Skene gland
Summary
The Skene glands (paraurethral glands, lesser vestibular glands) are paired glands flanking the distal female urethra that open near the external urethral orifice. They are the homologue of the male prostate, secrete mucus-like fluid for lubrication (and PSA-containing fluid), and can become infected (Skenitis) or form cysts/abscesses.
Detail
**Anatomy** - Paired glands located on either side of the distal urethra, in the anterior vaginal wall. Their ducts open lateral to or just inside the external urethral meatus. - Also called paraurethral glands or lesser vestibular glands. Not to be confused with Bartholin glands (greater vestibular glands).
**Embryology (high-yield homologies)** - Skene glands are derived from the urogenital sinus (endoderm) and are homologous to the male prostate gland. - Bartholin glands (greater vestibular glands) are homologous to the male bulbourethral (Cowper) glands. - Both Skene and Bartholin glands are lined by epithelium that secretes mucus; Skene gland tissue also expresses prostate markers (PSA, prostatic acid phosphatase).
**Function** - Secrete mucus that lubricates the urethral opening and vestibule. They may have a minor antimicrobial role. - Secretions contain PSA. They are sometimes linked to female ejaculation and the "G-spot" (the anterior vaginal wall region), though this remains debated.
**Clinical significance** - *Skenitis (paraurethral gland infection):* Classically associated with *Neisseria gonorrhoeae*; also Chlamydia trachomatis. Presents with dysuria, urethral discharge, and suburethral tenderness or swelling. Skene glands are a common site where gonococci persist in females. - *Skene duct cyst/abscess:* Occurs when the duct is obstructed. Presents as a paraurethral mass near the meatus, sometimes with voiding symptoms or dyspareunia. It is treated with antibiotics, drainage, or marsupialization/excision. - *Rare adenocarcinoma:* Skene gland adenocarcinoma is very rare. It may express PSA, which is a useful marker. - *Differential for a periurethral mass:* urethral diverticulum (often presents with the triad of dysuria, dyspareunia, and post-void dribbling), Gartner duct cyst (mesonephric remnant on the anterolateral vaginal wall), and Bartholin cyst (posterolateral introitus at 4 and 8 o'clock).
**Board pearls** - Skene = prostate homologue; Bartholin = bulbourethral homologue. - Bartholin gland lesions are at 4 and 8 o'clock on the posterolateral vestibule. Skene glands are adjacent to the urethral meatus. - Gonorrhea in women can involve the endocervix, urethra, and the Skene and Bartholin glands.
Sources
- First Aid for the USMLE Step 1 (Embryology and Reproductive chapters)
- Gray's Anatomy for Students
- Moore's Clinically Oriented Anatomy
- Netter's Atlas of Human Anatomy
- Williams Gynecology
- Robbins and Cotran Pathologic Basis of Disease
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