Skene gland cyst
Longstanding non-painful mass at the vaginal introitus. Clinician not certain if cyst or urethral diverticulum hence the MRI scan
A vitamin E capsule (bright on T1 and T2) was placed by the patient at the site of palpable swelling
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2.5 cm cystic mass in the anterior introitus containing T1 hyerintensity indicative of proteinaceous fluid. It has a clear connection to the distal anterior vagina (arrows). It does not have the appearance of a urethral diverticulum as it has no connection with the urethra.
Skene glands are paired paraurethral glands that connect with the anterior vagina at the introitus via Skene ducts providing lubrication especially at the time of orgasm. They are analagous to the prostate and are sometimes called the "female prostate". If the ducts obstruct, secretions (said to have very similar chemical composition to prostatic fluid) build up leading to a fluid-filled mass. If large and symptomatic, treatment is surgical excision usually with excellent outcome.