INFECTED URETHRAL CYST WITH URETHRAL STENOSIS

A 50 year old woman came with dysuria and painful urination for 6 months.She had persistent pain in the urethral region.

She was seen by a Gynecologist and then referred to us for the management.

We saw a cyst around 2 cm at the urethral meatal region .The cyst was opened and marsupialised. The cystoscopy was performed before and after the surgery and urethral dilatation was done till 11/14 Hegars dilators.

The cyst was causing the narrowing of the meatus. 

We  have decided to keep the catheter for 48 hours and has been started on antibiotic therapy.We have instructed her to avoid sexual act for 2 weeks to prevent scarring of the region because of the trauma.

Urethral cyst:
The urethral cysts are because of the infection and blockage of the duct opening of the skenes gland (paraurethral glands).It appears as glistening , tense and bulging mass at the under-surface of the urethral meatus on the anterior wall of the vagina.Because of the urethral blockage it can cause weak and interrupted stream,misdirected stream, UTIs and dysuria. If infected it can lead to fever and painful micturition and pain at the site of the cyst.  

The important message was the lady continued to take antibiotics; leading to antibioma formation but no relief.A simple vaginal examination diagnosed the condition.It stresses the importance of pervaginal examination for urethral problems.