The question of whether a Skene gland cyst can resolve without medical intervention is common. Skene’s glands, also known as the paraurethral glands, are located on either side of the urethra’s opening and secrete fluid for lubrication and urinary tract health. A cyst forms when a duct becomes blocked, causing the gland’s fluid to accumulate in a benign, fluid-filled sac. For small, asymptomatic cysts, a wait-and-see approach is often considered, depending on the cyst’s characteristics.
What Exactly Are Skene Gland Cysts?
The Skene’s glands are small glands situated in the tissue surrounding the lower end of the urethra. They secrete a mucus-like fluid through tiny ducts that open near the urethral meatus. Their function relates to lubrication and potentially providing antimicrobial properties.
A Skene gland cyst develops when the duct releasing glandular secretions becomes obstructed. This blockage prevents the fluid from draining, leading to its accumulation and the formation of a palpable, fluid-filled mass. Obstruction is frequently caused by inflammation or infection, often associated with urinary tract infections or sexually transmitted infections.
Most Skene gland cysts are relatively small, often less than one centimeter in diameter, and therefore cause no noticeable symptoms. When symptoms do occur, they typically involve the sensation of a small, movable lump near the urethral opening. Larger cysts may cause mild local discomfort, a feeling of pressure, or pain during sexual intercourse (dyspareunia).
The Likelihood of Natural Resolution
Small Skene gland cysts that do not present with symptoms often have the potential to resolve on their own. This spontaneous resolution happens if the duct blockage clears, allowing the trapped fluid to drain naturally. Many small, non-bothersome cysts are discovered incidentally during a routine pelvic examination and are simply monitored.
The medical approach for these non-symptomatic cases is typically “watchful waiting.” This means a healthcare provider observes the cyst over time for any changes in size or the onset of symptoms. This conservative management is preferred because these cysts are benign and may disappear without any need for invasive treatment. Resolution is a recognized possibility, but it is not guaranteed.
The likelihood of natural resolution is significantly influenced by the cyst’s internal status. A simple cyst, which is a sterile fluid collection, may reabsorb or drain if the obstruction is temporary. However, if the cyst becomes infected, it can develop into a Skene gland abscess, which is a painful collection of pus.
An abscess is highly unlikely to resolve on its own and requires medical intervention. The presence of bacterial infection means the condition has progressed beyond a simple blockage. Treatment is necessary to clear the infection and drain the material, as a painful, infected cyst will not clear up spontaneously.
When Professional Treatment Becomes Necessary
Medical consultation becomes necessary when a Skene gland cyst begins to cause discomfort or shows signs of complication. Any cyst that is rapidly increasing in size, causing severe pain, or interfering with daily activities warrants professional evaluation. Signs of a possible abscess, such as a painful, tender, swollen, and red lump, require immediate medical attention.
A cyst large enough to press on the urethra can cause significant urinary symptoms, including hesitancy, a weak urine stream, or urinary retention. Persistent symptoms like recurrent urinary tract infections or significant pain during intercourse indicate the cyst requires treatment.
The diagnostic process usually begins with a thorough pelvic examination. If the diagnosis is unclear, or to rule out a urethral diverticulum, imaging such as an ultrasound or magnetic resonance imaging (MRI) may be utilized. When intervention is necessary, several procedural treatments are available.
Needle Aspiration
Simple needle aspiration involves draining the fluid, which offers quick relief. However, this carries a high risk of the cyst recurring because the blocked duct remains.
Marsupialization
A more definitive treatment is marsupialization, a minor surgical procedure. The cyst is incised, and the edges are stitched open to create a permanent drainage pouch.
Surgical Excision
For recurrent or complicated cases, complete surgical excision of the cyst may be performed. This procedure minimizes the chance of the cyst returning.