A middle-aged woman was seen in the nephrology clinic for chronic kidney disease. She also had a history of recurrent urinary tract infections. Physical exam (POCUS) revealed an anechoic/hypoechoic structure posterior to urinary bladder. Its relatively well-circumscribed nature and echotexture made it look different than uterus. There was no internal flow on color Doppler. Of note, patient had hysterectomy. So, anatomically, this lesion was suggestive of Gartner’s duct cyst (GDC). While cystic structures are usually anechoic/black, this appears slightly echogenic likely due to acoustic enhancement from the bladder. Sometimes, cysts also contain homogeneous proteinaceous material.

CT Urogram confirmed that it is a GDC. See the anatomic illustration for better orientation. Patient was referred to Urology for further management.

A GDC is a benign vaginal cystic structure that arises from the vestigial remnant of the mesonephric (Wolffian) duct, which, during male embryogenesis, forms the seminal vesicles, vas deferens, and epididymis. Gartner’s ducts are paired structures on either side of the urethra; cysts are usually asymptomatic and <2 cm but sometimes can be bigger and cause dyspareunia, palpable mass on pelvic examination and/or urinary symptoms.