Gynecology . ons. The small vaginal cysts do not ordinarily give subjective symptoms, but inmarried women they often interfere with coitus and sometimes with childbirth. The diagnosis of vaginal cysts is extremely easy, there being little else withwhich they could be confused. The cysts have a thin wall lined with a singlelayer of epithelium and contain a clear serous fluid. NEW GROWTHS 255 The treatment is operative. The smaller cysts can usually be shelled outwith comparative ease, though care must be exercised not to injure the larger cysts, especially those that extend inward a


Gynecology . ons. The small vaginal cysts do not ordinarily give subjective symptoms, but inmarried women they often interfere with coitus and sometimes with childbirth. The diagnosis of vaginal cysts is extremely easy, there being little else withwhich they could be confused. The cysts have a thin wall lined with a singlelayer of epithelium and contain a clear serous fluid. NEW GROWTHS 255 The treatment is operative. The smaller cysts can usually be shelled outwith comparative ease, though care must be exercised not to injure the larger cysts, especially those that extend inward and upward between theleaves of the broad ligament, may present serious technical difficulties. Themethods of removal must be determined by the exigencies of the individual case. Cysts of the anterior wall sometimes communicate with the urethra, in whichcase they are not true cysts, but are rather diverticula of the urethral is probable that most cysts of this type originate as periurethral Fig. 73.—Wall of a Vaginal power. At the bottom is the layer of squamous epithelium which lines the vagina. Abovethis is the connective- and muscle-tissue wall of the vagina and at the top a layer of cuboidal epithe-lium which lines the cyst. This is characteristic of a cyst of Gartners duct. In the lower part of the vagina, near the introitus, cysts may arise from theinclusion of small areas of epithelium following healing from lacerations or opera-tions for repair of the perineum where there has been an incomplete denudationof the mucous membrane. These cysts might properly be included under theterm perineal cysts, but, as they often result from a high denudation, theymay be situated well up in the vaginal canal, usually on one side. The contents of these cysts is a yellowish, semifluid, sebaceous material, andrepresents the activity of the included epithelium with retention of the secretion. 256 GYNECOLOGY They are usually about the size of a pea, though the


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