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Gartner Duct Cyst

What Is It, Symptoms, and More

Author:Nikol Natalia Armata

Editors:Alyssa Haag,Emily Miao, PharmD

Illustrator:Jillian Dunbar

Copyeditor:David G. Walker


What is a Gartner duct cyst?

Gartner duct cysts (GDCs) are vaginal cysts that can develop along parts of the mesonephric duct, also known as the Wolffian duct, when the duct has failed to regress. The remnant of the mesonephric duct is known as the Gartner duct. GDCs are usually located along the anterior and lateral parts of the vaginal wall and, rarely, on the posterolateral wall. 

Remaining Gartner ducts are identified in approximately 25% of all adult individuals with vaginas; however, only 1% will develop Gartner duct cysts. Although GDCs are congenital (i.e., present from birth), they are usually not identified until adolescence and, sometimes, in late middle age (i.e., 45 - 65 years of age). 

Can a Gartner duct cysts be cancerous?

Gartner duct cysts are typically benign; however, malignant, or cancerous, transformations have been reported. 

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What causes Gartner duct cysts?

GDCs arise from remnants of the mesonephric ducts (Wolffian ducts) that do not regress successfully during the development of the reproductive and urinary systems. The mesonephric duct refers to an embryonic structure that exists in all embryos but is maintained only by the presence of increased testosterone in order to form the testicles, epididymis, and prostate in embryos with XY chromosomes. Occasionally, parts of the duct may remain in embryos with XX chromosomes, which may later present with GDCs. 

What are the signs and symptoms of a Gartner duct cyst?

Generally, Gartner duct cysts are small, usually less than 2 cm, and asymptomatic. However, some cysts may enlarge and cause mild symptoms, such as mild discomfort in the lower abdomen (e.g., vaginal pressure, pelvic pain), dyspareunia (i.e., painful intercourse), and loss of control of urination or defecation. In rare cases with large cysts, difficulties during vaginal delivery have been described.

Notably, Gartner duct cysts are typically associated with congenital malformations of the urinary tract, such as ipsilateral renal agenesis, or the absence of the kidney on one side; renal dysplasia, or the atypical development of the kidney; urethral diverticulum, or the formation of pockets along the urethra; and ectopic ureter, a ureter that does not connect to the bladder and drains to a different site. 

How is a Gartner duct cyst diagnosed and treated?

In order to diagnose a Gartner duct cyst, a detailed gynecological examination of the individual and a review of their medical history is essential. Gentle palpation of the vaginal wall, especially of the anterolateral wall, may reveal a cyst. Similarly, a speculum exam can ensure a clear view of the vaginal walls and may also reveal the presence of a cyst. Additional imaging can be used, including an ultrasound, CT, or MRI, for a more detailed visualization of the cyst and its borders. The use of injected fluorescein dye is very important in identifying the relationship between the Gartner duct cyst and the urinary system

Treatment of Gartner duct cysts is only recommended when symptoms are significant. In mild symptomatic cases, treatment typically involves cyst drainage and intracystic tetracycline sclerotherapy. In more severe cases, surgical removal of the cyst is recommended and can be achieved using various techniques. Complete surgical excision of the cyst is the preferred method as it minimizes the possibility of recurrence. Alternatively, cyst marsupialization can be performed, in which the edges of the incision are sutured together to form a permanently open "pocket," allowing additional fluid to drain freely.

What are the most important facts to know about Gartner duct cysts?

Gartner duct cysts are cystic lesions that typically present in the anterolateral wall of the vagina. They develop from the remaining parts of the Wolffian ducts that do not regress completely in individuals assigned female at birth. These vaginal cysts are mostly benign with only mild symptoms. GDCs are frequently associated with malformations of the urinary tract, which may even interfere with the available treatment options. Physical examination is essential for diagnosis and can be enhanced by further imaging. Surgical excision of the vaginal cyst is preferred among the treatment options and is necessary only if the individual is severely symptomatic. 

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Related links

Vaginal and vulvar disorders: Pathology review
Development of the reproductive system
Development of renal system
Renal agenesis
Cervix and vagina histology

Resources for research and reference

Bala, R., Nagpal, M., Kaur, M., & Kaur, H. (2015). Posterior vaginal wall Gartner's duct cyst. Journal of Mid-Life Health, 6(4), 187–190. DOI: 10.4103/0976-7800.172354 

Cope, A. G., Laughlin-Tommaso, S. K., Famuyide, A. O., Gebhart, J. B., Hopkins, M. R., & Breitkopf, D. M. (2017). Clinical Manifestations and Outcomes in Surgically Managed Gartner Duct Cysts. Journal of Minimally Invasive Gynecology, 24(3), 473–477. DOI: 10.1016/j.jmig.2017.01.003 

Hagspiel, K. D. (1995). Giant Gartner duct cyst: Magnetic resonance imaging findings. Abdominal Imaging, 20(6), 566–568. DOI: 10.1007/BF01256713 

Niu, S., Didde, R. D., Schuchmann, J. K., & Zoorob, D. (2020). Gartner's duct cysts: a review of surgical management and a new technique using fluorescein dye. International Urogynecology Journal, 31(1), 55–61. DOI: 10.1007/s00192-019-04091-9 

Yu, M., & Wang, S.M.. (2021). Embryology, Wolffian Ducts. In StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK557818/