Anterior Vaginal Wall Cyst Mimicking Advanced Cystocele: A Case Report

Anterior vaginal wall cysts are rare benign lesions that can clinically mimic pelvic organ prolapse, particularly cystocele, resulting in diagnostic challenges and inappropriate management if not accurately identified. We report the case of a 28-year-old multiparous woman who presented with a one-month history of a vaginal mass. Clinical examination suggested a Grade III cystocele in the absence of urinary or bowel symptoms. Ultrasonography raised suspicion of an anterior vaginal wall cyst. A simple bedside diagnostic technique combining bladder catheterisation with simultaneous assessment of the vaginal mass demonstrated no reduction in the size of the lesion following bladder drainage and clear demarcation from the urinary bladder, thereby excluding cystocele. The patient underwent complete surgical excision of the anterior vaginal wall cyst with anterior vaginal wall repair and repair of old posterior vaginal wall tears. Histopathological examination confirmed the diagnosis of an anterior vaginal wall cyst. The postoperative course was uneventful, and the patient remained asymptomatic with no evidence of recurrence at one-month followup. This case highlights the importance of considering anterior vaginal wall cysts in the differential diagnosis of anterior vaginal wall masses and demonstrates the value of combining careful clinical evaluation with simple bedside techniques and ultrasonography to achieve an accurate diagnosis and appropriate surgical management.