Gartner's Duct Research Articles

The migrating adenomyoma: past views on the etiology of adenomyosis and endometriosis

This article discusses the history surrounding the debate on the etiopathology of endometriosis, specifically deep infiltrating endometriosis, and traces the controversies in its management that are as pertinent today as they were when the disease was first described in the late 19th and early 20th centuries.

Symptomatic Giant Gartner's Duct Cyst of the Vagina

Background: Gartner's duct cysts are remnants of Wolffian ducts, which are usually found in the upper anterolateral part of the vagina. Gartner's cysts are remnants of mesonephric (Wolffian) ducts, which, in women are present in the uterus, vagina, and hymen until the third month of gestation and which give rise to the ureter. Remnants of the Gartner duct may be detected in up to one fourth of adult women, although Gartner's cysts arise only in approximately 1%–2% of the population. Most Gartner's cysts are small (< 3 cm), and they are usually paravaginal and in the anterolateral position; however, they can be large and cause urethral or even ureteric obstruction. Infrequently, giant Gartner's duct cyst has been reported in the literature.

Bilateral Leydig Cell Tumor in a Six-Year-Old Intersex Goat Affected by Polled Intersex Syndrome

A 6-year-old, sterile, Blanca Celtibérica breed adult doe was referred to our faculty. The doe had external female genitalia, a short anogenital distance, and normally shaped udders. Masculinization signs in the head shape and male behavior were also noted at the time of referral. Genetic analysis demonstrated normal 2n = 60 XX karyotype and an absence of the sex-determining region Y (SRY). The animal was homozygous for a DNA deletion responsible for the Polled Intersex Syndrome (PIS). A uterus and 2 uterine horns were present at the postmortem examination. Gartner's ducts and degenerated Wolffian derivatives persisted. There were 2 intra-abdominal testicle-like structures, one of which consisted of epididymal and deferent ducts. An advanced Leydig cell tumor, resulting in almost total destruction of the intratesticular structures, was also observed. Leydig cell tumors usually produce testosterone. Thus, these histologic findings are compatible with the evident virilization.

A Giant Gartner Duct Cyst Originating from the Uterine Cervix and Adjacent Myometrium: A Case Report

Gartner duct cysts are relatively common congenital cysts in the anterolateral wall of the vagina. Most are small (less than 2 cm) and asymptomatic, but larger cysts may cause problems. We report a rare case of a giant Gartner duct cyst (7 cm) originating from the right lateral portion of the uterine cervix and adjacent myometrium. It appeared as an exophytic multiseptated cystic mass containing different density fluids on CT.

Gartner duct cyst in pregnancy presenting as a prolapsing pelvic mass

Gartner duct cysts are the remnants of the Wolffian duct and they are rarely seen in adulthood. We present a case of a pregnant patient with a prolapsing vaginal mass. A diagnosis of Gartner duct cyst was made after MRI was performed. The Gartner duct cyst was drained when the patient went into labour allowing vaginal delivery to be performed.

Transarterielle Chemoperfusion des Beckens

To evaluate local transarterial chemoperfusion (TACP) of therapy-resistant, locally recurrent malignant tumors and lymph node metastases in the pelvis with respect to clinical response, tumor response and survival. Between 2003 and 2005, 24 outpatients (median age 56.5 years, range 33-82) were treated with 128 TACPs (min. 3; mean 5 sess/patient) in 4-week intervals. Depending on the tumor location and vascularization, a fluoroscopy catheter was placed either in the abdominal aorta or internal pelvic artery. A combination of mitomycin C (6 mg/m (2)) and gemcitabine (1500 mg/m (2)) was administered over 60 minutes. The tumor size was measured using CT or MRI. The radiological response was classified according to RECIST (Response Evaluation Criteria In Solid Tumors) as "complete response" (CR), "partial response" (PR), "stable disease" (SD) and "progressive disease" (PD). The clinical response was classified as "response (clinical)" if the symptoms improved distinctly, "stable disease (clinical)" if complaints were stabilized, and "progression (clinical)" if symptoms deteriorated or new symptoms appeared. After the third TACP, patients were evaluated for clinical and radiological response. In the case of clinical and radiological progression, therapy was stopped and the patient was referred to the hospital's tumor board. In the case of radiological response and clinical progression or clinical response and radiological progression, therapy was continued. Therapy could be stopped by the patient at any time. Treatment was tolerated well by all patients. No clinically relevant problems and no grade III or IV toxicity according to CTC (Common Toxicity Criteria) appeared. Tumor-related pain, bleeding, restricted mobility of the lower extremities, incontinence, urinary tract obstruction, and constipation were reduced in 9/17, 5/6, 3/3, 1/3, 2/5, and 1/3 of cases (clinical response rate: 54%). Radiologically, 4/24 (17%) patients showed PR, 12/24 (50%) SD, and 8/24 (34%) PD (tumor control (PR+SD): 67% of cases). Tumor response (median survival since first TACP) was as follows: colorectal: 2 PR, 7 SD, 2 PD (11.5 months), ovarian: 1 SD, 2 PD (8.5 mon), cervical: 1 PR, 1 SD (6 mon), breast: 2 SD (6 mon), gastric: 1 PD (11 mon), adrenal gland: 1 PD (12 mon), anal: 1 PD (10 mon), prostate: 1 PD (20 mon), Gartner's duct: 1 PR (20 mon), renal cell carcinoma: 1 SD (10 mon). Since tumor-related complaints were improved in 54% of the cases and control of tumor growth (PR+SD) was achieved in 67% of the cases, TACP for recurrent pelvic malignancies should be considered as a palliative oncological treatment option.

Diagnostic laparoscopy in a Gartner's duct cyst

Gartner's duct cysts associated with renal dysgenesis are rare malformations and represent a diagnostic challenge. We report on one such case in which final diagnosis was achieved by laparoscopy and discuss the possible role of minimally invasive surgery in the management of this condition.

A Gartner duct cyst of the vagina causing dysuria and dyschezia in a Yorkshire Terrier

A 5 year-old, intact female Yorkshire terrier was referred for dysuria and dyschezia. The radiographic and ultrasound examination showed a round shaped mass caudal to the urinary bladder that contained anechoic fluid within the thin walls. During surgery, the cyst was noted to be attached to the outer wall of the vagina, not connected to the vaginal lumen. Cystic fluid was removed and the cystic wall was resected. Then the remaining cystic wall was omentalized to prevent a recurrence.Histological examination confirmed that the cyst was of Wolffian duct origin. In this case, a large Gartner duct cyst causing urological problems was diagnosed and removed by surgical resection.

Pictures in practice: various cystic lesions

Essential pictorial guide to the identification of tricholemmal cyst, Bartholin's cyst, cyst of Moll, apocrine hidrocystoma, Gartner's duct cyst and meibomian cyst

Gartner duct cyst simplified treatment approach

We present two patients with Gartner's duct cyst managed with simple marsupialization and successful long-term follow up.

Why pelvic floor surgeons should utilize ultrasound imaging

Why pelvic floor surgeons should utilize ultrasound imaging

Gartner's Duct Cyst, Uterine Duplication, and Renal Agenesis: A Case Report and Literature Review

Background: Paravaginal cysts often represent Wolffian duct remnants and are frequently associated with congenital Mullerian and renal anomalies. While rare, it is important to consider the triad of a Gartner's duct cyst, uterine duplication, and ipsilateral renal agenesis when a patient presents with a pelvic mass suggestive of a paravaginal cyst. This constellation of anomalies has been referred to as Herlyn-Werner-Wunderlich Syndrome, and less than 80 case reports exist in the world literature.

Multicystic dysplastic kidney with ipsilateral abnormalities of genitourinary tract: Experience in children

Objectives To investigate the incidence, nature, and management of associated ipsilateral genitourinary malformations in children with multicystic dysplastic kidney (MCDK). Methods In this retrospective study, we analyzed the medical records and imaging studies of 93 patients with MCDK. Patients underwent ultrasonography, voiding cystourethrography, intravenous urography, and radionuclide renal imaging studies during their first month of age. Results A diagnosis of MCDK associated with malformation of the ipsilateral internal genitalia was confirmed in 11 patients after birth investigations of prenatal MCDK. Three were diagnosed at 1, 12, and 14 years of age because of epididymitis, pelvic pain associated with amenorrhea, and accidentally during lumbar pain assessment, respectively. The male/female sex ratio was 10:4. The left side was involved in 9 patients. We had 3 cases of Gartner duct persistence, 6 of cystic retrovesical and laterovesical masses with vanishing MCDK, 4 of cystic retrovesical or laterovesical masses with compressive MCDK, and 1 of a blind-ending hemivagina. Nine patients were periodically observed, and four underwent nephroureterectomy. All patients underwent 6-month follow-up examinations with ultrasonography (mean follow-up 6.54 years, range 36 months to 14 years). Conclusions Of the 93 patients with MCDK, 14 (15%) had malformations of the ipsilateral internal genitalia. Persistence of seminal cysts in boys and Gartner ducts were encountered even if the MCDK had involuted. These results suggest that follow-up of patients with MCDK should be performed until the end of puberty to detect genitourinary malformations.

Kyste de Gartner communiquant avec la vessie et le vagin, associé à un diaphragme vaginal complet

Gartner's duct cyst is a relatively common benign cystic lesion and represents embryologic remnants of Wolffian ducts. These cysts are usually small and asymptomatic and have been reported to occur in as many as 1% of all women. We report a case of a 30 month old baby presenting with recurrent urinary tract infection and Gartner's duct cyst communicating with the vagina and bladder with associated complete vaginal diaphragm. The diagnosis of Gartner's duct cyst was suggested by pelvic ultrasonography and MR imaging. Vaginal diaphragm and communication between the Gartner's cyst, the bladder and vagina were established during cystoscopy and vaginoscopy.

Diagnosis and treatment for persistent Gartner duct cyst in an infant: A case report

Persistent Gartner duct cysts are extremely rare in infants. The authors describe the case of an infant with persistent Gartner duct cysts and discuss its management. J Pediatr Surg 37:E4. Copyright 2002, Elsevier Science (USA). All rights reserved.

Pyonephrosis and urinary retention secondary to a large Gartner's duct cyst associated with single ectopic ureter in a pregnant woman

Pyonephrosis and urinary retention secondary to a large Gartner's duct cyst associated with single ectopic ureter in a pregnant woman

Diagnosing neonatal female genital anomalies using saline-enhanced sonography.

The purpose of this article is to show the usefulness of sonography in diagnosing genital anomalies early in female neonates who have unilateral renal malformations. Our patients were three female neonates with renal anomalies that had been detected in utero. We performed sonography of the inner genitalia of each girl after filling the vagina with saline solution. In two patients with multicystic dysplastic kidney disorder, the examination revealed uterus didelphys with obstruction of one of the vaginas. Sonographic examination of the third patient showed Gartner's duct cyst with renal agenesis. The neonatal period provides a unique opportunity to use sonography to detect uterine anomalies because maternal and placental hormone stimulation increases the size of the uterus. Simultaneous intravaginal saline instillation during imaging further improves the radiologist's ability to diagnose genital malformations precisely. This procedure is a simple, sensitive, and inexpensive examination method that is useful in imaging female neonates with renal dysplasia or agenesis detected in utero or in the neonatal period. Its particular value is to further characterize a cystic mass posterior to the bladder that is seen at transabdominal sonography.

Paravaginal abscess in pregnancy

Paravaginal abscess in pregnancy. We report the diagnosis and treatment of an infected Gartner's duct cyst during pregnancy. The patient presented with lower abdominal pain, fever (38.5 degrees C) and an elevated C-reactive Protein level. Pelvic examination revealed a painful paravaginal mass. Sonography was not able to detect the cranial border of the tumor. Magnetic resonance imaging (MRI) revealed fluid accumulation laterodorsal to the vagina without evidence of a connection with the retroperitoneal space. An infected Gartner's duct cyst with consecutive abscess formation along the mesonephric duct system, was diagnosed. Following transvaginal drainage, the remainder of the pregnancy was uneventful and the patient was delivered vaginally at 40 + 5 weeks without complications. - The rare clinical finding of a paravaginal abscess in pregnancy was treated without termination of the pregnancy. Preoperative planning of the surgical approach using MRI can be easier for pelvic processes extending out of the pelvis than using ultrasound and is less painful for the patient.

Ectopic ureter in 54 children

We reviewed 54 pediatric patients with ectopic ureter treated at our institution from 1975 to 1999. Our series comprised 40 female and 14 male children, with age from 1 month to 11 years. Clinical records of the patients were reviewed retrospectively. Chief complaint was urinary incontinence in 24, high fever in 18, abdominal mass in 6, scrotal swelling in 3 and growth retardation in 2 patients. Two patients were found to have ectopic ureters without symptom during urological work-ups for their anorectal anomaly. The ectopic ureters opened into vagina in 19, vestibulum in 8, bladder neck in 7, urethra in 17, seminal vesicle in 2 and ejaculatory duct in 1 patient (s). Treatment was ureterocystoneostomy in 30, nephroureterectomy in 19, hemi-nephroureterectomy in 2, and ureteral ligature in 1 patient (s). Postoperatively, most of the patients became symptom free except for 6 patients in whom urinary incontinence was not cured due to mal-development of the bladder neck and sphincter, and due to Gartner's duct cyst. Urinary incontinence and urinary tract infection are most frequent presentations of ectopic ureter in children. Although most of the patients are cured with ureterocystoneostomy or nephroureterectomy, some incontinent girls continue to have urinary incontinence due to mal-development of the bladder neck and sphincter or Gartner's duct cyst.

The Mayer-Rokitansky-Küster syndrome. An analysis of its morphology and embryology. Part I: Morphology.

The histological appearance of the rudimentary uterus, endometrium, uterine tube, Gartner's duct, round ligament, vagina and ovary is described in ten case of the MRK syndrome. When the layout of the pelvic contents of patients with this syndrome is compared with that of a normal embryo of 20 mm CRL (stage 20), the following conclusions may be drawn. The MRK syndrome can be regarded as resulting from the cessation of development of the Müllerian duct, which in this condition extends only as far as its attachment to the caudal mesonephric ligament, the round ligament. The adjacent structures beyond this point, which include the connecting strand and smooth muscle bundles dorsal to the bladder and vaginal rudiment, are derivatives of the Wolffian duct or Gartner's duct respectively. Our findings suggest that this syndrome is due to a deficiency of the estrogen and gestagen receptors. This deficiency may inhibit the further development of the embryonic Müllerian duct and account for the subsequent faulty differentiation of its existing elements. It is still undecided why, in cases of the MRK syndrome, development of the Müllerian duct ceases at the attachment of the caudal mesonephric ligament (later the round ligament). Further research is necessary to answer this question.