Vaginal mullerian cysts

A vaginal mullerian cyst in the vagina is a rare, benign fluid-filled lesion that forms in the vaginal wall of a woman.

Most cysts of this kind are small and have no symptoms, but some can become quite large and uncomfortable. Mullerian cysts are the second-most common type of cyst found in the vagina (after vaginal squamous inclusion cysts).

Mullerian cysts are lined by the same type of cells that endocervix and fallopian tubes are – columnar endocervical and tubo-endocervical-like cells. Causes of mullerian cysts can include trauma to the vaginal walls, perhaps due to a previous surgery.

Mullerian cysts are most often found in adult women, between the ages of 20 and 75. The peak age range for discovery is 30-40. Mullerian cysts can occur in any woman. Those who have had vaginal surgery have more of these cysts, as do those women who have a history of benign vaginal tumours.

Mullerian cysts are caused by the displacement of epithelium, which can occur in a foetus (with mullerian duct remnants) or after surgery.

Symptoms of mullerian cysts

  • Usually asymptomatic
  • Large cysts may cause discomfort and pain due to pressure
  • Cysts are painless
  • Usually found during examination
  • Looks like a polyp, and is soft
  • There is a noticeable lump in the vagina
  • Pain while using a tampon or having sex
  • Discomfort walking or sitting
  • It may itch or hurt

Diagnosis of mullerian cysts

Each case will be discovered and assessed as required, but diagnosing a mullerian cyst is likely to include a pelvic examination, sexually transmitted infection testing where applicable, and possibly scans. A biopsy may be requested, along with any other testing that seems important to your physician.

Issues can occur with mullerian cysts if the cyst turns into an infected abscess, which may cause fever and other symptoms. If the cyst bursts, secondary infection can be an issue that should be dealt with promptly. Large cysts may prove problematic for vaginal childbirth. Any surgery comes with risks, so make sure you have a great surgeon to avoid nerve or tissue damage.

Treatment of mullerian cysts

Treatment can include nothing – it might just recede on its own without treatment. There is likely to be a waiting period before any action is taken to see what happens. Drainage of the cyst may also be indicated, or surgical removal of the tissue.

Outcomes of mullerian cysts

Outcomes are good, since the cyst is benign and the treatment is straightforward.

Other types of vaginal or vulvar cysts

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Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)