Introduction

Skene’s glands, also known as paraurethral glands, receiving their name from the physician who discovered them, Alexander Johnston Chalmers Skene, are found in those assigned female at birth and are located on the upper wall of the vagina. Skene’s glands are branched and tubular and secrete fluid which empties into Skene’s ducts, also known as paraurethral ducts. They are very small and typically cannot be seen by the naked eye. Skene’s glands have several functions; they help keep the vagina lubricated during sexual intercourse, lubricate the urethra to help it stay open during urination, and can help protect the vagina from certain infections. Diseases of the Skene’s gland are rare but can include infections, trichomoniasis, and Skene’s gland cysts. 

Skene’s gland cysts refer to the presence of small sacs of fluid-filled tissue on the Skene’s gland. Though rare, people of any age can be impacted by Skene’s gland cysts, with the condition occurring in newborns. The cause of their occurrence in newborns is not known but infections and inflammation are often a result of Skene’s gland cysts in adults. Typically, due to their small size, Skene’s gland cysts do not cause signs and symptoms, but if they become large enough, they can cause difficulty urinating and pain during sexual intercourse. A physical examination is most often used to diagnose Skene’s gland cysts, though imaging techniques may sometimes be used too. Treatment is not always necessary for Skene’s gland cysts, though may be employed when the condition causes signs and symptoms and usually involves surgery.^{1 2}

Causes of skene’s gland cysts

Skene’s gland cysts can impact newborns; the cause of the condition in these cases is not known. However, in adults, Skene’s gland cysts can result from infections and inflammation. Infections associated with Skene’s gland cysts include gonorrhea, trichomoniasis, and tuberculosis.³

Gonorrhea

Gonorrhea is a sexually transmitted infection that is caused by a bacterium called Neisseria gonorrhoeae. This bacterium can be transmitted from one person to another through unprotected sexual intercourse, involving the vagina, penis, anus, or mouth, and through sharing sex toys. Gonorrhea commonly does not cause signs and symptoms, but, when it does, these signs and symptoms may include unusual discharge from the penis or vagina, pain during sexual intercourse, a burning sensation during urination, itchiness of the anus or mouth, and bleeding between periods. The condition can be cured using antibiotics. 

Trichomoniasis

Trichomoniasis is a sexually transmitted infection caused by a bacterium called Trichomonas vaginalis that is spread through semen and vaginal fluid. The majority of people with trichomoniasis never experience any signs and symptoms but the minority of those who do experience them may encounter unusual discharge from the penis or vagina, itchiness of the penis or vagina, burning during urination, and pain during sexual intercourse. The condition can be cured using antibiotics. 

Tuberculosis

Tuberculosis is an infection caused by mycobacterium tuberculosis which spreads from one person to another through being released into the air from coughing, sneezing, and talking. The condition most commonly impacts the lungs but can affect other organs, such as the brain and kidneys. Being infected with tuberculosis doesn’t necessarily cause signs and symptoms, with this being known as latent tuberculosis, but it can progress to active tuberculosis which does cause signs and symptoms. Signs and symptoms of the condition include coughing, chest pain, fatigue, weakness, loss of appetite, weight loss, chills, and a fever. The condition is treated with a variety of medications.

Signs and symptoms of skene’s gland cysts

As Skene’s gland cysts are typically small in size, they often do not cause any signs or symptoms. However, Skene’s gland cysts can grow, and, if they grow to a large enough size, they can cause several signs and symptoms:

• Frequent urination
• Difficulty urinating
• Pain during sexual intercourse
• Frequent urinary tract infections
• A small lump near the urethra

Diagnosis of skene’s gland cysts

Diagnosing Skene’s gland cysts can typically be done through a physical examination, specifically a pelvic examination. Sometimes, however, imaging techniques may be employed too.

Pelvic examination

A pelvic examination involves a physician examining your pelvic organs, such as your uterus, cervix, and vagina. Before starting a pelvic examination, you will be asked to remove your clothes and will be given a gown to wear. You will then be asked to lie on your back on a bed. A physician will visually inspect your pelvic organs, checking for any apparent physical abnormalities. Following this, a physician may place one or two fingers inside the vagina and use the other hand to gently press on the abdomen in that same area to feel for the shape and size of your organs. A speculum, a tool that is inserted into the vagina and can widen it, may then be used to help the physician inspect the region more easily. Usually, a pelvic examination takes around ten minutes to complete.

Imaging techniques

Sometimes imaging techniques may be used to help diagnose Skene’s gland cysts. Usually, an ultrasound scan or magnetic resonance imaging is employed.

Ultrasound scans, also known as sonograms, use sound waves to generate images of the inside of the body. Sound waves bounce off various parts of the body which creates echoes that allow for an image to be generated. An ultrasound probe, a small device which produces sound waves, is moved over the abdomen, on top of a layer of lubricating gel, and the inside of the part of the body the ultrasound probe moves over can be seen on a screen. Ultrasound scans usually take 15 to 45 minutes to complete.

Magnetic resonance imaging uses magnetic fields and radio waves to alter the movement of small particles in the body called protons, which move differently in different types of tissue. The information on how the protons move is recorded, which allows for a detailed image of the inside of the body to be generated. When undergoing magnetic resonance imaging, you will lie down on a bed that moves through a circular scanner. During the scan, you will need to lie as still as possible. The radiographer will communicate the necessary instructions to you. Typically magnetic resonance imaging lasts from 15 to 90 minutes.

Treatment of skene’s gland cysts

Skene’s gland cysts don’t need treatment if they are not causing any signs and symptoms. In some cases, Skene’s gland cysts can resolve themselves. However, if the condition is causing signs and symptoms, surgery may be needed. Surgery may involve the removal of fluid from the cyst using a needle or removing the cyst completely. Rarely, Skene’s gland cysts come back after surgery.

FAQs

What are skene’s glands?

Skene’s glands are found in those assigned females at birth and are located on the upper wall of the vagina. Skene’s glands are branched and tubular and secrete fluid which empties into Skene’s ducts, also known as paraurethral ducts. They are very small and typically cannot be seen by the naked eye. Skene’s glands help keep the vagina lubricated during sexual intercourse, they lubricate the urethra to help it stay open during urination and can help protect the vagina from certain infections.^{1 2}

Can skene’s gland cysts be prevented?

As the cause of Skene’s gland cysts in newborns is not known, they cannot be prevented in these cases. A method of prevention in adults has also not been established, but taking measures to avoid infections may be helpful, such as using protection when having sexual intercourse to avoid sexually transmitted infections.

Can skene’s gland cysts impact sexual function?

Skene’s gland cysts do not typically cause signs and symptoms. However, if they grow to a large enough size then they can, potentially resulting in pain during sexual intercourse.

Summary 

Skene’s gland cysts small sacs of fluid-filled tissue on the Skene’s gland. They are rare, but, when they do occur, they impact those assigned female at birth across all ages. What causes Skene’s gland cysts in newborns is not known but infections and inflammation are responsible for their occurrence in adults. Due to their small size, Skene’s gland cysts typically do not cause signs and symptoms. However, Skene’s gland cysts can grow to large sizes, which may result in difficulty urinating and pain during sexual intercourse. Diagnosing Skene’s gland cysts is often done through physical examination but imaging techniques may sometimes be used too. Treatment is often not needed for Skene’s gland cysts, however, it may be necessary, through surgery, if the condition is causing signs and symptoms.