Gartner duct cyst: Embryonic remnant of wolffian (mesonephric) duct, lined with nonmucinous columnar cells

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  Associated with renal/ureteral/müllerian anomalies

Ultrasound is modality of choice

Well-defined cyst with thin walls, may contain septa

Anechoic to hypoechoic with increased through transmission

Separate from cervix, in anterolateral vaginal wall

Infection or hemorrhage → increased echogenicity of fluid

Rarely, large enough to cause urethral obstruction

Cyst may be seen posterior to bladder or protrude into bladder, mimicking ureterocele or urethral diverticulum

MR provides better resolution and spatial differentiation from other organs

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  Usually low T1 signal intensity and high T2 signal intensity

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    Hemorrhage or proteinaceous debris results in high T1 and T2 signal intensity

No internal flow on Doppler

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  Helps to confirm cystic nature rather than solid mass, such as vaginal tumor

Nabothian cysts

Vaginal inclusion cysts

Urethral diverticulum

Ectopic ureterocele

Endometriosis

If solid-appearing, consider vaginal tumors or cervical/vaginal polyp

Associations

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  Müllerian duct anomalies

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    Unicornuate, bicornuate, didelphys, or septate uterus

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  Renal anomalies

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    Ipsilateral renal dysgenesis/agenesis

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    Cross-fused ectopia/ectopic ureter

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  Diverticulosis of fallopian tubes (salpingitis isthmica nodosa)

Occurs in 1-2% of women; usually asymptomatic

Incidental finding on imaging or pelvic examination

Symptomatic if large: Pelvic pressure symptoms, dyspareunia, obstructed labor

Infection/hemorrhage may cause acute pain

May present with urologic symptoms

In females with ipsilateral renal dysgenesis, ureterocele-like “cyst” without associated ureteric dilatation is highly suspicious for Gartner duct cyst

Partial withdrawal of transvaginal probe or light pressure helpful to minimize cyst compression

Transperineal sonography can be alternative