58例阴道壁囊肿的临床病理学特征分析

Analysis of clinicopathological features of vaginal cysts:58 cases

目的探索良性阴道壁囊肿的临床病理学特征。方法回顾总结北京协和医院妇产科2000年以来住院诊治的阴道壁囊肿病例,对患病年龄、症状、部位、大小、手术方式以及病理结果进行分析。结果总结完整病历58份,患者年龄19～71岁,平均(40±10)岁,高峰发病年龄位于30～40岁(25例,43.1%)。49(84.5%)例无临床症状,其中16例是在诊断其他妇科疾病时发现阴道壁囊肿。9(15.5%)例阴道壁囊肿引起临床症状,分别为阴道胀痛/不适(5例)、性交后出血/不适(3例)以及下腹痛(1例)。23例(39.7%)囊肿位于阴道前壁。57例(98.3%)进行了阴道壁囊肿切除术,1例术中发生膀胱损伤。阴道壁囊肿的病理主要为Mullerian囊肿19例(32.8%)、Gartner囊肿18例(31.0%)和表皮包涵囊肿10例(17.2%)。尿道憩室误诊为阴道前壁囊肿1例(1.7%)。结论阴道壁囊肿大多数为良性无症状,多在妇科体检中发现。以Mullerian囊肿、Gartner囊肿和表皮包涵囊肿最为常见,进行阴道壁囊肿切除治疗。阴道前壁囊肿应警惕尿道憩室。

Objective： To explore the clinieopathological features of benign vaginal cysts. Methods： All cases of benign vaginal cysts diagnosed in Peking Union Medical College Hospital after 2000 were studied retrospectively. Age of onset, symptom, location, size, surgical pattern and pathological findings were analyzed. Results： The medical records for 58 cases of benign vaginal cysts were retrieved. The patients＇ age ranged from 19 to 71 years （40 ± 10 yrs）, with the peak age of onset between 30-40 years （25 cases, 43.1%）. 84.5% （49/58） of patients were asymptomatic, in which 16 patients were found vaginal cysts during other gynecological examinations. 15.5% （9/58） of patients were symptomatic and the symptoms related with cysts were vaginal pain/discomfort （5 cases）, bleeding/discomfort after intercourse （3 cases） and hypogastralgia （1 case）. 39.7% of lesions were located in the anterior vaginal wall （23 cases）. 98.3% of cases were treated with local excision of cyst, in which there happened one case of bladder injury. The main pathological results were as follows： 19 cases of mullerian cysts （32.8%）, 18 cases of Gartner＇s duct cysts （31.0%） and 10 cases of epidermal inclusion cysts （17.2%）. One urethral diverticulum （1.7%） was misdiagnosed as anterior vaginal cyst. Conclusions： Benign vaginal cysts are asymptomatic in the majority of cases and often discovered incidentally during gynecological examination. The most common pathological results were Mullerian cysts, Gartnerrs duct cysts and epidermal inclusion cysts. Most cases can be treated with local excision of cyst. Anterior vaginal cyst should be distinguished from urethral diverticulum.