Definition

A gartner's cyst, also known as an inclusion cyst or gartner's duct cyst, is a type of vaginal cyst that typically appears without symptoms (asymptomatic) and is usually less than 2 cm in size, although it can be larger. A cyst is a closed sac that typically contains fluid, air, or other material and is usually harmless.

Gartner's cysts generally appear on the vaginal wall and are present from birth. The condition is called a gartner's cyst because the cyst originates from a structure called the wolffian duct. This structure exists during the development of the reproductive organs in a fetus. Normally, this structure disappears once the female reproductive system is fully formed. However, in some cases, the Wolffian duct does not fully disappear, resulting in gartner's cyst.

This condition is usually benign and not life-threatening. However, if bacteria infect the cyst, it can lead to an infection. A gartner's cyst does not affect your ability to become pregnant, but other organs should be examined. In the United States, gartner's cysts are diagnosed in up to 25% of adult women. Although these cysts are typically present from birth, they are most commonly found and diagnosed in women of reproductive age.

Causes

Around the 8th week of fetal development, the wolffian duct begins to disappear, and a pair of müllerian ducts join to form the uterus, cervix, and upper part of the vagina. When the wolffian duct structure from fetal development does not completely disappear during the formation of reproductive organs, a gartner's cyst may develop.

In males, the wolffian duct becomes an essential structure in forming the male reproductive organs, while in females, this structure disappears.

Incomplete development of the wolffian duct can also cause abnormalities in the urinary system and kidneys. Therefore, newborns with congenital abnormalities need further evaluation.

Risk Factor

Gartner's cysts occur due to issues during fetal development. Several risk factors can cause the cyst to enlarge, including:

• High-fat and low-fiber diet
• Lack of physical activity and sedentary lifestyle
• Smoking and alcohol consumption
• Exposure to pollution and infectious agents
• Physical or psychological stress
• Family history of vaginal cysts in the grandmother, mother, or other close relatives

Symptoms

Symptoms of a gartner's cyst are similar to those of vaginal cysts in general:

• Presence of a soft lump on the vaginal wall
• The lump is usually less than 2 cm in size, though it may vary
• Smaller lumps (less than 2 cm) typically do not cause pain
• Larger lumps (more than 2 cm) usually cause pain, especially during sexual intercourse

Diagnosis

Medical Interview

In reproductive-age patients, they may present with complaints of genital pain. The doctor will inquire about the following to diagnose the condition:

• Other accompanying complaints
• Current and past medical history
• Sexual behavior.
• Pregnancy and childbirth history
• Previous treatments
• Daily activities
• Family medical history

Physical Examination

Generally, the doctor will perform a physical examination of the genital area. The vagina and surrounding areas will be examined to see if there are any lumps visible externally, as well as any other visible abnormalities. The presence of abnormal genital discharge can also indicate a disorder.

Gartner's cysts are often found during an internal vaginal examination. During palpation, the consistency and size of the lump will be assessed. The initial examination can suggest whether the lump is benign or potentially malignant. Signs of inflammation, such as a lump that feels warm, will also be checked.

Diagnostic Examinations

The doctor will conduct further tests, which may include:

• Laboratory Tests

Routine blood tests and urine analysis to check for infection markers if there is a suspicion of infection.

• Vaginal Swab

A small sample of vaginal fluid will be taken for examination if the patient has risk factors for sexually transmitted infections (STIs) or if there is suspicion of an STI.

• Radiological Examinations

Imaging tests like ultrasound (USG) and MRI can be performed to obtain a detailed view of the cyst.

• Biopsy

A biopsy or tissue sample from the lump may be taken to determine if it is benign or has the potential to become cancerous or malignant.

Management

The treatment for a gartner's cyst depends on the size of the lump and the symptoms it causes. Patients with asymptomatic gartner's cysts are usually monitored clinically.

Some treatments for gartner's cysts include:

Sitz Bath

A sitz bath is a method that helps relieve lumps in the genital and anal areas. You can stand or sit over a basin of hot water, allowing the steam to provide comfort, especially if the cyst or lump is large.

Medications

Antibiotics may be prescribed for any vaginal cyst that has developed into an infection. Pain relievers like paracetamol or ibuprofen can be taken to alleviate pain.

Surgical Procedure

Surgery may be considered for large gartner's cysts causing significant symptoms. When symptoms arise, the cyst can be drained or its contents removed. In most cases, gartner's cysts do not recur after the procedure.

Complications

Gartner's cysts rarely cause complications. In women of reproductive age, the presence of a cyst can cause anxiety, particularly concerning their ability to conceive.

Gartner's cysts rarely affect female fertility, so complications are more psychological. Infections can occur if proper vaginal hygiene is not maintained.

Prevention

There is no specific way to prevent vaginal cysts in general, including Gartner's cysts. However, there are several steps you can take to prevent infections that may develop from cysts:

• Maintain vaginal and surrounding area cleanliness by washing from front to back with clean water
• Avoid sexually transmitted infections by not having multiple sexual partners
• Stay hydrated by drinking enough water every day
• Engage in physical activity, such as exercising 3-5 times a week for at least 30 minutes
• Reduce intake of processed and high-fat foods
• Educate yourself about cysts and vaginal abnormalities

When to See a Doctor?

If you have a family history of vaginal cysts, feel a lump in your vagina, or experience pain during sexual intercourse, it is advisable to consult a gynecologist. The doctor will provide appropriate treatment based on your condition.

Looking for more information about other diseases? Click here!