title: Perivaginal benign masses: diagnosis and therapy in a series of 66 women.
abstract: OBJECTIVE
  Benign perivaginal masses (PVM) are relatively rare. The aim of this study is, to create a higher awareness for these entities and to point out reliable diagnostics and an accurate treatment.
  
  
  METHODS
  The medical records of the Department of Obstetrics and Gynecology Tuebingen were searched for number and type of urogynecological surgery in general, and a surgery, which took place particularly owing to benign PVM, over a period of 5 years. Diagnostics, treatment, histology and postoperative management were summarized and analyzed. Vaginal endometriosis manifestations were not considered.
  
  
  RESULTS
  Between 2011 and 2015 a total number of 4.157 women underwent urogynecological surgery, 65 (1.6%) of these particularly because of benign PVM. The benign PVM in the patient cohort were composed as follows: urethral diverticula (UD), squamous epithelial inclusion cysts, periurethral cysts, Gartner's duct cysts, Müllerian cysts, pseudocysts, abscesses, epidermal inclusion cysts, angiofibromas, angiomyofibroblastomas, leiomyomas, solitary fibrous tumor and masses due to alloplastic materials. The PVM occurred singly or multiply. They were asymptomatic or accompanied by symptoms. Case history, clinical examination, pelvic floor sonography, urethrocystoscopy and MRI are essential tools for diagnostics. PVM simulated cystoceles and recto/enteroceles, were cause of an overactive bladder, dyspareunia, pain or were concomitants in women with stress urinary incontinence. The PVM were excised in 65 out of 66 cases, in one case an infected UD regressed completely under conservative antibiotic therapy.
  
  
  CONCLUSIONS
  The awareness for benign PVM is helpful for their diagnostics and management. As secondary pathology, intradiverticular stones and malignancy have to be considered.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tübingen, Germany.
authors.forename: Anna-Lena
authors.initials: AL
authors.lastname: Liaci
authors.affiliation: Department of Pathology, University Hospital Tuebingen, Liebermeisterstrasse 8, 72076, Tübingen, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Boesmueller
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tübingen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Huebner
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tübingen, Germany.
authors.forename: Sara Yvonne
authors.initials: SY
authors.lastname: Brucker
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tübingen, Germany. christl.reisenauer@med.uni-tuebingen.de.
authors.forename: Christl
authors.identifier: http://orcid.org/0000-0002-9676-5395
authors.initials: C
authors.lastname: Reisenauer
mesh_terms: D000328:Adult; D003560:Cysts / Q000175:diagnosis / Q000628:therapy; D004240:Diverticulum / Q000175:diagnosis / Q000628:therapy; D004414:Dyspareunia / Q000209:etiology; D004715:Endometriosis / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D014522:Urethral Diseases / Q000175:diagnosis* / Q000628:therapy*; D014623:Vaginal Diseases / Q000175:diagnosis* / Q000628:therapy*
keywords: Periurethral mass; Perivaginal mass; Transvaginal surgery; Urethral diverticulum