Skene glands (periurethral or paraurethral glands) are located adjacent to the distal urethra.
Skene duct cysts form if the duct is obstructed, usually because the gland is infected. They occur mainly in adults.
Cysts may become infected, leading to recurrent urinary tract infections (UTIs) and abscesses. Rarely, Skene duct cysts (if large enough) obstruct the urethra.
Most Skene duct cysts are < 1 cm and asymptomatic. Some are larger and cause dyspareunia. The first symptoms may be similar to those of UTIs (eg, dysuria). Abscesses are painful, swollen, tender, and erythematous but usually do not cause fever.
Diagnosis of Skene Duct Cyst
Clinical evaluation
Diagnosis of Skene duct cysts is usually clinical. Most symptomatic cysts and abscesses are palpable adjacent to the distal urethra; however, a diverticulum of the distal urethra may be clinically indistinguishable, requiring ultrasonography or cystoscopy for differentiation.
Treatment of Skene Duct Cyst
Surgical excision or marsupialization if the cyst causes symptoms
Symptomatic cysts are excised or marsupialized (the everted edges of the cyst are sutured to the exterior). Abscesses are treated initially with oral broad-spectrum antibiotics (eg, cephalexin 500 mg every 6 hours for 7 to 10 days) and are excised or marsupialized.
Key Points
Skene duct cysts form if the duct is obstructed, usually because the gland is infected.
Cysts may form abscesses and/or cause recurrent UTIs.
Most are small and asymptomatic; large cysts may cause dyspareunia.
Diagnose Skene duct cysts by physical examination and, if needed, by ultrasonography or cystoscopy.
Excise or marsupialize symptomatic cysts, and treat abscesses with broad-spectrum antibiotics and excision or marsupialization.
