Large Epithelial Inclusion Cysts after In-situ Vaginal Wall Sling Procedure

Kim, In Keun; Kim, Taek Sang; Choi, Seong

Abstract

Since the procedure of a full thickness vaginal wall sling for stress urinary incontinence was first described, concern has been raised regarding the potential formation of inclusion cysts due to buried vaginal mucosa. Recently, two female patients, who underwent an in-situ vaginal wall sling procedure, visited our department presenting with painless large anterior vaginal wall masses. The masses were cystic, and cyst excisions performed. The cyst fluid was aseptic and the cyst wall lined with stratified squamous epithelium. At the 1 year follow up, the patient remained continent and the cyst had not reformed. To our knowledge, this is the first reported case of inclusion cyst formation after an in-situ vaginal wall sling procedure in Korea. An epithelial inclusion cyst is an under-recognized complication of the in-situ advancing vaginal wall sling. The vaginal surgeon should be aware of the potential for an epithelial inclusion cyst and actively search for their formation at the postoperative examination following an in-situ sling placement.