Gartner duct cysts are the remnants of the Wolffian duct and are uncommon in adulthood. Most of the mesonephric (Wolffian) ducts degenerate, some remnants may persist in the mesovarium where they form the epoophoron and paroophoron. The mesonephric cysts known as Gartner duct cysts are seen in 1%-2% of the women. Diagnosis is usually made with pelvic examination. Here, we present a case of 33 yr. old woman with the chief complaints of dyspareunia and a prolapsing vaginal mass. A diagnosis of Gartner's duct cyst was made after pelvic examination and ultrasonography. Surgical marsupialization was done with a histopathology report consistent with a Gartner's cyst. KEYWORDSGartner's duct cyst. Dyspareunia, Prolapsing mass, Marsupialisation. Gartner's cysts are usually asymptomatic and most commonly diagnosed on routine gynecologic examination, but patient complaints can include that of skin tag, dysuria, boggyness, itching, dyspareunia, pelvic pain or protrusion from the vagina if it enlarges to a detectable size making surgery inevitable. [2] Gartner duct cysts are the remnants of the Wolffian duct. The mesonephric (Wolffian) ducts begin to develop at 20-30 days of gestation and contribute to the development of the male reproductive excretory system that includes vas deferens, epididymis and seminal vesicles while they degenerate and remain as a vestigial system in the females. [3] Here we present a case of a large Gartner's cyst with the symptoms of dyspareunia and prolapsing vaginal mass, which was surgically excised. HOW TO CITE THIS CASE REPORTPatient was a 33 yr. old female para 2 with previous 2 normal deliveries. Came to us with the chief complaints of dyspareunia and a prolapsing vaginal mass. Patient gave no history of difficulty in passing urine or stools. Per Speculum Examination showing Large CystFinancial or Other, Competing Interest: None. Submission 13-11-2015, Peer Review 14-11-2015, Acceptance 02-12-2015, Published 10-12-2015 Rd., Chembur-400071, Mumbai. E-mail:sumit9146@yahoo.com DOI:10.14260/jemds/2015/2448 No other history of any menstrual irregularity or any kind of vaginal discharge. Per speculum examination showed a large S shaped cyst originating from the proximal vagina with a size of about 6x7x5cm. Per vaginal examination revealed the origin of the mass from the upper right lateral wall of the vagina and cystic is nature. The ultrasound showed a large anechoic fluid filled cyst of 6x7 cm that was distinct from the uterus. Her laboratory routine investigations were within normal limits. Surgical excision was done in lithotomy position. Due to dense adhesion between the cyst wall and the vagina, complete excision was not possible and hence marsupialization of the remaining cyst was done. Fluid from the cyst and cyst wall was sent for histopathological examination, which showed non-mucin secreting low columnar and cuboidal epithelium, which are consistent with Gartner's cyst. Patient did not have any complaints at threemonth post-operative follow-up.

Pelvic floor weaknesses are usually caused as a result of a vaginal delivery and are caused by tearing and stretching of the endopelvic fascia, the levator muscles and the perineal body. Sometimes pudendal and perineal neuropathies may also be associated with childbirth. 1 Prolapse in a nulliparous woman may occur due to congenital weakness of pelvic floor ligments, spina bifida occulta or associated neurological abnormalities. Here we present a case of a 20 year old unmarried woman with complete uterine prolapse not associated with any other disease. She underwent a Shirodkar's sling operation for the same with no recurrence for a followup of 1 year.

BACKGROUNDA 22-year-old Gravida 4, Para 2, Living 2, MTP 1, previous 2 lower segment caesarean sections with 36 weeks of gestation presented with scar tenderness. An emergency lower segment caesarean section was performed. A huge ovarian cyst was found during lower segment caesarean section which was successfully excised. The patient had good feto-maternal outcome.

Objective: To assess a case of infertility and amenorrhea following bilateral internal iliac ligation for post-partum hemorrhage. Review of literature shows only few series evaluating fertility and obstetric performance after bilateral internal iliac ligation. The data reviewed does not appear to have any adverse effect on menstrual / ovarian function or fertility. We have presented an unusual case of amenorrhea and infertility following bilateral internal iliac ligation done for ruptured uterus and PPH. All parameters of pituitary functions were within normal limits ruling out the possibility of Sheehan's syndrome. New investigational modality using color Doppler has clearly shown absent or diminished uterine artery flow velocimetry.

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