Prevalence of cystic paraurethral structures in asymptomatic women at endovaginal and perineal sonography

First case report of urothelial cyst in a dog: diagnostic approach

IMPORTANCE

Cystic masses in the abdominal cavity near the vaginal area can have a range of origins, including urothelial cysts, which have never been reported in dogs. This paper reports the first known occurrence of a urothelial cyst in a dog.

CASE PRESENTATION

An 18-year-old, 2.05 kg intact female Maltese dog presented with a mammary nodule with no systemic clinical signs. The radiographs and ultrasound revealed a large cystic mass in the abdominal cavity. Computed tomography imaging showed that the mass was in contact with the bladder, urethra, and vagina but had no direct connections to these organs. Surgical removal was performed. Histopathology analysis confirmed a urothelial cyst lined with transitional and stratified squamous epithelium.

CONCLUSIONS AND RELEVANCE

This case highlights the need to include urothelial cysts in a differential diagnosis of cystic masses near the vaginal region in dogs. Early imaging-based detection is crucial to preventing misdiagnoses and ensuring appropriate surgical intervention. Veterinarians must carefully differentiate this condition from other reproductive disorders, including pyometra and uterine tumors, to avoid complications and ensure appropriate management.

Benign and Inflammatory Lesions of the Human Female Prostate: A Narrative Review of Diagnostic and Therapeutic Approaches

Skene's glands are recognised as the female equivalent of the male prostate gland. They can be affected by a variety of benign, inflammatory, or malignant conditions.This review critically analyses the current literature on the diagnosis and management of non-malignant lesions associated with Skene's gland.A comprehensive search of Scopus, Web of Science, and PubMed/MEDLINE was conducted, focusing on non-malignant lesions of Skene's gland while excluding studies involving newborns and animals.Sixty relevant articles were identified, primarily comprising small case series. The benign lesions reviewed include cysts, hyperplasia, tubular-squamous vaginal polyps, leiomyomas, adenofibromas, and Skene's gland lithiasis. Inflammatory conditions such as abscesses and female prostatitis were also analysed.Physical examination, ultrasound, cystoscopy, MRI, and micro-ultrasound are essential diagnostic modalities for evaluating Skene's gland pathologies. Timely conservative or surgical interventions can effectively manage benign conditions, with treatment options typically guided by the severity of symptoms. This review underscores the necessity for further research into the biology of Skene's gland, particularly regarding potential diagnostic and therapeutic implications, and emphasizes the importance of a routine evaluation of Skene's gland in urological and gynaecological practice.

Transperineal and endovaginal ultrasound for evaluating suburethral masses: comparison with magnetic resonance imaging

OBJECTIVE

To evaluate the utility of pelvic floor ultrasound (US) in the detection and evaluation of suburethral masses, using magnetic resonance imaging (MRI) as the reference standard.

METHODS

This was a retrospective analysis of US and MRI scans of all women with a suburethral mass on clinical examination at a single urogynecology clinic over a 13-year period (February 2007 to March 2020). All women were examined using two-dimensional transperineal US (2D-TPUS) with or without three-dimensional endovaginal US (3D-EVUS). All patients underwent unenhanced T1-weighted and T2-weighted MRI, which was considered the reference standard in this study. Presence of a suburethral mass and its size, location, connection with the urethral lumen and characteristics were evaluated on both pelvic floor US and MRI. Agreement between pelvic floor US and MRI was assessed using intraclass correlation coefficients (ICC; 3,1).

RESULTS

Forty women suspected of having a suburethral mass on clinical examination underwent both MRI and US (2D-TPUS with or without 3D-EVUS). MRI detected a suburethral mass in 34 women, which was also detected by US. However, US also identified a suburethral mass in the remaining six women. Thus, the agreement between US and MRI for detecting a suburethral mass was 85% (95% CI, 70.2-94.3%). The ICC analysis showed good agreement between MRI and 2D-TPUS for the measured distance between the suburethral mass and the bladder neck (ICC, 0.89; standard error of measurement (SEM), 3.64 mm) and excellent agreement for measurement of the largest diameter of the mass (ICC, 0.93; SEM, 4.31 mm). Good agreement was observed between MRI and 3D-EVUS for the measured distance from the suburethral mass to the bladder neck (ICC, 0.88; SEM, 3.48 mm) and excellent agreement for the largest diameter of the suburethral mass (ICC, 0.94; SEM, 4.68 mm).

CONCLUSIONS

2D-TPUS and 3D-EVUS are useful in the imaging of suburethral masses. US shows good-to-excellent agreement with MRI in identifying and measuring suburethral masses; therefore, the two modalities can be used interchangeably depending on availability of equipment and expertise. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. - Legal Statement: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Paraurethral cyst with multiple stones: A rare case report

Paraurethral cyst is a benign cystic disorder of anterior vaginal wall. Many secondary complications have been described in literature, but stone formation in the cyst is a rare phenomenon. We are reporting a case of a 35-year-old multiparous woman who presented with lower urinary tract symptoms, dysuria, and dyspareunia. She was diagnosed as a case of the paraurethral cyst with stones and was managed successfully. Various differential diagnoses have been suggested, most important being urethral diverticulum, ruled out by urethroscopy. Many imaging modalities have been described, but physical examination plays the key role in reaching the diagnosis of stone. For definitive management incision over the cyst with stone removal followed by marsupialization is performed to prevent recurrence.

Lesions of Skene glands and periurethral region: a review

The periurethral (Skene) glands may become involved by a variety of conditions. Mass-like lesions need to be distinguished from other lesions arising from the anterior vagina. Familiarity with these lesions will be helpful if a patient with a lesion of the Skene glands or periurethral region is encountered.

3-D ultrasonographic appearance of two intermittent paraurethral cysts: a case report

INTRODUCTION

In the adult female, a cyst of the Skene's duct is a rare event that may be either the late consequence of a congenital abnormality or the result of a chronic acquired inflammation.

AIM

To report a case of bilateral paraurethral Skene's duct cysts.

METHODS

A young (32 years old), eumenorrheic (menstrual cycle of >25 and <35 days) woman complained of a 6-month intermittent scarce lubrication during intercourse and a sensation of a small intravaginal "extraneous" body. The patient was repeatedly assessed with a detailed history, with a bimanual pelvic examination and with bi- and tridimensional ultrasonographic and color Doppler analyses of the urethrovaginal space.

MAIN OUTCOMES MEASURES

Transvaginal two-dimensional ultrasonographic evaluation of internal genitalia, bladder, and urethra and three-dimensional analysis of the paraurethral structures.

RESULTS

The evaluation of the structures comprised in the urethrovaginal space evidenced two small (1.7 and 1.1 cm in the maximum diameter) anechoic cysts with some debris in the most declivous part, laterally displaced to the middle/distal urethra. The cysts disappeared after a medical therapy.

CONCLUSIONS

A sudden reduction of the vaginal lubrication requires a prompt gynecological and ultrasonographic evaluation of the urethrovaginal space.