A Painful Periurethral Mass

Abstract

A 17-year-old female presents with vaginal ‘‘pain and a bump.’’ Her last menstrual period ended 1 day earlier. She denied vaginal bleeding, discharge, abdominal pain, fevers, hematuria, dysuria, post-void dribbling, incontinence, history of sexual transmitted infections, or change in hygiene products. She is currently finishing a course of nitrofurantoin for a urinary tract infection (UTI). She admits to sexual activity without use of barrier contraception. Recent gonorrhea and chlamydia testing were negative. On examination, she is afebrile with normal vital signs, and her abdomen is nontender. External genitalia demonstrated a small, somewhat firm irritated-appearing 1-cm midline mass anterior to the vaginal introitus just posterior to the urethra (Fig. 1). Compression yielded no urine or purulent discharge.