Obstetrics & Gynaecology · Prolapse, Urinary Incontinence and Fistulas

A 45-year-old woman presents with a tender, fluctuant mass in the anterior vaginal wall that expresses purulent urine on compression. The most likely diagnosis is:

  • A Urethral diverticulum
  • B Gartner's duct cyst
  • C Cystocele
  • D Skene's gland abscess
Correct answer: A. Urethral diverticulum

Explanation

Urethral diverticulum presents as a tender anterior vaginal wall mass that may express urine or purulent material on compression, along with the classic triad of dysuria, dyspareunia, and post-void dribbling. Gartner's duct cyst is typically lateral and asymptomatic. Cystocele is a bladder prolapse, not a discrete fluctuant mass. Skene's gland abscess is periurethral but does not communicate with the urethra.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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