Generality
Skene's glands are two small structures belonging to the external female genital apparatus, located near the urethra meatus.
Also called paraurethral glands, their function is mainly related to sexual activity: in the excitement phase of the woman, these structures contribute to the secretion of a clear and viscous liquid which, pouring into the vaginal vestibule, acts as a lubricant.
Given their position, the Skene glands are mainly affected by inflammation, during which they increase in volume and are painful.
When obstructing the channels from which the lubricating fluid flows (Skene ducts), they may be cysts . The latter can remain for a long time asymptomatic but, if they become infected, they evolve into abscesses (that is, saccular formations containing pus).
Other conditions that can affect the Skene glands are trauma, neoplastic processes and congenital malformations of the genital tract.
The pathologies affecting the Skene glands require the evaluation of the gynecologist, who can carry out the correct diagnostic classification, in addition to indicating the most appropriate treatment for the specific case.
What are
What are Skene's Glands?
The Skene glands are two round-shaped structures, located deeply in the thickness of the skin that covers the vestibule of the vagina (understood as an oval space between the small lips), near the outlet of the distal urethra .
Compared to the vaginal canal orifice, the Skene glands are located in the upper part and are arranged symmetrically (one on each side).
The Skene glands are therefore surrounded by epithelial tissue which also forms part of the labia minora and clitoris ; to the vulva, these structures are connected by the excretory ducts of Skene .
Like the major vestibular glands (g. Of Bartolini) and the minor ones scattered in the wall of the vestibule of the vagina, in a state of sexual excitement, these structures begin to secrete a viscous fluid that appears to contribute to vaginal lubrication during copulation.
Skene's glands are very small and not palpable (except in the presence of diseases or infections).
To learn more: Bartolini's Glands - What They Are, What They Serve and Associated Disorders »Synonyms
Skene's glands are also known as:
- Paraurethral glands ;
- Exocrine periurethral glands ;
- Minor vestibular glands ;
- Female prostate .
Skene's glands owe their name to the Scottish gynecologist who first described them in the 1880s, Alexander Skene, although the "paternity" of their discovery is rather debated.
Did you know that…
Skene's glands are considered the ancestral homologues of the male prostate . The similarities concern the structures under examination of the electron microscope and the composition of the fluids secreted by the Skene ducts during female excitation and by the male prostate gland. For this reason, Skene's glands are also known as " female prostate ".
Functions
Skene's glands: what is their function?
Similarly to the Bartholin's glands, also those of Skene secrete a mucous, viscous and transparent substance, which contributes to the maintenance of lubrication of the vaginal canal, when a woman is sexually aroused.
During intercourse, a small amount of this thick liquid can help to moisten the opening of the vagina, making sexual intercourse more comfortable.
Female ejaculation: how the Skene Glands participate
In some women, Skene's glands are responsible for the phenomenon referred to as "female ejaculation" (or "squirting"). In practice, during sexual stimulation, some women experience an involuntary and rather copious leakage of fluid from the urethra at the time or just before orgasm.
diseases
Skene's glands are mainly affected by inflammation and cyst formation; these problems are common in women of reproductive age, particularly between the ages of 20 and 30. In some cases, however, these structures may be affected by infections and neoplastic processes.
What pathological conditions can affect the Skene Glands?
Skene's glands may be affected by:
- Inflammatory processes ;
- Infections ;
- Injuries .
Skene's glands can be involved in sexually transmitted diseases such as gonorrhea, chlamydia and trichomoniasis.
When the excretory ducts of the glands are blocked from which the lubricating fluid normally escapes, the formation of Skene's cysts may result. The latter can remain for a long time asymptomatic but, if they become infected, they evolve into abscesses (saccular formations containing pus).
Less often, the Skene glands are affected by tumors or congenital malformations, responsible for the abnormal development of one or more tissues of the genital tract.
Skene cysts
Skene cysts are vulvar cystic formations that arise following an obstruction of the excretory ducts, from which the swollen gland derives due to the stagnation of its secretion.
The reason why the fluid produced by Skene's glands finds it difficult to flow normally is not always identifiable. Sometimes, cysts can be related to traumatic injuries, infections and inflammatory processes.
The bulky cysts of the Skene glands can cause an unpleasant sensation, especially during sexual intercourse and walking.
Skene cysts usually occur between 20-30 years of age. With time, however, the condition is less likely to manifest. In peri-menopausal women, in fact, in the same way as other glands attached to the external genitalia, even those of Skene undergo a physiological involution . For this reason, the possible appearance of a lump or a vulvar mass requires an excisional biopsy, in order to exclude the presence of a malignant tumor.
Abscess of the Skene Glands
When the liquid contained within a Skene cyst becomes infected, an abscess can form (ie a collection of pus, following the penetration of some pathogenic microorganisms).
The abscess formation becomes very voluminous and causes intense pain around the gland and secretions (usually yellowish). In some cases, there may also be some fever lines. The abscesses of the Skene gland are sensitive to the touch and cause a redness of the mucosa above them.
Abscesses affecting the Skene gland are often polymicrobial ; the most frequently isolated pathogens are Escherichia coli, Neisseria gonorrhoeae and Chlamydia trachomatis .
This pathology makes it necessary to resort to antibiotics prescribed by the doctor and to drainage to favor the escape of the purulent material. This approach allows a sudden improvement of vulvar pain.
In case of recurrence of the abscess, marsupialization may be indicated, ie the gland is incised and left open to allow continuous drainage and prevent the liquid from stagnating inside; after surgery, the walls of the abscess cyst retract, leaving a new orifice for secretions. Alternatively, it is possible to proceed with surgical removal of the infected cystic formation.
Skenite (Inflammation of the Skene's Glands)
Skenite is an inflammation that can affect only one or both of the Skene glands. Usually, the process involves a swelling of the upper third of the labia majora, associated with acute pain, redness and tension of the overlying skin. Other often related symptoms are weight loss in the lower abdomen and local itching.
Inflammation of the Skene glands is usually caused by a vaginal infection ( vaginitis ). The predisposing factors include poor hygienic conditions, sexual intercourse, the impossibility of washing oneself for a long time and the excessive use of synthetic underwear or tight-fitting clothes that cause rubbing.
The simple inflammation of the Skene's glands can be transient and resolves within 3-5 days. In several cases, however, the pathological process can give rise to the formation of a cyst.
Neoplastic processes
Rarely, tumors of the vulva originate from the neoplastic transformation of the epithelial components of the Skene gland.
Symptoms and Complications
Most disorders of the Skene glands do not cause symptoms, but if the increase in their volume becomes significant or they become infected, it may be annoying to sit, walk or have sex.
Skene cysts
Frequently, cystic formations are asymptomatic; however, larger Skene cysts can cause an uncomfortable feeling, especially during walking and sexual intercourse.
In addition, larger lesions can be associated with:
- Tenderness ;
- Vulvar irritation ;
- Dyspareunia .
Most cysts of the Skene glands are unilateral and palpable near the vaginal orifice; when they are large, these formations extend the large lips of the affected side and cause a vulvar asymmetry.
Infections of the Skene Glands
If the Skene glands are affected by an infectious process, they can manifest:
- Swelling ;
- Redness ;
- Very intense pain ;
- Fever
Infections of the Skene's glands can be associated with the production of vaginal secretions (usually yellowish or white).
Inflammation
The inflammations of the Skene's glands can cause vulvar irritation and pain during sexual intercourse .
The inflammatory process can also involve tension in the skin overlying the upper third of the labia majora, redness, local itching and a lower belly weight . Urination can also become difficult.
Skene Gland Tumors
The tumor of the Skene's glands usually presents as an irregular, nodular and persistently hardened palpable vulvar formation. Belatedly, clinical signs such as excoriation, pain and itching appear. The lesion may become necrotic or ulcerated, sometimes causing bleeding or watery vaginal secretions .
Diagnosis
The evaluation of disorders affecting the Skene glands involves a specialist medical examination . With the physical examination, the gynecologist can carry out the correct diagnostic classification and indicate the most appropriate treatment for the case.
In women over the age of 40, an excisional biopsy is almost always performed to exclude any vulvar cancer.
Pelvic exam
If the Skene cyst is quite voluminous or causes symptoms, the doctor can observe or palpate it during the gynecological examination. Furthermore, from his appearance he can determine if he is infected. The diagnosis is generally clinical.
To learn more: Gynecological examination - What the exam consists of »In case of infections of the Skene Glands
If abnormal secretions are present, the doctor can send a sample to the laboratory, to ascertain whether or not there are infections, including sexually transmitted diseases. If an abscess has developed in the Skene glands, the physician also performs the culture of the relative liquid.
Biopsy
In some cases, the signs of vulvar cancer mimic those of the Skene cyst. Therefore, the doctor can perform a biopsy exam to examine a lesion sample under a microscope and characterize it from a histological point of view.
Usually, the biopsy is performed if the woman is over 40 years of age and the cyst appears irregularly shaped or has strange bumps.
Differential diagnosis
The differential diagnosis of diseases of the Skene glands is posed with other cystic and solid lesions of the vulva, such as:
- Epidermal inclusion cysts (round and asymptomatic bulges located in the labia majora);
- Papillary hydroadenoma (benign neoplasm that derives from the sweat glands, located mainly at the level of the labia minora);
- fibroma;
- Lipoma.
During the investigations, it is possible for the doctor to resort to an ultrasound or cystoscopy to confirm the presence of a diverticulum of the distal part of the urethra, which can be clinically indistinguishable from a cyst of the Skene glands.
Treatment
The goal of any treatment is to preserve, whenever possible, the Skene gland affected by the pathological process and its function.
Generally speaking, it is important to maintain proper intimate hygiene, have protected sex and consult your doctor when you notice lumps or inflammation in the genital area.
Regarding the inflammation of the Skene glands (skenite), the doctor can prescribe a pharmacological-type treatment based on anti-inflammatories to counteract the acute inflammatory process in progress and, possibly, antibiotics, both orally and through the use of products to be used locally. If the inflammation returns two or three times over the course of a year, surgical removal of the involved Skene glands may be indicated.
Generally, cysts of Skene's glands do not need treatment when they are small, do not cause discomfort and are not infected. When Skene's cysts cause mild and tolerable disturbances, it is possible to bathe in hot water, to be performed 3 or 4 times a day, for 10-15 minutes each, immersing yourself to the pelvis ( local sitz baths ). This practice has a calming effect and can be useful to reduce congestion in the area. If the local sitz baths are ineffective, consult your doctor.
When to consult a doctor
- The cyst of the Skene gland continues to swell or persists after several days, despite diving in hot water (in the tub or by sitz baths);
- Skene's cyst is painful and fever occurs; these manifestations indicate the probable evolution of the lesion in an abscess;
- The Skene cyst interferes with walking or does not allow sitting.
If the Skene cyst has become complicated in an abscess, an antibiotic therapy is prescribed by the doctor, followed by drainage to favor the escape of the purulent material, with or without resection of the affected gland. This approach allows a sudden improvement of vulvar pain. After surgery, the cyst walls retract, leaving a new orifice for secretions. Alternatively, it is possible to proceed with the surgical removal of the infected Skene glands.
Following these interventions, the patient can observe losses on the underwear; these are none other than the secretions coming from the Skene's glands abscessised during their emptying. Running several warm sitz baths several times a day can help relieve discomfort, as well as speed up healing.
The therapy of neoplastic lesions of the Skene glands involves the surgical excision of the local tumor and the dissection of the inguinal and femoral lymph nodes. These approaches are sometimes associated with post-operative radiotherapy and chemotherapy.
Prevention
How can the disorders of the Skene Glands be prevented?
- The first and most important rule of prevention of inflammation, cysts and other diseases of the Skene glands is the maintenance of good genital hygiene . Care must therefore be taken to thoroughly clean local daily and, especially in summer, change underwear frequently.
- Another good habit to reduce the risk of incurring genital infections is to avoid the abuse of sanitary napkins and panty-liners (for example, their application throughout the day), if not necessary, as they do not allow the correct skin perspiration. For the same reason, the use of synthetic clothing and particularly narrow underwear is not recommended: the continuous rubbing of the fabric on the skin can cause local irritation.
- Another useful preventive measure consists in practicing safe sex - using, in particular, a condom whenever there is a cohort relationship with one's partner - it can help reduce the chances of developing a cyst infection and the formation of an abscess of Skene's glands.
