Skene's Gland Research Articles

Recent Developments in Non-HPV-related Adenocarcinomas of the Lower Female Genital Tract and Their Precursors.

Most adenocarcinomas in the lower female genital tract (cervix, vagina, vulva) arise in the cervix and are associated with high-risk human papillomavirus (HPV) infection. However, there is an emerging spectrum of non-HPV-related cervical adenocarcinomas, the most common of which is so-called gastric type. In this review, the concept of gastric-type cervical adenocarcinomas and their possible precursor lesions is covered, the precursor lesions still being poorly understood. Other non-HPV-related cervical adenocarcinomas are also discussed, including new information regarding molecular events in mesonephric adenocarcinoma. A variety of primary vaginal adenocarcinomas, including clear cell, endometrioid, intestinal and gastric types are also discussed. The spectrum of benign and malignant glandular lesions involving the lower female genital tract and probably derived from misplaced Skene's (periurethral) glands is also covered.

Skene's gland cyst excision.

We review our experience with long-term outcome after Skene's gland cyst excision. After receiving institutional review board approval, we reviewed a surgical database of all procedures performed by two surgeons at one institution for Skene's gland cyst excision. Parameters evaluated include presenting symptoms, preoperative evaluation, excision site, perioperative complications, and clinical outcomes. The technique of surgical excision is presented in the accompanying video, and includes cystoscopy, dissection of cyst wall from the floor of the urethra, complete removal of the cyst wall, and primary vaginal-wall closure. From 2001 to 2013, ten women underwent Skene's gland cyst excision. Mean follow-up was 3.5years (range 3-96months). Presenting symptoms were dyspareunia (4), urinary tract infections (4), vaginal mass (1), and voiding dysfunction (1). Five patients had more than one presenting symptom. To exclude urethral diverticulum, magnetic resonance imaging (MRI) was done in all patients and a voiding cystourethrogram in five. No perioperative complications were reported. A distal meatoplasty was done in two women. No recurrence occurred. Eight of ten women who were sexually active remained sexually active postoperatively. Excision of Skene's gland cyst is a safe procedure with acceptable long-term functional outcomes.

Long-term outcomes after the excision of horseshoe urethral diverticulum

The objective was to report our long-term experience with horseshoe urethral diverticulum (HUD) excised using the urethral preservation technique. Following IRB approval, charts of women who underwent HUD excision and had at least 6 months' follow-up were reviewed. HUD was defined as a bilateral posterior diverticulum that extended laterally and anteriorly past 3 and 9 o'clock on the left and right sides respectively. HUD was diagnosed by pre-operative MRI. Success was defined as no evidence of residual diverticulum on post-operative imaging and the reported resolution of diverticulum symptoms. Between 1998 and 2014, 12 out of 15 women who underwent HUD excision met the inclusion criteria. Mean follow-up was 81 (median: 52, range: 7-163) months. Presenting symptoms included urinary leakage (n = 8), dyspareunia (n = 6), dysuria (n = 6), frequency (n = 5), urgency (n = 5), and vaginal pain (n = 8). Two patients reported having all three symptoms of the historic triad: dysuria, dyspareunia, and post-void dribbling. Three patients had prior urological interventions, including excision of a unilateral diverticulum, a Spence procedure, and a Skene gland incision. Only 1 patient had a recurrent HUD confirmed by MRI 10 years later, which required reoperation. HUD symptoms resolved in the remaining 11 patients, with post-operative imaging showing no evidence of recurrent HUD, and no further therapy was needed. Of 4 women who reported stress urinary incontinence (SUI) pre-operatively, only 2 reported SUI symptoms post-operatively. There were no cases of post-operative urethro-vaginal fistula. At a mean follow-up of 6-7 years, excision of HUD with urethral preservation produced long-lasting resolution in the majority of patients.

The Case Files

A 19-year-old woman with no past medical or surgical history presented to the emergency department stating that she had noticed a growth protruding from her vagina. It has been painless except during intercourse and constant in all characterizations since detection three days earlier. She denies vaginal bleeding, urinary retention, incontinence, fever, injury, and back, abdominal, and pelvic pain. Her vital signs are normal, but her physical examination was significant for a 2.5 cm x 4 cm stalk-like, pedunculated, fluctuant, nontender, mobile, cystic-appearing mass protruding from the right anterolateral vaginal wall. The rest of the genitourinary and abdominal systems were without notable abnormalities and pathology. A blood sample sent to the lab failed to note leukocytosis, and urinalysis and pregnancy tests were negative. A supporting ultrasound was obtained, a Gartner's duct cyst was diagnosed, and gynecological follow-up was made for marsupialization to prevent a recurrence. Gartner's ducts are identified in approximately 25 percent of all adult women, and nearly one percent evolves into Gartner's duct cysts. The mesonephric (Wolffian) ducts develop during embryological development, form their predetermined structures, and later regress. Remnants often remain, however, until they develop a secretory mechanism, cause dilation of surrounding cells, and yield a Gartner's duct cyst, most often during and after late adolescence. Classically, the cysts are solitary, unilateral, less than 2 cm in diameter, and are located in the anterolateral vaginal wall of the proximal third of the vagina. (J Gynecol Surg 2009;1[2]:94; J Pelvic Med Surg 2007;13:141.) Gartner's duct cysts are generally asymptomatic, and most commonly diagnosed upon routine gynecologic examination, but patient complaints can include skin tag, dysuria, pressure, itching, dyspareunia, pelvic pain, or protrusion from the vagina if it enlarges to a detectable size, making it a candidate for surgical removal. (J Diagn Med Sonog 2008;24:344; J Pelvic Med Surg 2007;13:141; J Am Osteopath Assoc Dermatol 2007;8:40.) The cyst can be drained to facilitate delivery if it is large enough to cause obstetrical complications.FigureMRI can be a useful tool to define the course of the Gartner's duct cyst and differentiate it from other pathologic considerations and structures. Histologic examination may be employed to correctly identify the cellular remnants composed of non-mucin secreting low columnar or cuboidal epithelium, but it is not necessary in clinical practice. (J Diagn Med Sonog 2008;24:344.) The differential diagnosis can include but is not limited to Bartholin's gland cyst or abscess, prolapsed urethra, prolapsed uterus, vaginal wall inclusion cyst, endometriosis, leiomyoma, sarcoma botryoides, malignant mass, Skene's gland cyst, or abscess and ureterocele. (J Am Osteopath Assoc Dermatol 2007;8:40.) Only in exceptionally rare and isolated cases has a malignant transformation been identified. (Int J Gynecol Cancer 2009;19[9]:1655.) Patients may be discharged safely from the emergency department with gynecologic follow-up for definitive treatment.

Lesions of Skene glands and periurethral region: a review.

The periurethral (Skene) glands may become involved by a variety of conditions. Mass-like lesions need to be distinguished from other lesions arising from the anterior vagina. Familiarity with these lesions will be helpful if a patient with a lesion of the Skene glands or periurethral region is encountered.

V2-06 SKENE'S GLAND CYST EXCISION

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 ...

2077416 Skene's Gland Duct Cysts: the Utility of Vaginal/Transperineal Imaging In Diagnosis And Mapping For Surgery. a Case Series And Review of The Literature

2077416 Skene's Gland Duct Cysts: the Utility of Vaginal/Transperineal Imaging In Diagnosis And Mapping For Surgery. a Case Series And Review of The Literature

Female bladder ectopic skene glands: one case report and literature review

Objective To investigate the pathological and immunohistochemical characteristics of female bladder ectopic skene glands. Methods A female with bladder tumor was treated in our hospital in May 2013. Preoperative sonography revealed a 0.9 cm×0.6 cm round solid mass in the bottom of bladder wall. Mass was hypoechoic homogeneous with regular shape, blood flow within the mass was noted. The tumor was treated with transurethral resection. Routine pathological examination suggested bladder ectopic Skene glands. Immunohistochemical stains for prostate specific antigen (PSA), prostate spectific acid phosphatase (PSAP), androgen receptor (AR), estrogen receptor (ER), CD10,cytokeratin 14 (CK14), cytokeratin 18 (CK18), P63, high molecular weight cytokeratin (34βE12), α-methylacyl-CoA racemase (AMACR/p504s) were further performed. Results Routine pathological examination showed prostate glands composed of prostate gland epithelial cells and basal cells in a submucosal location. Immunohistochemical stains showed: PSA –, PSAP + , AR + , ER –, CD10 + , CK18 + , CK14 –, P63 + , 34βE12 + , AMACR –. Conclusions Routine pathological examination combined with immunohistochemical stains such as PSA, PSAP, and others, can be used to diagnose ectopic Skene glands disease. Female bladder ectopic Skene glands is a benign lesion, and the prognosis is good. Key words: Female; Urinary bladder neoplasms; Ectopic skene glands; Ectopic prostate tissue; Pathology

Chlamydia Infections in Children and Adolescents

1. Lorena M. Siqueira, MD, MSPH* 1. *Division of Adolescent Medicine, Miami Children’s Hospital, Miami, FL. * Abbreviations: CDC: : Centers for Disease Control and Prevention FDA: : Food and Drug Administration HIV: : human immunodeficiency virus LGV: : lymphogranuloma venereum MIF: : microimmunofluorescent MSM: : men who have sex with men NAAT: : nucleic acid amplification tests PID: : pelvic inflammatory disease STI: : sexually transmitted infection 1. The need for annual screening for chlamydia in sexually active adolescents and young adults is underrecognized because this infection is asymptomatic in most females (75%) and males (50%). 2. Difficulty in diagnosis arises from the range of possible symptoms at presentation of symptomatic infections and the type of testing that can be used in each situation. After completing this article the reader should be able to: 1. Recognize the spectrum of clinical manifestations of chlamydia infection in neonates, children, and adolescents. 2. Discuss the appropriate use of culture and nonculture diagnostic tests for chlamydia infections in various age groups. 3. List the current recommendations for screening and treatment of chlamydia infections. A 17-year-old girl presents with prolonged menstrual bleeding associated with severe menstrual cramping pain. Her menarche was at age 13 years. Subsequent menstrual cycles were monthly, lasting 5 days, with average flow associated with mild to moderate pain relieved by over-the-counter pain medications. The current cycle began a month ago and is associated with severe lower abdominal pain. She admits to sexual activity with one partner and uses condoms intermittently. On examination she is afebrile and in discomfort, with a heart rate of 120 beats per minute. She does not appear anemic and has good capillary refill. She has diffuse abdominal pain with significant tenderness in both the right lower and upper quadrants. Chlamydiae are small obligate, gram-negative, intracellular bacteria that contain both DNA and RNA and were formerly considered to be viruses. There are 3 species that are pathogenic to humans: Chlamydia trachomatis , Chlamydophilia pneumoniae, and Chlamydophilia psittaci . They fall within 2 genera in the family Chlamydiaceae . C trachomatis is in …

Surgical Management of Complex Uretheral Diverticulum

Background: Urethral diverticulum is a herniation between the periurethral fibromuscular layer and anterior vaginal wall continuous with the lumen of the urethra. The incidence is 1 to 6%.It occurs commonly in the third to fifth decade of life. The condition can be acquired or congenital. The etiology is not understood. The most widely accepted theory is obstruction and subsequent infection of the periurethral glands with rupture of the abscess into the lumen. Other causes include trauma from vaginal or urethral surgery and childbirth trauma.The diagnosis of urethral diverticulum can be confused with vaginal wall inclusion cysts,mesonephric or paramesonephric cysts, Skene gland cysts, urethral caruncles, and urethroceles.

Uterine Cervical Tubulosquamous Polyp Resembling a Penis

This case report describes a tubulosquamous polyp resembling a penis in the uterine cervix. A 34-yr-old, gravida 0, para 0, woman showed an 18 × 8 × 5 mm polypoid lesion in the uterine ectocervix. The polyp had a penis-like appearance; the tip looked like glans penis and the middle portion resembled the shaft of the penis. Its surface was covered by squamous epithelium, and tissues resembling those of a urethra, corpus spongiosum penis, and external orifice urethra were observed. Foreskin-like tissues were also observed, although a corpus cavernosum penis was not seen. Skene glands and Cowper glands were also observed. Immunohistochemically, Skene glands and the urethra-like epithelium were focally positive for prostate-specific antigen and/or prostatic acid proteins. Histologically and immunohistochemically, the polypoid lesion overlapped with a tubulosquamous polyp of the vagina and ectopic prostatic tissue of the uterine cervix and encompassed these lesions in the lower female genital tract. The most likely theory of histogenesis is a developmental anomaly and misplacement of Skene glands.

L’émission fontaine ou l’éjaculation féminine

For centuries, squirting (female ejaculation) has been known all over the world. In female sexuality, three subjects are in controversy: the G spot (erogenous anatomical zone), the female prostate (glandular peri-urethral tissue) and the female ejaculation (incorrect but often used expression). The term “fountain emission” is more accurate: involuntary fluid expulsion, which arises rather often at the same time as the orgasm but not systematically. Prevalence would be from 6 to 10% of the women. It seems interesting to hear “fountain women” talk, for such a long time absent in this debate. What do they say on the Internet and during the personal inquiries? What are the partner's actual experiences? Results of my inquiriesGenerally, a squirting woman is easily multi-orgasmic and is happy with her flood, often associated with great emotional intensity and appreciated by her partner, in spite some inconvenience. She does not speak a lot about this phenomenon, which remains not very well known by the medical field. She has a tacit request towards the doctors even she rarely consults on this subject (excepted for the woman embarrassed by her flood). Circumstances that may trigger this issue, are emotional (to let go and to trust her partner), and technical: digital caresses (two fingers hooked into the vagina and strong pressure; 92% of success); coitus (Andromache's position and importance of penile inclination; 61% of success); masturbation (66% of success) and cunnilingus (28% of success). The origin and the composition of these fluids still remain a mystery for many people. Scientific researchesIn 2012, results are always divergent on this subject. However, by 1950, Gräfenberg [9], father of the G spot (Fig. 1) and female ejaculation, had almost everything already discovered! ConclusionsThere exist three stages: an excessive lubrification; an ejaculation (squirting): average quantities coming through para-urethral ducts. Involvement of para-urethral glands (skene glands). The female prostate (Zaviacic [17]) would be a misnomer; the fountain woman: existence of a loss of modified and diluted urine. This is confirmed by the experience of the laboratory and other searchers (Godberg; Schubach [14]…). Significant amounts expelled from urethra. For some women, light emissions also come out from para-urethral ducts. The bladder is implied, for sure. The liquid has a clear appearance, a more or less strong smell, a pungent and salty taste. Emitted quantities: half glass to two glasses per emission or a little puddle after several orgasms. The two ages of predilection are: early sexual intercourse and after 40years old. From this age, some fountain women may suffer from urinary incontinence. All women cannot be fountain women. Some of them have predispositions. Treatment in case of embarrassment: perineal reeducation first (Foldes [2,8]). We can accept in 2012 the evidence of this phenomenon, which is no longer a myth. However, “female sexuality is still an obscure and unknown part of medicine” (Jannini [3]).

Prenatal diagnosis of a paraurethral cyst

Paraurethral cysts arising from Skene's gland are a rare cause of urogenital masses in the neonate. We report the case of a pelvic mass noted at the vaginal introitus on prenatal ultrasound that following delivery was found to be a paraurethral cyst. On prenatal ultrasound, there was no evidence of involvement of the urinary, gastrointestinal, or upper genital tract. Serial ultrasounds demonstrated slight enlargement of the cyst without other changes. The patient delivered at 33 weeks and postnatal evaluation demonstrated a paraurethral cyst. The cyst was managed expectantly and drained spontaneously on the second day of life with complete resolution.

New developments in endocervical glandular lesions

McCluggage W G (2012) Histopathology New developments in endocervical glandular lesions There is evidence that the prevalence of premalignant and malignant endocervical glandular lesions is increasing in real as well as in apparent terms. In this review, new developments and selected controversial aspects of endocervical glandular lesions are covered, concentrating mainly on premalignant and malignant lesions. The terminology of premalignant endocervical glandular lesions is discussed with a comparison of the World Health Organization classification and the cervical glandular intraepithelial neoplasia (CGIN) system, which is in widespread use in the United Kingdom. Primary cervical adenocarcinomas comprise a heterogeneous group of different morphological types, and while it is known that the majority of these are associated with high-risk human papillomavirus (HPV), it has become clear in recent years that most of the more uncommon morphological types are unassociated with HPV, although they may sometimes be p16-positive. A spectrum of benign, premalignant and malignant cervical glandular lesions exhibiting gastric differentiation is now recognized; these include type A tunnel clusters, typical and atypical lobular endocervical glandular hyperplasia, adenoma malignum and gastric-type adenocarcinoma. The latter is a recently described variant of primary cervical adenocarcinoma which has a different morphological appearance to the usual endocervical type and which is probably associated with different patterns of spread and a worse prognosis. There is accumulating evidence that 'early invasive' cervical adenocarcinomas have an excellent prognosis and are suitable for conservative management. Immunohistochemical markers of value in the distinction between a primary cervical and endometrial adenocarcinoma are discussed. While it is well known that a panel of markers comprising oestrogen receptor (ER), vimentin, p16 and monoclonal carcinoembryonic antigen (CEA) is useful, several major pitfalls are pointed out and this panel of markers is predominantly of value in 'low-grade' adenocarcinomas. A related group of lesions, including cervical ectopic prostatic tissue and vaginal tubulosquamous polyp, are probably derived from para-urethral Skene's glands and may be positive with prostatic markers. Recent developments in cervical neuroendocrine neoplasms are discussed, as these are associated not uncommonly with a premalignant or malignant endocervical glandular lesion.

Adenoid Cystic Carcinoma of Skene Glands

Adenoid cystic carcinoma (ACC) is a relatively uncommon malignancy that most frequently arises in the salivary glands. In the genital tract, approximately 60 cases of ACC that originated from Bartholin glands have been reported to date. In this report, we describe a case of ACC that arose from Skene glands, a very rare origin for this disease. In this patient, the disease had an indolent clinical course, with few symptoms other than localized pain. During the surgical operation, the tumor was found to have invaded more extensively than had been estimated preoperatively, and it required pelvic exenteration with radical vulvectomy. Although the precise preoperative assessment and the preparation for an extended operation are difficult, they are necessary for the successful treatment of this rare disease.

Management of primary adenocarcinoma of the female urethra: Report of two cases and review of the literature

Primary adenocarcinoma of the female urethra is rare and only a few retrospective cases have been published. The origin of urethral adenocarcinomas remains unclear. Certain authors have suggested that urethral adenocarcinomas in females originate at the periurethral Skene's glands. We report one case of urethral adenocarcinoma of the proximal urethra in a 44-year-old female who presented with painless urethral bleeding. Abdominal and pelvic CT scan with contrast and chest radiology were unremarkable. Biopsy of the mass revealed adenocarcinoma of the urethra. The patient was treated with partial urethrectomy and was free of disease for more than 5 years. We also present another rare case of mucinous adenocarcinoma in a 52-year-old female who complained of an enlarged urethral mass. Pelvic MRI revealed a tumor surrounding the whole urethra and bilateral inguinal lymph nodes. A puncture biopsy later revealed that the tumor was mucinous adenocarcinoma. Anterior pelvic exenteration with pelvic and bilateral lymph node dissection was performed and chemotherapy was administered. The patient was followed up for 12 months and did not experience local recurrence or distant metastasis. In conclusion, for the diagnosis of urethral cancer, a biopsy is necessary for any suspicious urethral lesions. MRI is recommended for tumor staging. Small, superficial, distal urethral tumors may be treated with excision of the distal urethra. For advanced female urethral cancer, a combination of chemotherapy, radiation therapy and surgery is recommended for optimal local and distant disease control. Regular follow-up is required in these patients.

Absence of Prostatic Growth in Large Cohort of Adult Female Patients with Congenital Adrenal Hyperplasia

In girls with congenital adrenal hyperplasia the degree to which excess androgen exposure leads to the development of prostatic tissue is largely uncharacterized, except in rare case reports of prostatic growth and adenocarcinoma. Such growth yields concern for future malignant degeneration. Chart review identified 43 adult women with congenital adrenal hyperplasia who had been longitudinally followed from birth, of whom 11 were available for history and physical examination, laboratory testing for androgen metabolites, and pelvic magnetic resonance imaging. Periurethral thickening was noted on digital rectal examination in 1 patient with increased 17-hydroxyprogesterone and tissue analogous to prostatic tissue was impalpable in the remaining 10. Prostate specific antigen was 0.2 ng/ml in another patient with notably increased testosterone, androstenedione, dihydrotestosterone and 17-hydroxyprogesterone, and was less than 0.1 ng/ml in the remaining patients. Magnetic resonance imaging revealed an absence of definitive prostatic tissue in all 11 patients despite evidence of genitourinary masculinization in all. Of the 11 women 7 had marked androgen excess. Despite androgen excess and genitourinary masculinization in patients with congenital adrenal hyperplasia, as well as case reports citing evidence of prostatic tissue and adenocarcinoma in these women, our study successfully documents the absence of notable prostatic growth in these patients. A better understanding of the timing and factors involved in prostatic growth would aid in identifying the degree to which adult women with congenital adrenal hyperplasia are at risk for adverse sequelae of Skene gland growth.

Tubulosquamöser Vaginalpolyp

Tubulosquamous vaginal polyp is a rare form of lesion. It is thought to derive from displaced paraurethral Skene's gland which is the female equivalent of the prostate gland in men. We report on a case of tubulosquamous vaginal polyp in a 77-year-old female patient. Histological examination showed prominent epithelial nests in a spindle cell-rich stroma. The nests were predominantly squamous in type with small tubules at the periphery of the island. Using immunohistochemistry the tubules were found to be positive for CK7, prostate-specific acidic phosphatase (PAP) and androgen receptor (AR) but negative for CK 5/6 and prostate-specific antigen (PSA). The solid parts were positive for CK5/6 and most interestingly, also expressed AR but not CK7, PAP or PSA. The stroma also showed strong staining for AR but not for the other markers applied. To our knowledge this is the first report on AR expression in this benign polyp. Our findings confirm the view that tubulosquamous polyp of the vagina is derived from paraurethral Skene's gland.

Misplaced Skeneʼs Glands

So-called ectopic prostatic tissue in the cervix and vaginal tubulosquamous polyps are rare morphologically similar lesions that may show positive immunohistochemical staining with prostatic markers. It has been suggested that they are related to paraurethral Skene's glands that are the female equivalent of prostatic glands in the male. We report a large series of lesions in women aged 23 to 81 years, found within the cervix (n=24), vagina (n=10), and vulva (n=2), which we believe to be a part of a spectrum of lesions derived from Skene's glands, either eutopic or more commonly misplaced during embryonic development. In all cervical cases, the lesion was predominantly situated in the ectocervix and was an incidental finding in specimens procured for a variety of reasons. In the vagina, the lesions usually presented themselves as polyps or cysts, although occasionally they were an incidental finding. The 2 vulval cases were incidental findings in punch biopsies. The basic morphological features were of epithelial elements of both glandular and squamous type; in some cases, the glandular elements formed a double cell layer. Uncommon findings included the presence of sebaceous glands in 2 cases (1 cervix, 1 vagina), basaloid formations resembling hair follicle structures in 4 (2 cervix, 2 vagina), and a microglandular proliferation resembling nephrogenic adenoma in 1 vaginal case. Prostate-specific antigen was positive in 13 of 26 cases and prostatic acid phosphatase in 16 of 26 tested. Six cases were negative with both markers. We propose that these benign lesions in the cervix, vagina, and vulva are derived from eutopic or misplaced Skene's glands.

Surgical management of Skene’s gland abscess/infection: a contemporary series

We report our experience with surgical excision for treatment of Skene's gland abscess/infection after conservative measures have failed. A retrospective review of patients that underwent surgical excision of Skene's gland abscess/infection by a single surgeon from 06/1995 to 09/2008 was performed. Patients were separated into groups based on indication for procedure. Recurrence rate and success rate were calculated. The final study group included 34 patients. After initial excision, 88.2% (30/34) of patients had resolution of symptoms. Recurrence of signs and symptoms that prompted further treatment occurred in 30% (9/30). In those that recurred, 88.8% (8/9) of patients had resolution of symptoms after further therapy. Overall success rate in complete resolution of symptoms after all treatment was 85.3%. Only patients to fail were in the urethral pain and recurrent UTI groups. Surgical excision is a safe and effective therapy for the treatment of Skene's gland abscess/infection after conservative measures have failed.