Nabothian Cysts

What are Nabothian Cysts?

The cervix has a structure that resembles a canal and connects the vagina with the uterus. Both of these are the two most important parts of the female reproductive system. It has links to the cervical glands that produce mucus. The glands may have excess growth of skin cells covering them that may block the glands. Thus, resulting in the accumulation of mucus and the formation of tiny bumps on the surface of the cervix called nabothian cysts. These are benign growths that are not life-threatening or cancerous. They are also known as cervical cysts, epithelial cysts or mucinous retention cysts.

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Nabothian Cyst Causes

• Infection: The cervical glands produce mucus in large amounts to protect the area from all sorts of infections and inflammations. One can understand this process as the body’s natural way of washing out foreign bodies that can cause health problems. Since the level of mucus production increases, there will obviously be an increase in the chances of blockages and cyst formations as well. Thus infections and inflammations can cause the growth of nabothian cysts.
• Hormonal changes: The cervix connects the two most important parts of the female reproductive system. Hence, hormonal changes will have a direct effect on it. These cysts develop mostly occur at the time of pregnancy, childbirth or menopause. Thus, the development of these cysts could be a result of the changes in the hormonal levels.
• Trauma: Injury or scarring of the tissues that line the cervix could cause the formation of nabothian cysts. The body tries to grow new tissues to repair and heal the wounded area, but sometimes there may be an excessive growth of the tissues. Mucus then fills the excess tissues that further develop into cysts. Such damage is common during an abortion, dilation, childbirth, curettage or other gynecological procedures.
• Pregnancy: Normally, the cervix remains open to allow the movement of the sperm from the vagina to the uterus and the flow of menstruation fluid from the uterus to the vagina. However, during pregnancy, the body’s mechanism closes the cervix to ensure the development of the fetus inside the uterus. New tissues grow over the mucus gland after childbirth due to the process of metaplasia. In case of excessive growth of these tissues, they could block the glands and prevent the mucus from flowing out and therefore leading to the development of nabothian cysts.
• Cervical problems: Women undergoing menopause may experience thinning of the cervical skin. Inflammation of the uterine cervix is a common effect of cervicitis. These problems along with other sexually transmitted cervical infections could lead to the development of the cysts on the surface of the cervix.

Nabothian Cyst Symptoms

• Cysts measuring few millimeters to 4 centimeters in diameter
• Smooth texture
• May appear white or yellow
• Severe pain in the cervical region, especially during intercourse
• Discomfort
• Pelvic congestion
• Dragging sensation
• One or more raised bumps
• Irregular bleeding and vaginal discharge
• Pale yellow to amber mucus secretion

Nabothian Cyst Diagnosis

• Physical examination
• Enquiry about the patient’s age and medical background
• Pelvic examination
• Ultrasound
• MRI
• CT Scan
• Colonoscopy
• Biopsy of the cyst
• Tests for presence of sexually transmitted diseases
• Complete blood count
• Tests to check hormone levels

Nabothian Cyst Risk Factors

People are prone to develop nabothian cysts when they experience the following:

• Childbirth
• Puberty
• Menopause
• Adenoma malignum

Complications of Nabothian Cysts

• May appear as a complication of hysterectomy
• Having too many cysts on the cervix may create difficulty in reproductive care
• Cysts may rupture and result in the release or discharge, odor and bleeding
• Larger cysts may be mistaken for malignant tumors and result in the patient undergoing unnecessary surgeries
• Larger or multiple cysts may cause infertility or difficulty in conceiving by allowing fluid to stagnate in the uterus
• Higher chances of inflammatory diseases
• Makes the genital system more susceptible to various infections
• Pus may form inside the cyst if the cyst ruptures the contents can fester the surrounding tissues

Preventions of Nabothian Cysts

• Maintain good personal hygiene
• Use protection while participating in intercourse
• Use other methods of contraception to avoid unplanned pregnancies or abortions that increase the risk of cyst formation
• Undergo routine preventive gynecological examination twice a year
• Undergo treatment for inflammatory diseases of the genitourinary system

Nabothian Cysts Treatment

First, the surgeon must pierce the tumor and remove the liquid contents. After this, the removal of the cyst capsule is imperative to reduce the high risk of relapse. Removal of the cyst capsule can be done using any of the following methods:

• Excision: Removal of cyst and surrounding tissue through a surgery using an endoscope
• Radio wave: Removal of the cyst capsule is also possible by the use of a radio wave ‘knife’
• Ultrasound: Destruction of the cyst capsule can be done using ultrasound
• Cryotherapy: Minimally invasive procedure that involves the use of liquid nitrogen to freeze and destroy the cervical cyst
• Electrocautery: Surgery includes introduction of high-frequency current to the cervical region for the removal of the mass. The main advantage of this procedure is that it induces minimal blood loss.
• Laser therapy: Facilitates the removal of the cyst capsule through a fast and safe technique. The use of laser beam for the removal reduces chances of complications such as infections and bleeding. However, this treatment is costly.

When to Visit a Doctor?

Nabothian cysts are commonly benign and do not pose a threat to life. However, the symptoms may include severe pain and discomfort which creates difficulty in performing daily activities. Moreover, some people may experience the formation of multiple or large cysts that cause serious complications like infertility. Thus, it is advisable to consult a doctor when the individual begins to experience the symptoms of the cyst, at the earliest.