Cysts of the vagina: Classification and clinical correlations

The clinical and morphologic features, as well as the classification, of surgically excised cysts of the vagina were reviewed. Sixty-four cysts were available for study. Classification was principally along developmental grounds, based on histologic and histochemical features of cyst epithelium. Detection of epithelial mucus production reduced significantly the incidence of Gartner's duct (mesonephric) cysts, indicating that this is an uncommon lesion. Cysts of mullerian origin, lined mainly by endocervical and occasionally by fallopian tubal epithelium, comprised one-third of the cases. Inclusion cysts of surface mucosa constituted the most common, but usually a clinically insignificant, type of vaginal cyst. Dilation of paraurethral glands and ducts could not adequately explain all the several cysts lined by urothelium. These lesions were difficult to distinguish on clinical grounds, alone, although mullerian cysts were nor symptomatic, due to their greater size.