Department of Gynaecology, St. Georg Hospital of Eisenach, Academic Teaching Hospital of Jena University, Germany; Women's University Hospital of Jena, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany.
Women's University Hospital of Jena, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany; Department of Gynaecology, Hospital Bremen-Nord, Germany.
Eur J Obstet Gynecol Reprod Biol. 2021 Dec;267:280-284. doi: 10.1016/j.ejogrb.2021.11.422. Epub 2021 Nov 22.
Benign anterior-vaginal-wall cysts (0.5-1% prevalence) often mimic other structures (e.g. cystoceles). No algorithm for their diagnosis, treatment, recurrence or complication prediction can be derived from existing data. Careful preoperative diagnosis can minimize intraoperative surprises and complications due to differences in cyst origin.
This retrospective study was performed with data from consecutive patients with anterior vaginal cysts who underwent surgery at the Pelvic Floor Centre, University Women's Hospital of Jena, within a period of 7 years. Data on patient age, symptoms, history of previous surgery, lesion characteristics, preoperative imaging findings, surgeries, postoperative stays, complications and histological and microbiological findings were collected.
Out of 797 consecutive anterior vaginal prolapse repairs 19 (2.4%) anterior vaginal cystic lesions were found, mean age 47 [standard deviation (SD) 14, range 22-72] years. Symptoms reported were pressure (58%), voiding dysfunction (26%), dyspareunia (5%) and inflammation signs (37%); 26% of cases were asymptomatic. Two patients had received prolapse pessary treatment before. Two patients had history of previous vaginal surgery. Five cases were diagnosed preoperatively by ultrasound. Cysts were located on the medial anterior vaginal wall (42%), suburethral (42%) and the vaginal apex (16%). The mean lesion size was 2.6 (SD 0.9) cm. Eleven percent of cases showed microbiological positivity. Most (89%) vaginal cysts were excised; 11% were fenestrated, biopsied and drained. Twenty-six percent of patients underwent outpatient procedures; for inpatient procedures, the median stay was 2.7 days. Postoperative hemorrhage with no transfusion requirement occurred in one patient. All lesions were benign.
Anterior-compartment vaginal cysts can be found incidentally during pelvic organ prolapse assessment and surgery, as they can mimic anterior-vaginal-wall prolapse. In this cohort, all excised lesions were benign.
良性前阴道壁囊肿（占比 0.5-1%）常与其他结构类似（例如膀胱膨出）。目前尚无关于其诊断、治疗、复发或并发症预测的算法，无法从现有数据中得出。仔细的术前诊断可以最大限度地减少由于囊肿起源不同而导致的术中意外和并发症。
这项回顾性研究纳入了在耶拿大学妇女生殖医学中心行手术治疗的前阴道囊肿连续患者的数据，研究时间为 7 年。收集患者年龄、症状、既往手术史、病变特征、术前影像学检查结果、手术、术后住院时间、并发症以及组织学和微生物学检查结果等数据。
在 797 例连续的前阴道脱垂修复术中，发现 19 例（2.4%）前阴道囊性病变，平均年龄 47 岁（标准差 14 岁，范围 22-72 岁）。报告的症状有压迫感（58%）、排尿功能障碍（26%）、性交困难（5%）和炎症体征（37%）；26%的病例无症状。两名患者曾接受过阴道脱垂治疗。两名患者有阴道手术史。五例术前通过超声诊断。囊肿位于阴道前壁内侧（42%）、尿道下（42%）和阴道顶端（16%）。平均病变大小为 2.6（标准差 0.9）cm。11%的病例有微生物学阳性。大多数（89%）阴道囊肿被切除；11%被开窗、活检和引流。26%的患者为门诊手术；住院患者的中位住院时间为 2.7 天。术后 1 例发生无需输血的出血。所有病变均为良性。
前阴道壁囊肿在盆腔器官脱垂评估和手术中可偶发发现，因为它们可能与前阴道壁膨出类似。在本队列中，所有切除的病变均为良性。
