What are the most common perineal cystic lesions seen in the women?
Several types of perineal cystic lesions can be seen in the female patient arising from the urethra, vagina, labia, or ischiorectal fossa. The more common periurethral cystic lesions include urethral diverticula and Skene’s duct cysts. The most common vaginal and labial cysts include Gartner’s duct cysts and Bartholin’s gland cysts, respectively.
Urethral diverticula are usually located at the level of the midurethra, whereas Skene’s duct cysts are located lateral to the external urethral meatus and inferior to the pubic symphysis. Gartner’s duct cysts are found in the anterolateral vagina down to the level of the inferior margin of the pubic symphysis. Bartholin’s gland cysts are found at the posterolateral introitus medial to the labium. MRI is very helpful for diagnosis because of its excellent soft tissue contrast. Accurate localization of the palpable abnormality is one of the major keys to diagnosis, and location of origin will markedly narrow the differential diagnosis.