A two-day old female infant was referred with a presumptive diagnosis of
"imperforate hymen". On examination, she had a soft, ovoid, interlabial
cystic mass (Fig. 1). It was approximately 10 mm in
diameter and deviated to the right side of the urethral meatus. A clinical
diagnosis of Skene’s duct cyst was made. Incision and unroofing of the
cyst was performed. No recurrence was observed at follow up visit six
months later.
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|
Fig. 1.
Paraurethral cyst as an
interlabial cystic mass. |
Skene’s ducts are the largest of 30 paraurethral ducts
that empty into the female urethra. Occasionally, duct obstruction may
lead to a periurethral cyst which presents as an interlabial mass. The
differential diagnosis in newborns includes prolapsed ectopic
ureterocele, genital prolapse and imperforate hymen. Among these different
conditions, the displacement of the urethral meatus by the mass is a
distinguishing feature of a paraurethral cyst. A normal vaginal introitus
can be seen below the cyst. Moreover, a paraurethral cyst contains a
milky-fluid if aspirated. Treatment options vary from simple observation
to surgery.
