Infected Anterior Vaginal Wall Cyst Causing Acute Urinary Retention during Pregnancy: A Case Report

Acute urinary retention (AUR) is a rare but serious condition during pregnancy that can lead to significant maternal and fetal complications. Pregnancy induces various anatomical and functional changes in the lower urinary tract, increasing the risk of AUR. In this report, we present a novel case of acute urinary retention secondary to a large infected anterior vaginal wall cyst.

A 31-year-old woman in her second pregnancy at 18 weeks of gestation presented with vulval pain, fever, and urinary retention. On examination, a 5x6 cm tense mass on the anterior vaginal wall was identified, with no abnormalities in the cervix or lateral fornixes. For the above complaints, the patient visited another hospital; she was started on oral antibiotics and Foley catheterization was performed. A transvaginal ultrasound imaging showed a hypoechoic lesion on the anterior vaginal wall with increased vascularity. After 24 hours of intravenous antibiotic therapy post-admission, the cyst started collapsing and there was evidence of spontaneous pus drainage from the cyst wall. The remaining loculi were removed under aseptic conditions. The symptoms subsided and, hence, Foley’s catheter was removed. The patient comfortably passed urine post-catheter removal. She was discharged after five days of oral antibiotics and returned for a follow-up two weeks later with no recurrence of symptoms. Further surgical intervention was postponed due to increased vascularity from pregnancy.

An infected large anterior vaginal wall cyst during pregnancy can cause acute urinary retention. This condition is managed with conservative treatment, with cyst excision typically deferred until after delivery.