女性尿道口旁囊腫 病例報告及文獻回顧

楊欣庭¹  唐靖²

¹國泰綜合醫院 外科部 泌尿科; ²汐止國泰綜合醫院 外科部 泌尿科

A huge symptomatic paraurethral cyst in a young female: A case report and review of literature

Hsin-Ting Yang¹, Chin Tang²

¹ Division of Urology, Department of Surgery, Cathay General Hospital, Taipei, Taiwan

² Division of Urology, Department of Surgery, Sijhih Cathay General Hospital, New Taipei, Taiwan

Abstract

We present a case of a 23-year-old female with no past medical history presented to our outpatient urologic clinic for a self-palpated paraurethral mass. She had been bothered by painful sensation of the mass during physical activity for several months. She denied distorted urinary outflow, dyspareunia, or dysuria.

During the physical examination, a cystic lesion measuring approximately 2cm was observed just below the urethral meatus and above the vaginal opening. The lesion displayed a smooth surface and contained fluid-like content. Urinalysis revealed mild pyuria. Pelvic MRI revealed a sub-urethral cyst measuring 1.8cm in diameter with generalized wall thickening due to poor expansion, while Bartholin’s cyst could not be ruled out. A transvaginal sonogram was performed by gynecologist, revealing polycystic ovary. The mass was suspected to be a Skene's gland urethral cyst based on their opinions. Considering the patient's distressing symptoms and cosmetic concerns, she expressed a strong desire for surgical intervention.

Tumor excision was performed and a vertical incision was made between the urethral meatus and vaginal opening. A paraurethral cystic tumor was identified and en-bloc resected completely. Urethro-cystoscopy was performed pre- and post-operatively to ensure the urethra was not breached and the sphincter was intact. No post-operative complications were mentioned. Pathology reported a cystic lesion lined with urothelial and squamous epithelium.

Paraurethral cysts are classified as either acquired or congenital, though establishing a clear primary differential diagnosis can be challenging. In symptomatic adult patients with paraurethral cysts, surgical resection combined with fulguration proves to be an effective treatment option without any complications or recurrence. Previous reports of paraurethral cyst cases are limited. This report aims to contribute to the understanding of the clinical etiology and management of such cases, highlighting the importance of recognition and effective management strategies.