Gartner's duct cysts – an interdisciplinary management is needed

Purpose:

Gartner's duct cysts are usually small and asymptomatic and occur in about 1% of all women. Sometimes they present as perivaginal masses and usually appear in infants. These cysts can be large enough to protrude from the vaginal introitus and can be associated with symptoms such as vaginal discharge or recurrent infections. Gartner's duct cysts are embryological remnants of the Wollfian duct and can therefore be associated with other urogenital malformations like ectopic ureters, unilateral renal agenesis or multicystic dysplastic kidneys.

Material and methods:

We describe the cases of three females, one newborn, one 5-year-old child and one 56-year-old woman. The pediatric patients each presented with a vaginal mass on suspicion of an ureterocele, the adult patient had vaginal discharge and recurrent infections for over 10 years.

Results:

The 56-year-old patient underwent a marsupialization of the Gartner's duct cyst and an ureteroureterostomy due to an ectopic ureter of a duplex kidney. The two other patients were diagnosed with multicystic dysplastic kidneys. Both underwent marsupialization of the cyst, one of them had a laparoscopic nephrectomy.

Conclusions:

Gartner's duct cysts are diagnosed in all ages. In most cases they present as asymptomatic findings on routine examination, but they can also be symptomatic with e.g. recurrent infections or dyspareunia. If a Gartner's duct cyst is suspected, an interdisciplinary urogynecological approach is recommended to exclude further urogenital malformations and important differential diagnoses like ureteroceles or malignant tumors. Treatment options should be chosen carefully in regard to symptoms and patients will.