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Skene glands are small glands that are located on the distal urethra. It is believed that they help with immune responses and also can secrete fluids to help promote flow through this cavity but at times they can become inflamed and infections leading to Skene duct cysts forming. These are a rare medical condition that are better known as periurethral and paraurethreal ductal cysts. The etiology of the these ductal cysts can be attributed to bacterial infections that clog the pores of the cyst and eventually lead to infections. In one population study to determine the underlying bacteria, there was a high prevalence of sexually transmitted infections and the eventual development of Skene duct cysts. The chief bacteria responsible for this was Chlamydia and N. gonorrhea. Opportunistic infections in patients suffering from HIV also could cause this type of infection. [1]

These cysts will be diagnosed mostly through clinical presentation. Most of the time, the glands will be less than 1 centimeter in diameter and will be asymptomatic. When patients start to notice dyspareunia, pain, swelling and patients will have an extensive history of recurrent urinary tract infections. If this cyst progresses without treatment, it will develop further into an abscess that can become much more complicated for patients to cope with. 

Once these glands get to the point of being a burden for the patient, urgent medical attention will be required in order to make this problem disappear. Patients will at first require a procedure called a preoperative urethrocystoscopy to determine if there is any underlying cancer causing this condition. To the location and the high rates of inflammation in these tissues, they are at a predisposed state to transform into cancer so this must be ruled out first in every situation. Don't worry, you will be given anesthesia to make sure that any pain you may be experiencing will not be magnified. Transvaginal ultrasonography will also be needed to measure the dimensions of the cyst to determine the approach during the surgical procedure soon to follow. 

Surgical excision will be the next step if everything turns out fine in the preoperative work-up. Typically, surgical excision will involve the doctors cutting into the cyst and removing one border of the cyst anchored in the vagina while the border of the cyst of attached to the urethra could be cauterized off. Catheters will be inserted for the first few days post-operation to allow the tissue to have a chance to heal to prevent another infection. In follow-up check-ups one year after the procedure, all patients in this investigation reported that they had no further symptoms of urinary discomfort and had no visual evidence of Skene ductal cysts during examination. [2]

Women can reduce their risk of developing these cysts by making sure they are using proper hygiene techniques. Cleaning vaginal openings after urination, wearing clean clothing daily and removing tampons routinely during period cycles can reduce the chance of infection. Management is straightforward and results are promising so if you are unlucky enough to get these problems, treatments are very effective. 

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