Atypical presentation of Skene's gland cyst

A nulliparous female presented with lower abdominal pain, initially diagnosed as incisional scar hernia, which was repaired. However, her pain persisted despite unremarkable radiology imaging. She was then diagnosed with anterior cutaneous nerve entrapment syndrome (ACNES) and underwent a right-sided ilioinguinal and iliohypogastric nerve block. Her pain returned after a month, accompanied by lower urinary tract symptoms. During examination, a paraurethral cyst was incidentally discovered. As her pain was unresponsive to medication, surgical excision of the cyst was planned as a possible cause of pain, leading to the complete resolution of her symptoms.