V2-06 SKENE'S GLAND CYST EXCISION

Abstract

You have accessJournal of UrologyFemale Voiding Dysfunction1 Apr 2015V2-06 SKENE'S GLAND CYST EXCISION Philippe Zimmern and Gary Lemack Philippe ZimmernPhilippe Zimmern More articles by this author and Gary LemackGary Lemack More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.331AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To review our experience with the long-term outcome after Skene's gland cyst excision METHODS A surgical database of all procedures performed by two surgeons at one institution was reviewed for Skene's gland cyst excision. Data extracted from an electronic medical record or medical charts were presenting symptoms, pre-operative evaluation, site of excision, peri-operative complications, and clinical outcomes. Technique of surgical excision is presented in the attached movie, and includes cystoscopy, dissection of cyst wall from the floor of the urethra with scissors or bovie on low setting, distal urethroplasty as indicated, complete removal of the cyst wall, and primary vaginal wall closure. Urethral Foley catheter is left indwelling for 3–5 days afterwards and sexual function is resumed after completion of vaginal healing. RESULTS From 2001 to 2013, ten women were studied. Mean age was 45 (range: 29 to 66). Presenting symptoms were: dyspareunia (4), urinary tract infections (4), vaginal mass (1) and voiding dysfunction (1), with half of women having more than one presenting symptoms. Evaluation included an MRI in all women, and a voiding cystourethrogram in 5 to exclude a urethral diverticulum. Skene's gland cyst was observed on the left (5) or right (5) sides, with no cases being bilateral. No peri-operative complications were reported. All procedures were done on an outpatient basis. A distal meatoplasty was done in 2 women, and a urethral dilation in another 2. Mean follow-up was 3.5 years (range 3 to 96 months). One woman died of unrelated cause (stroke). Four women had mild stress urinary incontinence in follow-up years, one requiring pelvic floor therapy, the others simple observation. Two have been treated for occasional urinary tract infections. One underwent a distal urethroplasty 6 years later after a failed urethral dilation. Eight of ten women who were sexually active remained sexually active post-operatively. CONCLUSIONS Excision of Skene's gland cyst is a safe procedure with acceptable long-term functional outcomes. Excision of a Skene's gland cyst is: a. A frequent vaginal procedure due to the large incidence of this condition b. A bloody procedure possibly requiring blood transfusion c. A delicate operation that can lead to distal urethral wall damage and possible meatoplasty (∗) d. Similar to a urethral diverticulum removal and requiring closure of the urethral ostium e. Likely to recur even after complete excision of the gland linings © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e99 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Philippe Zimmern More articles by this author Gary Lemack More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...