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Festering vaginal cysts: causes, symptoms, diagnosis, treatment
Medical expert of the article
Last reviewed: 04.07.2025
Vaginal cysts are derivatives of the remnants of the Gartner duct (embryonic ureter), lined with cylindrical (ciliated or cuboidal) or stratified squamous epithelium.
Causes of suppurating vaginal cysts: infection of the contents of the cysts.
Symptoms of suppurating vaginal cysts. Complaints appear when the tumors reach significant sizes. These include dyspareunia and pressing pain in the vagina and perineum. When the cysts suppurate, the pain intensifies, the temperature rises. Sometimes a spontaneous rupture of the cyst occurs. In this case, a viscous yellow liquid or pus flows out. The symptoms temporarily disappear, but with repeated accumulation of fluid in the cyst cavity, they inevitably resume.
Diagnosis of a suppurating vaginal cyst is not difficult. Usually, examination in a mirror and palpation are sufficient. Vaginal cysts are formations of a hard-elastic consistency, ovoid or elongated in shape, with clear contours, localized in the upper or middle third of the vagina, more often on the lateral wall, often near the urethra. The base of the cyst can be either wide or narrow. Sometimes the visual impression of the size of the formation is deceptive, since its upper pole goes far into the paravaginal and paravesical tissue and is in close proximity to the wall of the bladder and urethra, which is difficult for surgical treatment (risk of injury to the urinary organs and subsequent formation of fistulas).
Differential diagnosis
Most often, vaginal cysts must be differentiated from cystocele, rectocele and diverticulosis.
- Cysto- and rectocele: the hernial protrusion is most pronounced on the anterior or posterior vaginal wall, respectively, and increases with straining. Signs of pelvic floor muscle failure are determined. Catheterization of the bladder or digital rectal examination easily help to clarify the diagnosis.
- Diverticulosis of the urethra and bladder is a protrusion of the wall of the urethra or bladder, communicating with its cavity. The disease can be complicated by the development of inflammation in the sac - diverticulitis, peridiverticulitis.
Probing with a male catheter and urethrocystoscopy help to clarify the diagnosis.
Treatment of suppurating vaginal cyst
In case of small cysts and absence of complaints and suppuration, observation alone is sufficient. In other cases, surgical treatment is indicated - removal of the cyst, and the key to success is complete removal of the capsule. In case of suppuration of the cyst, it can be removed at one time, together with the capsule. If it is impossible to completely remove the capsule (large size, pronounced inflammatory tissue infiltration, lack of proper experience), as a palliative intervention, the cyst cavity is opened and sanitized. Later, in the "cold" period, radical treatment is carried out - removal of the vaginal cyst.
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