Paraurethral cysts are frequently mistaken both clinically and on MRI for urethral diverticulum. The aim of our study was to report and describe our management of paraurethral cysts in women.

We retrospectively reviewed a prospectively maintained database of 16 consecutive women of median age 35 [range 17-54] having surgical excision of paraurethral cysts between October 2011 and April 2017 for presenting symptoms, surgical management and outcomes.

15 (93.8%) women presented with a palpable vaginal lump.  Other complaints included dyspareunia, vaginal discharge and voiding difficulty. 10 (62.5%) were referred with a clinical and MRI diagnosis of urethral diverticulum.
8 (50%) had urodynamic evidence of BOO consequent to their cyst, whilst 3 (18.8%) had evidence of detrusor overactivity (2 in association with BOO). All cysts were solitary and measured from 1.1 to 4.5cm in maximum dimension. 10 (62.5%) patients had cyst excision, 5 (31.3%) had cyst excision, repair of underlying adherent distal urethra and interposition of paraurethral tissue whilst 1 (6.3%) had cyst excision, repair of adherent mid and distal urethra and interposition of a modified Martius labial fat pad flap. The median follow-up period was 6 months (2.5-35). No complications or recurrences were demonstrated and presenting symptoms resolved in 15 (93.8%).

Paraurethral cysts are often mistaken both clinically and on MRI for urethral diverticulum. They cause similar symptoms and are associated with urodynamic abnormalities in > 50%. Complete excision resolves symptoms in 93.8% but may required urethral repair and tissue interposition in 37.6%.

Complete excision of paraurethral cysts resolves symptoms in 93.8% but may required urethral repair and tissue interposition in 37.6%.