Why do Nabothian cysts appear?
The cervical canal is lined with glandular epithelium that produces mucus. When ectopia or inflammation heals, the adjacent squamous epithelium creeps onto the glandular zone and blocks the mouths of the glands. The secretion continues to be produced, but cannot come out and stretches the gland, forming a cyst ranging in size from a few millimeters to a centimeter. This mechanism is called retention. Most often this occurs after childbirth, previous cervicitis or treatment of ectopia, so cysts are especially common in women who have given birth.
- Closure of the excretory duct of the cervical gland
- Healing of cervical ectopia
- Consequences of inflammation
- Childbirth and cervical trauma
- After cauterization and other interventions
- Dimensions are usually from 2 to 10 mm
Are they dangerous?
Nabothian cysts do not degenerate into a malignant tumor and are not considered precancerous changes. They do not interfere with pregnancy and do not affect its course. However, their presence does not replace routine cervical screening: cytology and HPV testing are needed for all women by age, regardless of cysts. Rare problems are associated with very large or multiple cysts that deform the cervix, as well as with suppuration of the contents during active inflammation.
- They are not a tumor and do not degenerate
- Do not interfere with conception and pregnancy
- Does not require cancellation of routine screening
- Large cysts can deform the cervix
- Possible suppuration with concomitant cervicitis
Symptoms
In the vast majority of cases, the woman does not feel anything, and the cysts are found during a routine examination or ultrasound, where they are visible as anechoic inclusions in the cervix. Large formations occasionally give a feeling of discomfort or pressure, slight mucous discharge, and in case of injury during sexual intercourse - scanty spotting. Heavy discharge, pain and bleeding are usually not associated with cysts, but with concomitant inflammation or other diseases that need to be looked for separately.
- Most often there are no complaints
- Incidental finding during examination or ultrasound
- Sometimes mucous discharge
- Rarely discomfort in the cervical area
- Spotting due to traumatization of a large cyst
Diagnostics
The diagnosis is usually made by examination in a speculum: cysts look like yellowish or whitish translucent vesicles with a thin vascular network. Colposcopy clarifies the picture and at the same time allows you to assess the condition of the cervical epithelium. With a pelvic ultrasound, cysts are defined as small fluid inclusions in the thickness of the cervix. Cytology and an HPV test remain a mandatory part of the examination - not because cysts are dangerous, but because the examination does not replace screening. A smear on the flora helps to identify inflammation.
- Inspection in the mirrors
- Videocolposcopy
- Ultrasound of the uterus and ovaries
- Pap test or liquid cytology
- High-risk HPV test
- Smear for flora and infections
Treatment and observation
Most women do not require treatment—routine preventive examinations are sufficient. If the cysts are large, multiple, deform the cervix, support chronic inflammation, or interfere with the evaluation of the epithelium during colposcopy, the doctor can open and empty them, and treat the walls with radio waves or lasers. The procedure is outpatient and takes a few minutes. It is important to simultaneously treat the concomitant infection, otherwise cysts will form again. No pills, suppositories or herbs will resolve Nabothian cysts.
- Observation for asymptomatic cysts
- Routine cervical screening by age
- Treatment of concomitant cervicitis
- Opening and emptying large cysts
- Radio wave or laser treatment of the bed
- Follow-up examination after the procedure