A girl presents, with cystic swelling at the junction of lower 1/3rd and upper 2/3rd of anterior wall of vagina at 10 0' Clock position. The Diagnosis is :

Ans. is b i.e. Ganer's cyst Ganer's cyst is a cyst formed in Ganer duct. Ganer's duct is a remnant of Wolffian duct. The duct passes downward by the side of the uterus to the level of internal os. It then runs forward to reach the anteriolateral aspect of the vaginal wall and may reach down as far as the hymen. The cyst can be diagnosed by its position as it is found on the lateral or anterolateral wall (here 10 0' clock position) of the vagina. lnfact majority of the vaginal cysts arise from Ganer's duct. They can be distinguished from Baholin's cyst, urethrocele, cystocele and urethral diveiculum by their position, by the fact they do not disappear with pressure or with change of posture and by demonstrating with around or other means that they do not communicate with the bladder or urethra. On the other hand Baholin's cyst arises from Baholin's gland which lies near the junction of middle and posterior third of labia majora therefore the cyst is also found there (not on the junction of lower 1/3 and upper 2/ 3 anterior wall of vagina). Vaginal inclusion cyst (Shaw 14/e, p 122) is mainly seen at lower end of the vagina on its posterior surface and is caused by tags of mucosa embedding inside the scar that later forms a cyst.