rpmjResearch'n Practical Medicine JournalResearch and Practical Medicine Journal2410-1893"QUASAR", LLC10.17709/2409-2231-2019-7-1-5rpmj-499Research ArticleОбзорыReviewПарауретральные кисты у женщин. Особенности диагностикиParaurethral cysts in women. Features of diagnosticshttps://orcid.org/0000-0002-0792-6012КостинА. А.KostinA. A.

Костин Андрей Александрович – член-корреспондент РАН, д.м.н., профессор, заведующий кафедрой урологии, онкологии и радиологии ФПК МР

первый заместитель генерального директора 

SPIN: 8073-0899,

Scopus Author ID: 16175361500

Andrei A. Kostin – corresponding member of the Russian Academy of Sciences, Dr. Sci. (Med.), professor, head of department of urology, oncology and radiology Faculty of Advanced Training of Medical Workers 

first deputy general director 

SPIN: 8073-0899,

Scopus Author ID: 16175361500

ШаплыгинЛ. В.ShaplyginL. V.

Шаплыгин Леонид Васильевич – заслуженный врач РФ, д.м.н., профессор кафедры урологии и оперативной нефрологии с курсом онкоурологии Медицинского института 

SPIN: 6054-0934

Leonid V. Shaplygin – Dr. Sci. (Med.), professor of department of urology and operative Nephrology with course of oncourology of the Medical Institute 

SPIN: 6054-0934

https://orcid.org/0000-0002-4468-3670КульченкоН. Г.KulchenkoN. G.

Кульченко Нина Геннадьевна – к.м.н., врач-уролог, врач ультразвуковой диагностики, старший преподаватель кафедры гистологии, цитологии и эмбриологии Медицинского института 

Адрес: 117198, г. Москва, ул. Миклухо-Маклая, д. 6  

SPIN: 1899-7871

Nina G. Kulchenko* – Cand. Sci. (Med.), urologist, senior lectures of the departmens of histology, cytology and embryology of the Medical Institute 

SPIN: 1899-7871

kle-kni@mail.ruМансурА.MansurA.

Мансур Ахмад – врач-уролог, ассистент кафедры урологии и оперативной нефрологии с курсом онкоурологии Медицинского института

Ahmad Mansur – urologist, assistant of department of urology and operative nephrology with course of oncourology of the Medical Institute

ШульпинаИ. С.ShulpinaI. S.

Шульпина Ирина Сергеевна – врач-уролог, ассистент кафедры урологии и оперативной нефрологии с курсом онкоурологии Медицинского института

Irina S. Shulpina – urologist, assistant of department of urology and operative nephrology with course of oncourology of the Medical Institute

ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской Федерации; ФГАОУ ВО «Российский университет дружбы народов»РоссияNational Medical Research Radiological Centre; Peoples Friendship University of Russia (RUDN University)Russian FederationФГАОУ ВО «Российский университет дружбы народов»РоссияPeoples Friendship University of Russia (RUDN University)Russian Federation202012032020714854Copyright © Костин А.А., Шаплыгин Л.В., Кульченко Н.Г., Мансур А., Шульпина И.С., 20202020Костин А.А., Шаплыгин Л.В., Кульченко Н.Г., Мансур А., Шульпина И.С.Kostin A.A., Shaplygin L.V., Kulchenko N.G., Mansur A., Shulpina I.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpmj.ru/rpmj/article/view/499

Парауретральные кисты встречаются у 1–6% женщин в возрасте от 20 до 60 лет. В большинстве случаев клиническое течение парауретральных кист бессимптомное, поэтому их диагностика может вызывать затруднения. Женщины с парауретральными кистами могут предъявлять жалобы на боль, диспареунию, нарушение мочеиспускания. Размер кисты более 2 см оказывает влияние на качество жизни пациентки и чаще всего провоцирует симптомы нижних мочевыводящих путей, в том числе признаки обструкции. Парауретральные кисты необходимо дифференцировать с другими образованиями промежности. В этой статье представлен обзор литературы об этиологии, клиническом течении и диагностике парауретральных кист. Также освещены основные моменты дифференциальной диагностики парауретральной кисты с дивертикулом уретры, аденокарциномой. Учитывая особенность анатомического расположения парауретральных кист и специфику их лечения, данная проблема принимает междисциплинарный характер и требует внимания таких специалистов, как уролог, гинеколог, хирург.

In women aged from 20 up to 60 years paraurethral cysts occur in 1–6%. In most cases, the clinical course of paraurethral cysts is asymptomatic, so their diagnosis can cause difficulties. Women who have paraurethral cysts may complain of pain, dyspareunia, and urinary disorders. The size of a cyst more than 2 cm can affect the quality of patient’s life, and very often causes symptoms of the lower urinary tract, including obstructive ones. Paraurethral cysts need to be differentiated other perineal formations. This article presents a review of the literature on the etiology, clinical course and diagnosis of paraurethral cysts. The main points of differential diagnosis of paraurethral cyst with urethral diverticulum, adenocarcinoma are also consecrated. Taking into consideration the anatomical location and the specifics of the treatment of paraurethral cysts, this problem has an interdisciplinary nature and requires the attention of specialists such as: urologist, gynecologist, surgeon.

парауретральная кистадиагностикаультразвуковое исследованиеМРТдивертикул уретрыаденокарциномаparaurethral cystdiagnosisultrasound examinationMRIurethral diverticulumadenocarcinomaReferencesPrakash G, Karan S, Sankhwar SN, Karan S. Paraurethral cyst with multiple stones: A rare case report. Urol Ann. 2016; 8 (4):509–511. https://doi.org/10.4103/0974–7796.192088Prakash G, Karan S, Sankhwar SN, Karan S. Paraurethral cyst with multiple stones: A rare case report. Urol Ann. 2016; 8 (4):509–511. https://doi.org/10.4103/0974–7796.192088Аполихина И.А., Тетерина Т.А., Евсеева М.М. Консервативное лечение пациентки с кистами парауретральных желез. Акушерство и гинекология. 2012; 2:93–95.Apolikhina I.A., Teterina T.A., Evseyeva M.M. Medical treatment in a female patient with paraurethral cysts. Journal of Obstetrics and Gynecology. 2012; 2:93–95. (In Russian).Blaivas JG, Flisser AJ, Bleustein CB, Panagopoulos G. Periurethral masses: Etiology and diagnosis in a large series of women. Obstet Gynecol. 2004; 103 (5 Pt 1):842–847.Blaivas JG, Flisser AJ, Bleustein CB, Panagopoulos G. Periurethral masses: Etiology and diagnosis in a large series of women. Obstet Gynecol. 2004; 103 (5 Pt 1):842–847.Desmarais CM. Skene's Gland Abscess: Detection with Transperineal Sonography. Journal of diagnostic medical sonography. 2015; 31 (6):390–393. https://doi.org/10.1177/8756479315599545Desmarais CM. Skene's Gland Abscess: Detection with Transperineal Sonography. Journal of Diagnostic Medical Sonography. 2015; 31 (6):390–393. https://doi.org/10.1177/8756479315599545Пушкарь Д.Ю., Анисимов А.В. Дифференциальная диагностика и лечение парауретральной кисты и/или дивертикула. Урология. 2007; 4:49–54.Pushkar D. Yu., Anisimov A.V. Paraurethral cyst and/or urethral diverticulum – differential diagnosis. Urologiya. 2007; 4:49–54. (In Russian).Anderson SR. Benign vulvovaginal cysts. Diag Histop. 2010; 16:495–499.Anderson SR. Benign vulvovaginal cysts. Diag Histop. 2010; 16:495–499.Tepper S. L., Jagirdar J., Heath D., Geller S.A. Homology between the female paraurethral (Skene's) glands and the prostate. Immunohistochemical demonstration. Arch. Pathol. Lab. Med. 2006; 108 (5):423–425.Tepper S. L., Jagirdar J., Heath D., Geller S.A. Homology between the female paraurethral (Skene's) glands and the prostate. Immunohistochemical demonstration. Arch. Pathol. Lab. Med. 2006; 108 (5):423–425.Ceyhan M., Nural MS., Oztas T., Bayrak IK., Rizalar R. Paraurethral cyst: a case report. Central European Journal of Medicine. 2010; 5 (2):243–245. https://doi.org/10.2478/s11536–008– 0076–0Ceyhan M., Nural MS., Oztas T., BayrakIK., Rizalar R. Paraurethral cyst: a case report. Central European Journal of Medicine. 2010; 5 (2):243–245. https://doi.org/10.2478/s11536–008–0076–0Battaglia C, Venturoli S. 3–D ultrasonographic appearance of two intermittent paraurethral cysts: a case report. J Sex Med. 2010; 7:2903–2906.Battaglia C, Venturoli S. 3–D ultrasonographic appearance of two intermittent paraurethral cysts: a case report. J Sex Med. 2010; 7:2903–2906.Sharifi–Aghdas F, Ghaderian N. Female paraurethral cysts: experience of 25 cases. BJU Int. 2004; 93:353–356.Sharifi–Aghdas F, Ghaderian N. Female paraurethral cysts: experience of 25 cases. BJU Int. 2004; 93:353–356.Анисимов А.В. Современные возможности дифференциальной диагностики парауретральных кистозных образований у женщин. Врач-аспирант. 2010; 42 (5.1):193–201.Anisimov A.V. Modern possibilities of differential diagnostics of paraurethral cystic formations at women. Vrach-aspirant. 2010; 42 (5.1):193–201. (In Russian).Sharifiaghdas F., Daneshpajooh A., Mirzaei M. Paraurethral cyst in adult women: experience with 85 cases. Urol J. 2014; 11 (5):1896–1899.Sharifiaghdas F., Daneshpajooh A., Mirzaei M. Paraurethral cyst in adult women: experience with 85 cases. Urol J. 2014; 11 (5):1896–1899.Köse O, Aydemir H, Metin O, Budak S, Sonbahar A, Adsan O. Experiences with the management of paraurethral cysts in adult women. Cent European J Urol. 2014; 66 (4):477–480. https://doi.org/10.5173/ceju.2013.04.art24Köse O, Aydemir H, Metin O, Budak S, Sonbahar A, Adsan O. Experiences with the management of paraurethral cysts in adult women. Cent European J Urol. 2014; 66 (4):477– 480. https://doi.org/10.5173/ceju.2013.04.art24Пушкарь А.Ю., Гумин Л.М., Анисимов А.В. Применение магнитно-резонансной томографии в диагностике нарауретральных образований у женщин. Российский вестник акушера-гинеколога. 2008; 8 (S9):60.Pushkar D.Yu., Gumin L.M., Anisimov A.V. The use of magnetic resonance imaging in the diagnosis of paraurethral formations in women. Russian Bulletin of the Obstetrician-Gynecologist. 2008; 8 (S9):60. (In Russian).Foster J, Lemack G, Zimmern P. Skene’s gland cyst excision. Int Urogynecol J Pelvic Floor Dysfunct. 2016; 27 (5):817–820.Foster J, Lemack G, Zimmern P. Skene’s gland cyst excision. Int Urogynecol J Pelvic Floor Dysfunct. 2016; 27 (5):817–820.Nickles SW, Burgis JT, Menon S, Bacon JL. Prepubertal Skene’s abscess. J Ped Adol Gynecol. 2009; 22:21–22.Nickles SW, Burgis JT, Menon S, Bacon JL. Prepubertal Skene’s abscess. J Ped Adol Gynecol. 2009; 22:21–22.Heller DS. Lesions of Skene Glands and Periurethral Region: A Review. Journal of lower genital tract disease. 2015; 19 (2):170–174.Heller DS. Lesions of Skene Glands and Periurethral Region: A Review. Journal of Lower Genital Tract Disease. 2015; 19 (2):170– 174.Peschers U, Jundt K. Ultrasound in urogynecology. Urologe A. 2004; 43 (11):1357–61.Peschers U, Jundt K. Ultrasound in urogynecology. Urologe A. 2004;43 (11):1357–61.Hahn WY, Israel GM, Lee VS. MRI of female urethral and periurethral disorders. American journal of roentgenology. 2004; 182 (3):677–682.Hahn WY; Israel GM; Lee VS. MRI of female urethral and periurethral disorders. American Journal of Roentgenology. 2004; 182 (3):677–682.Bennett GL, Hecht EM, Tanpitukpongse TP, Babb JS, Taouli B, Wong S, Rosenblum N, Kanofsky JA, Lee VS. MRI of the Urethra in Women with Lower Urinary Tract Symptoms: Spectrum of Findings at Static and Dynamic Imaging. American journal of roentgenology. 2009; 193 (6):1708–1715. https://doi.org/10.2214/AJR.08.1547Bennett GL, Hecht EM, Tanpitukpongse TP, Babb JS, Taouli B, Wong S, Rosenblum N, Kanofsky JA, Lee VS. MRI of the Urethra in Women with Lower Urinary Tract Symptoms: Spectrum of Findings at Static and Dynamic Imaging. American Journal of Roentgenology. 2009; 193 (6):1708–1715. https://doi.org/10.2214/AJR.08.1547Громов А.И., Буйлов В.М. Лучевая диагностика и терапия в урологии: национальное руководство.М.: ГЭОТАР-Медиа, 2011, 544 с.Gromov AI, Builov VM. Radiation diagnostics and therapy in urology. Мoscow: «GEOTAR-Media» Publ., 2011, 544 p. (In Russian).Portnoy O., Kitrey N, Eshed I, Apter S, Amitai MM, Golomb J. Correlation between MRI and double-balloon urethrography findings in the diagnosis of female periurethral lesions. European journal of radiology. 2013; 82 (12):2183–2188. https://doi.org/10.1016/j.ejrad.2013.08.005Portnoy O., Kitrey N, Eshed I, Apter S, Amitai MM, Golomb J. Correlation between MRI and double-balloon urethrography findings in the diagnosis of female periurethral lesions. European Journal of Radiology. 2013; 82 (12):2183–2188. https://doi.org/10.1016/j.ejrad.2013.08.005Archer R, Blackman J, Stott M, Barrington J. Urethral diverticulum. Obstetrician & Gynaecologist. 2015; 17 (2):125–129. https://doi.org/10.1111/tog.12192Archer R, Blackman J, Stott M, Barrington J. Urethral diverticulum. Obstetrician & Gynaecologist. 2015; 17 (2):125– 129. https://doi.org/10.1111/tog.12192Asfaw TS, Greer JA, Ramchandani P, Schimpf MO. Utility of preoperative examination and magnetic resonance imaging for diagnosis of anterior vaginal wall masses. Int Urogynecol J. 2012Aug; 23 (8):1055–1061. https://doi.org/10.1007/s00192–012–1666–6Asfaw TS, Greer JA, Ramchandani P, Schimpf MO. Utility of preoperative examination and magnetic resonance imaging for diagnosis of anterior vaginal wall masses. Int Urogynecol J. 2012 Aug; 23 (8):1055–1061. https://doi.org/10.1007/s00192– 012–1666–6Fortunato P., Schettini M., Gallucci M. Diagnosis and therapy of the female urethral diverticula. Int Urogynecol J Pelvic Floor Dysfunct. 2001; 12 (1):51–57.Fortunato P., Schettini M., Gallucci M. Diagnosis and therapy of the female urethral diverticula. Int Urogynecol J Pelvic Floor Dysfunct. 2001; 12 (1):51–57.Greenwell TJ, Spilotros M. Urethral diverticula in women. Nature reviews urology. 2015; 12 (12):671–680. https://doi.org/10.1038/nrurol.2015.230Greenwell TJ, Spilotros M. Urethral diverticula in women. Nature reviews urology. 2015; 12 (12):671–680. https://doi.org/10.1038/nrurol.2015.230Abbey J., Hawary A. Female urethral diverticula: An elusive pathology that can cause significant problems. Journal of Clinical Urology. 2018; 11 (4):266–270. https://doi.org/10.1177/2051415817740796Abbey J., Hawary A. Female urethral diverticula: An elusive pathology that can cause significant problems. Journal of Clinical Urology. 2018; 11 (4):266–270. https://doi.org/10.1177/2051415817740796Boyce L, Belfield J. Urethral diverticulum: a review of the literature and local experience. Urol News. 2016; 20:30–33.Boyce L, Belfield J. Urethral diverticulum: a review of the literature and local experience. Urol News. 2016; 20:30–33.Mukhtar BMB, Solomon E, Naaseri S, Aughwane P, Pakzad M, Hamid R, Ockrim JL, Greenwell TJ. Urethral diverticula in women are associated with increased urethra-sphincter complex volumes: A potential role for high-tone nonrelaxing sphincter in their etiology? Neurourol Urodyn. 2019 Sep; 38 (7):1859–1865. https://doi.org/10.1002/nau.24080Mukhtar BMB, Solomon E, Naaseri S, Aughwane P, Pakzad M, Hamid R, Ockrim JL, Greenwell TJ. Urethral diverticula in women are associated with increased urethra-sphincter complex volumes: A potential role for high-tone nonrelaxing sphincter in their etiology? Neurourol Urodyn. 2019 Sep; 38 (7):1859–1865. https://doi.org/10.1002/nau.24080Liu D, Qing ZZ, Wen LM. The use of tomographic ultrasound imaging on three-dimensional translabial ultrasound: a diagnostic sign for urethral diverticulum. Int Urogynecol J. 2019 Nov 28. https://doi.org/10.1007/s00192–019–04111–8Liu D, Qing ZZ, Wen LM. The use of tomographic ultrasound imaging on three-dimensional translabial ultrasound: a diagnostic sign for urethral diverticulum. Int Urogynecol J. 2019 Nov 28. https://doi.org/10.1007/s00192–019–04111–8Gugliotta G, Calagna G, Adile G, Polito S, Speciale P, Perino A, et al. Use of trans-labial ultrasound in the diagnosis of female urethral diverticula: A diagnostic option to be strongly considered. J Obstet Gynaecol Res. 2015 Jul; 41 (7):1108–1114. https://doi.org/10.1111/jog.12676Gugliotta G, Calagna G, Adile G, Polito S, Speciale P, Perino A, et al. Use of trans-labial ultrasound in the diagnosis of female urethral diverticula: A diagnostic option to be strongly considered. J Obstet Gynaecol Res. 2015 Jul; 41 (7):1108–1114. https://doi.org/10.1111/jog.12676Gillor M., Dietz HP. Translabial ultrasound imaging of urethral diverticula. Ultrasound in Obstetrics & Gynecology. 2019; 54 (4):552–556. https://doi.org/10.1002/uog.20305Gillor M., Dietz HP. Translabial ultrasound imaging of urethral diverticula. Ultrasound in Obstetrics & Gynecology. 2019; 54 (4):552–556. https://doi.org/10.1002/uog.20305Dell'Atti L., Galosi AB. Female Urethra Adenocarcinoma. Clinical Genitourinary Cancer. 2018; 16 (2):263–267. https://doi.org/10.1016/j.clgc.2017.10.006Dell'Atti L., Galosi AB. Female Urethra Adenocarcinoma. Clinical genitourinary cancer. 2018; 16 (2):263–267. https://doi.org/10.1016/j.clgc.2017.10.006Awakura Y., Nonomura M., Itoh N., Maeno A., Fukuyama T. Adenocarcinoma of the female urethral diverticulum treated by multimodality therapy. International Journal of Urology. 2003; 10 (5):281–283. https://doi.org/10.1046/j.1442–2042.2003.00613.xAwakura Y., Nonomura M., Itoh N., Maeno A., Fukuyama T. Adenocarcinoma of the female urethral diverticulum treated by multimodality therapy. International Journal of Urology. 2003; 10 (5):281–283. https://doi.org/10.1046/j.1442–2042.2003.00613.xPongtippan A., Malpica A., Levenback C., Deavers MT., Silva EG. Skene's gland adenocarcinoma resembling prostatic adenocarcinoma. International Journal of Gynecological Pathology. 2004; 1:71–74. https://doi.org/10.1097/01. pgp.0000101144.79462.39Pongtippan A., Malpica A., Levenback C., Deavers MT., Silva EG. Skene's gland adenocarcinoma resembling prostatic adenocarcinoma. International Journal of Gynecological Pathology. 2004; 1:71–74. https://doi.org/10.1097/01.pgp.0000101144.79462.39Massari F, Ciccarese C, Modena A, Maines F, Segala D, Luchini C, Marcolini L, Cavicchioli F, Cavalleri S, Bria E, Brunelli M, Martignoni G, Artibani W, Tortora G. Adenocarcinoma of the paraurethral glands: a case report. Histol Histopathol. 2014; 29 (10):1295–1303. https://doi.org/10.14670/HH 29.1295Massari F, Ciccarese C, Modena A, Maines F, Segala D, Luchini C, Marcolini L, Cavicchioli F, Cavalleri S, Bria E, Brunelli M, Martignoni G, Artibani W, Tortora G. Adenocarcinoma of the paraurethral glands: a case report. Histol Histopathol. 2014; 29 (10):1295–1303. https://doi.org/10.14670/HH 29.1295.Tregnago AC, Epstein JI. Skene's Glands Adenocarcinoma A Series of 4 Cases. American Journal of Surgical Pathology. 2018; 42 (11):1513–1521. https://doi.org/10.1097/PAS.0000000000001108Tregnago AC, Epstein JI. Skene's Glands Adenocarcinoma A Series of 4 Cases. American Journal of Surgical Pathology. 2018; 42 (11):1513–1521. https://doi.org/10.1097/PAS.0000000000001108Nagano M, Hasui Y, Ide H, Itoi T, Takehara T, Osada Y. Primary adenocarcinoma arising from a paraurethral cyst in a female patient. Urol Int. 2002; 69 (3):244–246.Nagano M, Hasui Y, Ide H, Itoi T, Takehara T, Osada Y. Primary adenocarcinoma arising from a paraurethral cyst in a female patient. Urol Int. 2002; 69 (3):244–246.Nagano M, Hasui Y, Ide H, Itoi T, Takehara T, Osada Y. Primary adenocarcinoma arising from a paraurethral cyst in a female patient. Urol Int. 2002; 69 (3):244–246.

The authors declare that there are no conflicts of interest present.