Paraurethral cysts in newborn girls

Abstract

The Skene's glands are located in the distal urethral floor, and they are the largest paraurethral glands. Skene's gland cysts are unusual at any age, but specially newborns. However, due to lack of systematic reporting, true incidence is probably higher than the one described in the literature. We present a newborn girl found to have a paraurethral cyst at birth. Characteristic displacement of the urethral opening was revealed on catheterisation. Review of literature, and comparison to a similar case of interlabial mass previously evaluated, were carried out. We suggest a prenatal development possibly due to maternal oestrogen exposure, although further studies are necessary to determine the exact aetiology. Treatment options include observation, needle aspiration and incisional drainage, partial excision, unroofing and marsupialisation. Expectant management is preferred in asymptomatic cases, particularly in newborns, since spontaneous resolution can occur without long-term sequalae or recurrence. Cases with acute obstruction require immediate surgical management.

Paraurethral cyst in a newborn

“…Paraurethral glands were first described by Alexander Johnston Chalmers Skene in 1880 (2). They are located in the distal part of the urethra and considered to be homologues of the prostate in females; they generate mucoid secretion with sexual stimulation (3). The distal urethra of an adult woman has between 6 and 30 ducts in the paraurethral glands, the largest of which is called the Skene duct.…”

Newborn with interlabial cystic mass

“…The paraurethral cyst typically presents during the first month as a small (average size, 0.5–2 cm in diameter), yellowish or whitish interlabial cystic mass with capillary vessels on the surface. Its location adjacent to one side of the urethra and displacement of the urethral meatus are characteristic clinical findings 1,3,4 . However, it rarely causes any voiding problems.…”

Paraurethral cyst in a female newborn: A case report

“…The cyst is filled with a milky‐colored liquid, and its incidence varies from 1 in 2,000 to 1 in 7,000 female newborns. Its etiology has not been determined yet, but prenatal maternal estrogen exposure, obstruction or stenosis of the Skene's duct, or dislocation of the urothelium have been suggested to lead to its development . Although more than 50 cases of this lesion have been reported in the literature, many clinicians still seem to be unfamiliar with it or its appropriate management.…”

“…Its etiology has not been determined yet, but prenatal maternal estrogen exposure, obstruction or stenosis of the Skene's duct, or dislocation of the urothelium have been suggested to lead to its development . Although more than 50 cases of this lesion have been reported in the literature, many clinicians still seem to be unfamiliar with it or its appropriate management. Here we report a female newborn with a paraurethral cyst that was diagnosed and evaluated for its local extent with urethro‐ and vaginograms and magnetic resonance imaging (MRI) before ultimately resolving spontaneously.…”

“…Our literature search with PubMed revealed 24 cases reported in English in 2000–2019, and the clinical data of 25 cases, including ours, are described in Table . The lesions in 12 cases resolved spontaneously in a few days to 10 months . Thirteen cases had surgical treatments, including aspiration, incision, or unroofing, ten of whom had no urinary obstructive symptoms and could have been managed conservatively .…”