibly repair the area with surgery.

Here, something blocks a gland around a hair or irritates the opening (follicle) that holds it, often on your face, ear, head, trunk, or groin. That causes a bump to grow slowly under the skin. It’s usually soft enough to move when you touch it.   Usually, it doesn’t hurt, but you might notice a bad smell. Smaller ones usually go away on their own, but your doctor may need to drain or remove larger, swollen, or painful cysts.

A loose hair gets pushed back into the skin. Your body sees it as a threat and builds a pocket around it that holds dead skin and fluid. You might notice irritation at the base of your spine in the crease where your buttocks start.  If it gets infected, it can become very painful and may need to be drained or removed. Younger men get it more often, as do people who sit a lot, aren’t active, or are obese.

It’s a lump filled with liquid, most often near joints or tendons on your wrist or fingers. Tendon or joint stress might cause it, but it’s not clear. It may hurt and sometimes changes in size or goes away on its own. Anti-inflammatory meds or splints might curb pain. In more serious cases, your doctor may drain it with a needle or remove it completely.

Oil from the meibomian glands around the eyelids gets too thick or the opening clogs. Either way, it builds up and inflames the gland and forms a lump. The cause is often unclear, but certain skin types get it more. You may have no pain unless it gets fairly large. Really big ones can press on your eye and blur your vision. It usually goes away on its own, and warm compresses can help. Talk to your doctor if it sticks around.

Eggs from a pork tapeworm, a parasite, can pass into your food or drink contaminated with poop. They hatch in your gut and send small round “oncospheres” through your blood to the brain, muscles, liver, and other organs where they form cysts. You doctor will probably only treat them if they’re in your brain where they could cause headaches, seizures, confusion, or other problems. You’d likely take steroids to ease inflammation.

This cyst forms inside the epididymis, a coiled tube inside a man’s scrotum that connects to their testicles and helps move sperm. It seems to happen when sperm build up at the end of the tube. It’s not cancerous and doesn’t usually hurt, but your doctor should check to be sure. It usually goes away on its own. About a third of all men will get a spermatocele in their lifetime.

It happens before you’re born if the layers of your skin don’t grow together properly, usually on the head, neck, or face. That causes a pocket that traps skin, hair follicles, sweat glands, blood, fat, nails, teeth, and other structures. It might not be noticeable until fluid builds up and makes it bigger, sometimes years after birth. Then it looks like a small lump with skin on top that’s easy to move. Your doctor will likely remove the cyst with surgery.

IMAGES PROVIDED BY:

1) jarabee123 / Thinkstock

2) Dr P. Marazzi / Science Source

3) Dr P. Marazzi / Science Source

4) CNRI / Science Source

5) ZEPHYR / Science Source

6) (Both)  BSIP / Science Source

7) Girand / Science Source

8) Stocktrek Images / Science Source

9) Barry Slaven / Medical Images

10) ISM / BARRAQUER, Barcelona

11) Steve Gschmeissner / Science Source  (inset), Living Art Enterprises / Science Source  (background)

12) PIXOLOGICSTUDIO / Science Source

13) SPL / Science Source

American Academy of Dermatology: “Different kinds of pimples,” “What can clear severe acne?”

American Association for Pediatric Ophthalmology and Strabismus: “Chalazion. ”

American Pediatric Surgical Association: “Urachal Cysts.”

American Society for Surgery of The Hand: “Ganglion Cysts.”

Cleveland Clinic: “Spermatocele,” “Sebaceous Cysts,” “Breast Cysts,” “What is a Baker’s cyst?”

Johns Hopkins Medicine: “Sebaceous Cysts.”

Mayo Clinic: “Pilonidal cyst.”

Merck Manual: “Tapeworm Infection,” “Bartholin Gland Cysts.”

Michigan Medicine Kellogg Eye Center: “Chalazion and Stye.”

National Center for Advancing Translational Sciences: “Urachal cyst.”

St. Louis Children’s Hospital: “Dermoid Cyst in Children.”

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Operative gynecology

Treatment of formations of the vulva and vagina.

Most benign diseases of the vulva and vagina are asymptomatic or with minimal manifestations, and do not cause much discomfort to a woman. Virtually all formations of the vulva and vagina require surgical treatment, since such a correction is optimal in terms of preventing recurrence or the development of any additional symptoms.

The TN-Clinic performs minimally invasive surgical interventions for diseases of the vulva and vagina. Experienced gynecological surgeons, Ph.D. with many years of experience, use classical and innovative surgical techniques, which minimizes complications and significantly reduces the recovery period.

Vulvar and vaginal masses: general information

Benign diseases of the vulva and vagina occur in women of different age groups – in girls and girls, patients of reproductive, middle and old age. Distinguish:

• retention cysts (tumor-like formations – Bartholin gland cyst, epidermal cyst, cyst of the vaginal wall and others),
• benign tumors (angioma, lipoma, myxoma, papillary hydradenoma, vaginal fibroma and others),
• other benign lesions (kraurosis, leukoplakia and others).

A number of diseases are formations that are relatively safe in terms of transition to malignant tumors (cysts), others may be precancerous conditions (leukoplakia, kraurosis). In the case of cysts and benign tumors, modern surgical treatment is the best type of medical correction. A timely operation allows not only to get rid of the symptoms and restore intimate comfort, but also to prevent the further development of malignant diseases of the female reproductive system.

Symptoms

Cysts

Formations can reach an impressive size (up to several cm), and in this case they cause physical discomfort, difficulty and pain during intimate contacts, and with large cysts, even when sitting or walking. In the absence of an inflammatory reaction, the cysts themselves are usually painless.

Benign tumors

Deliver discomfort only in case of large sizes. Usually painless.

Causes and development

• Retention cysts are formed due to obstruction of the excretory duct of one of the glands (Bartholin, sebaceous, sweat and others). They increase due to the large volume of fluid inside the cyst.
• Benign tumors are formed as a result of the growth of cells of any tissue. So, angiomas are formed from blood or lymphatic capillaries, arterioles or venules that can grow into nearby tissues, lipoma – from adipose tissue, papillary hydradenoma – from sweat gland tissues.
• Other benign lesions are inflammatory, ulcerative, degenerative changes in the mucous membranes and skin in the vulva. Changes in cells and their uncontrolled growth occur under the influence of various factors, individual in each case (hormonal levels, exposure to toxic substances, trauma, etc.).

Surgical treatment at the TN Clinic

The TN-Clinic performs minimally invasive surgical operations using modern equipment, with the participation of experienced highly qualified gynecological surgeons.

Before the operation

Consultation of the following specialists is required:

• therapists,
• anesthesiologists,
• cardiologists.

Research results needed:

• ECG,
• ultrasound,
• laboratory diagnostics: including general and biochemical blood tests, urinalysis, tests for sexually transmitted diseases, etc.

The volume of research is determined by the doctor depending on the general health of the woman and her health deviations. Standard studies can be supplemented with other tests, about which the patient will be informed in advance.

Before surgery, a range of restrictions and contraindications is also determined, which, as a rule, are similar for all gynecological interventions: severe chronic diseases in the acute stage, active infectious processes, heart, lung or kidney failure, pregnancy, and others.

Operations are carried out on an outpatient basis, in an equipped operating room, under local anesthesia and take 20-30 minutes or a little more.

During surgery for a cyst of the Bartholin gland, marsupialization is most often performed (restoration of the patency of the excretory duct of the gland), in the case of other types of cysts, removal without injuring the surrounding tissues.

Removal of benign tumors is indicated for large sizes and progressive growth of formations.

The recovery period after removal of a cyst or a benign tumor depends on the technique of the operation and the extent of the intervention. Operations at the TN-Clinic are performed on an outpatient basis, the patient stays in the day hospital for several hours, then goes home.

It is necessary to comply with all restrictions of the recovery period – the patient’s discipline determines the speed of returning to the usual rhythm of life.

Not allowed within 4 weeks:

physical activity,
bathing,
visiting saunas and swimming pools,
intimate contacts.

Timely removal of cysts or benign tumors of the vulva and vagina is the main condition for restoring intimate comfort. In the TN-Clinic, preparation for surgery, the actual surgical intervention and a short period after surgery are carried out in comfortable conditions, with the participation of friendly and sensitive medical staff, which guarantees not only a quick recovery, but also an excellent mood for our patients!

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Authors of the article: candidate of medical sciences – O.Yu.Ermolaev, experienced gynecologist, physiotherapist-health resort specialist – E.K.Ermolaeva

Gartner’s duct cyst is often referred to as a “vaginal cyst”.

The Gartner tract cyst is located in the broad ligament of the uterus along the lateral wall of the uterus and vagina.

Vaginal cyst, Gartner duct cyst is a rudimentary cyst, i.e. formed from the remnants of the embryonic Wolfian stream. The duct is symmetrical, but the vaginal cyst is rarely bilateral.

Vaginal cyst, Gartner’s passage cyst in most cases is small.

Clinically, the cyst of the vagina manifests itself only when it reaches the wall of the vagina. Women note the “appearance of an elastic bubble” in the vagina when straining.

Sometimes, when straining, this “bubble” completely blocks the entrance to the vagina and is easily painlessly reduced with a finger, or disappears spontaneously (spontaneously) at rest and the woman is lying on her back.

Pay attention to the excellent quality of the photographs taken with our colposcope.

You can find photos of vaginal cysts, cysts of Gartner’s tract, performed by us, on many Russian and foreign sites and in textbooks.

Suppuration of the cyst of the Gartner’s passage is rarely observed.

Suppuration of the Gartner’s tract cyst, vaginal cyst is accompanied by general symptoms of the inflammatory process: pain in the corresponding side of the vagina during exercise, at rest and during sexual intercourse; possible weakness, increased fatigue.

At the beginning of the inflammatory process, the pain in the vagina is aching in nature; with the “maturation” of the pain process, they acquire a pulsating character.

With a digital examination of the vagina, the area of ​​​​the cyst of the Gartner passage, the cyst of the vagina is sharply painful.

The temperature in the vagina due to an inflammatory reaction at any time of the day is 0.3° C or more higher than in the anus or axilla.

If left untreated, purulent fusion of tissues occurs, a fistula (hole) is formed, and pus is poured into the vagina.

Gartner’s passage cyst, vaginal cyst does not interfere with conception and pregnancy.

The cyst of the vagina does not interfere with the process of childbirth and the fetus does not injure, due to its elasticity and ability to “reset”.

Alternative treatment of cysts of Gartner’s course, cysts of the vagina with herbs does not exist.

A cyst of Gartner’s passage, a cyst of the vagina with a small size does not require surgical treatment.

Surgical treatment of vaginal cysts is resorted to when suppuration or cyst reaches a size that makes it difficult to have sexual intercourse.

A number of patients of the Women’s Health Resort Clinic note as a positive moment during sexual intercourse REDUCTION OF THE VAGINA VOLUME due to a cyst that appears with a conscious slight straining.

There is no prevention of the formation, growth or suppuration of a Gartner’s passage cyst, a vaginal cyst.

There are NO LIMITATIONS and features of nutrition, sexual intimacy with a cyst of Gartner’s passage.

It is advisable to AVOID strenuous exercise.

OBSERVATION of the condition of the Gartner’s passage cyst, vaginal cyst is carried out with a regularity of 1 time in 5-6 months.

In the Women’s Health Resort Clinic, it is possible to perform an examination in order to EXACTLY identify the cyst of the Gartner tract and malformations of the genital organs.

Long-term experience of scientific and practical work and the availability of expert-class devices with 3D/4D and elastography modes allow us to implement modern diagnostic techniques and solve diagnostic problems of any complexity.

The remote high-density LED-monitor of the ultrasound device allows the doctor to comment on the dynamic (“live”) image, and the patient to actively participate in the discussion of what he saw.

The capabilities of the diagnostic devices of the Women’s Health Resort Clinic are presented on the website in the articles Colposcopy, Ultrasound of the small pelvis, Ultrasound of the abdominal cavity.

Doctors and midwives of the Women’s Health Resort Clinic are ALWAYS READY for regular patients, if face-to-face treatment is impossible, TO COMMENT remotely (by phone, on the Internet) on an existing or new situation and suggest ways to solve it.

Leading specialists in the treatment of vaginal cysts, Gartner’s tract cysts in the Southern Federal District

Ermolaeva Elvira Kadirovna

He is a well-known and recognized specialist in the North Caucasus in the diagnosis and treatment of vaginal cysts, cysts of the Gartner’s passage.

Gynecologist, ultrasound doctor, physiotherapist-resortologist.

Elvira Kadirovna is approached by women who want to improve the aesthetics of the genitals, reduce the vagina and refresh intimate relationships from all regions of Russia and foreign countries.

Ermolaev Oleg Yurievich

Candidate of Medical Sciences, operating gynecologist with 30 years of successful experience in the treatment of vaginal cysts, Gartner’s tract cysts.

Able to see relationships that elude others.

INTERNATIONAL RECOGNITION of the reputation and achievements of the Women’s Health Resort Clinic in the development and implementation of effective and safe treatment methods and the quality of the medical services provided IS THE AWARDING of the Women’s Health Resort Clinic in Pyatigorsk with the SIQS International QUALITY CERTIFICATE in the field of medicine and healthcare. International Socratic Committee, Oxford, UK and Swiss Institute for Quality Standards, Zurich, SWITZERLAND. Read more…

Each doctor of the Clinic has long experience, several specializations and is able to comprehensively assess the situation.

Women’s health spa clinic works WITHOUT DAYS OFF and holidays:

Monday – Friday from 8.00 to 20.00,
Saturday – Sunday from 8.00 to 17.00.

Treatment of vaginal cysts, cysts of Gartner’s passage by appointment by multi-channel phone 8 (800) 500-52-74 (toll-free in Russia), or +7 (928) 022-05-32 (for foreign calls).

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Frequently Asked Questions

Can a vaginal cyst be treated? K.Kh., Mineralnye Vody.

Answer:

With a small size of the Gartner’s passage cyst (vaginal cyst), surgical treatment is not required.
Surgical treatment of vaginal cysts is resorted to when suppuration or the cyst of the vagina reaches a size that makes it difficult to have sexual intercourse.
Herbal treatment, alternative and other treatment that promotes the resorption of the Gartner’s cyst (vaginal cyst) does not exist.

I have a paraovarian cyst next to the right ovary with a transition to the posterior fornix, almost 7 cm in size. Will it be able to resolve if it has a hole from which pus comes out when you touch it. Z.M., Cherkessk.

Answer:

Judging by the description, we are talking about the resolution (breakthrough) of a festering cyst of the Gartner passage into the vagina. Even after complete evacuation of the pus, the cyst of the Gartner passage will not disappear (“it will not resolve”).

Gartner’s tract cyst is a contraindication to spa treatment in Pyatigorsk? N.I., Moscow.

Answer:

Gartner’s passage cyst, vaginal cyst is not a contraindication to spa treatment in Pyatigorsk, but requires restrictions: gynecological massage, mud tampons, mud panties and body wraps, including galvanic mud and electric mud, are not desirable.

I have a small vaginal cyst. The gynecologist took a puncture for cytology, but there was no fluid at all, only mucus. She prescribed tampons with troxevasin ointment for 7-10 days. Maybe it was not necessary to do a puncture? Or was the treatment correct? What would be your actions? A.N., Nalchik.

Answer:

It is pointless to discuss what has already been done. The cyst of the vagina does not resolve.

I have a vaginal cyst. The doctor said it was a Gartner duct cyst.
After childbirth, the vaginal cyst increased from 3 by 4 to 5 by 6 cm. Sometimes I feel discomfort. Is it possible to remove a vaginal cyst and what are the consequences after that? V.A., Essentuki.

Answer:

Removal of a Gartner’s tract cyst is a technically difficult operation. There are no specific (characteristic only for this operation) consequences of surgical treatment, there are no relapses (recurrence) of the Gartner’s cyst. But you should always take into account possible general surgical complications.
Thus, if the vaginal cyst (Hartner’s passage cyst) does not cause severe discomfort, further observation is possible.

Is it possible to treat vaginal cysts simultaneously in gynecological and therapeutic programs? What will be the results and planned cost of treatment?

Answer:

We consider a woman/girl as a whole and treat not a disease, but a suffering (sick) person!
We provide a combination of gynecological and therapeutic treatment programs.