Sida Niu1, Ryan D Didde2, Jennifer K Schuchmann3, Dani Zoorob4. 1. Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA. 2. University of Kansas School of Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd. MS 3016, Kansas City, KS, 66160, USA. rdidde@kumc.edu. 3. Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, KS, USA. 4. Department of Obstetrics and Gynecology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: Gartner's duct cysts (GDC) are benign lesions that may become symptomatic, leading to surgical intervention. There is no standard surgical technique for management of GDC. This article provides a comprehensive review of surgical the management of GDC. We also present a new technique using fluorescein dye to help delineate GDC walls and facilitate complete cyst excision. METHODS: We conducted a PubMed search for English-language articles without a defined time range. The search combined subject headings, title, abstract, and text words relating to Gartner duct cysts. Articles describing surgical management of GDC were included. Exclusion criteria included inadequate diagnosis of GDC, infected cysts, nonsurgical management, or article unavailable for interlibrary loan. A novel approach using intra-cyst fluorescein dye injection is described. RESULTS: Two hundred sixty-seven articles were identified via PubMed, and 34 articles were included in the review based on eligibility criteria. Concomitant genitourinary malformations occurred in 19 of the 92 surgically managed patients. Surgical techniques included cyst excision (50 patients), tetracycline injection following aspiration (15), marsupialization (14), unroofing/partial excision (9), and puncture/evacuation (4). Recurrences occurred in 4, 1, 0, 0, and 1 patient, respectively. One patient underwent uncomplicated fluorescein dye-assisted cyst excision with no recurrence 30 months post-procedure. CONCLUSIONS: The low incidence of GDCs necessitating surgical intervention has resulted in a lack of standard surgical technique, especially in patients with concurrent genitourinary malformations. Utilizing fluorescein dye provides a surgical method that can help confirm the absence of urologic involvement as well as facilitate precise excision of GDC.
INTRODUCTION AND HYPOTHESIS: Gartner's duct cysts (GDC) are benign lesions that may become symptomatic, leading to surgical intervention. There is no standard surgical technique for management of GDC. This article provides a comprehensive review of surgical the management of GDC. We also present a new technique using fluorescein dye to help delineate GDC walls and facilitate complete cyst excision. METHODS: We conducted a PubMed search for English-language articles without a defined time range. The search combined subject headings, title, abstract, and text words relating to Gartner duct cysts. Articles describing surgical management of GDC were included. Exclusion criteria included inadequate diagnosis of GDC, infected cysts, nonsurgical management, or article unavailable for interlibrary loan. A novel approach using intra-cyst fluorescein dye injection is described. RESULTS: Two hundred sixty-seven articles were identified via PubMed, and 34 articles were included in the review based on eligibility criteria. Concomitant genitourinary malformations occurred in 19 of the 92 surgically managed patients. Surgical techniques included cyst excision (50 patients), tetracycline injection following aspiration (15), marsupialization (14), unroofing/partial excision (9), and puncture/evacuation (4). Recurrences occurred in 4, 1, 0, 0, and 1 patient, respectively. One patient underwent uncomplicated fluorescein dye-assisted cyst excision with no recurrence 30 months post-procedure. CONCLUSIONS: The low incidence of GDCs necessitating surgical intervention has resulted in a lack of standard surgical technique, especially in patients with concurrent genitourinary malformations. Utilizing fluorescein dye provides a surgical method that can help confirm the absence of urologic involvement as well as facilitate precise excision of GDC.
Authors: Adela G Cope; Shannon K Laughlin-Tommaso; Abimbola O Famuyide; John B Gebhart; Matthew R Hopkins; Daniel M Breitkopf Journal: J Minim Invasive Gynecol Date: 2017-01-12 Impact factor: 4.137