Nabothian Cyst

What is Nabothian Cyst?

Nabothian cysts are non-malignant benign cysts filled with pale yellow colored mucus present on the surface of the cervix (narrow, lower part that extends to the vagina). It mostly occurs in women during the reproductive stages but does not cause any serious health hazard.

Terminology

Nabothian cyst also has other names, such as:

  • Nabothian follicles
  • Cervical cyst
  • Mucinous Retention Cyst
  • Epithelial Inclusion Cyst

Can Nabothian Cyst be Cancerous?

The cyst is not cancerous but can cause irritation, abnormal vaginal bleeding, pain, etc. Filled with mucus secreted by the cervical glands, they are not a threat to the health or a sign of cervical cancer.

Nabothian Cyst Causes

  • Mucus-producing gland in the cervix gets coated with skin cells and clogs
  • Physical trauma & childbirth causes extra skin cells to grow on the mucus gland and trap the mucus resulting the formation of the cyst.
  • Hormonal Changes have a direct role in formation of such cysts, for example, Menopause is a stage when a woman may experience thinning of the cervical skin. It leads to inflammation of the uterine cervix causing cervical infection.

Nabothian Cyst Risk Factors

The duration of reproductive age starts from puberty till the onset of menopause, in rare cases the cyst may appear in the 40s or 50s. If a person has adenoma malign condition, then he/she is likely to have a similar type of cyst.

Symptoms of Nabothian Cyst

  • Most patients remain unaware till accidentally discovered during gynecological examination.
  • Size varies between 2mm to 10mm in diameter, but large tumor or multiple cysts can vary up to the size of 3-4 cm in diameter.
  • Cysts having a diameter of more than 8 cm is likely to have symptoms of uterine tumor or cervical cancer. They are smooth, solid, elevated bump and are yellowish or white in color but they do not cause any pain or any kind of discomfort.
  • Cysts large in size can cause rectal or anal symptoms which occur due to compression of the rectal region when it grows posteriorly.
  • Congestion in the Pelvic region
  • Vaginal discharge or irregular bleeding

How dangerous is the Nabothian Cyst?

The cyst is similar to the tumor but not dangerous, however, some risks do exist. It may lead to an increase in the risk of genital system susceptibility and inflammatory disease. The stagnation of the fluid in the uterus can lead to infertility and if the cyst inflames, it can rupture and release the festering mass of the adjacent tissue.

Nabothian Cyst during Pregnancy

If nabothian cyst increases its size significantly during pregnancy, it can be dangerous for the mother as well as the child. The growth of tumor which distorts the cervix can lead to miscarriage or premature birth of a child.

It is still debated whether to treat the cyst during pregnancy or after the birth of the child. If it is treated during pregnancy then premature delivery is likely, so after diagnosis, doctors usually recommend to spend time alone, reduce physical work and give up on time for sex.

Diagnosis 

  • Pelvic or cervical ultrasound: Shows if the cyst is close to the endocervical canal and if this region is enlarged. Whether the cyst is benign in nature is identified by the examination of the color Doppler which provides no allied color flow.
  • Pelvic MRI: Detects if the cyst is single or compound laceration with cervical trauma.
  • CT Scan: Focal low attenuation region may be noticeable within the cervical area when the cyst is small in size.
  • Colposcopy: Adequate and precise diagnosis is through colposcopy where colposcope (an instrument attached with magnification lenses & color filters) is used to examine the cervix and the vaginal walls through the vaginal Pelvic ultrasonography follow this process.
  • Biopsy of the Cyst
  • Tests to check for sexually transmitted diseases
  • Checking hormone levels

Treatment for Nabothian Cyst

As they are asymptomatic, no treatment is usually required. But if the cyst is more than 1 cm, then removal is needed to prevent the body from discomfort and harmful effects.  There are three methods to remove the cyst:

  • Excision: Blade or scalpel can be conducted in the excessive growth of the cyst. It involves removal of the cyst and its surrounding tissues using endoscope.
  • Electrocautery: The electrocautery ablation involves usage of high-frequency electric currents to remove the abnormal mass of the cervical region and also drain the fluid. Doctors mostly prefer this surgical treatment because it has minimal blood loss.
  • Cryotherapy: The cyst is frozen with the aid of liquid nitrogen to shrink and destroy it. It is less invasive than ablation and excision.
  • Radio Waves: Involves usage of radio waves for removing the cyst capsule.
  • Laser Therapy: Utilizes laser beams to reduce the chances of complications i.e. bleeding or infections and hence remove the cyst both quickly and safely.

Complications of Nabothian Cyst

No severe difficulty occurs due to the nabothian cyst, but hysterectomy can be a complication. However, it does not cause any serious threat to health. Too many cysts or large cyst on the cervix causes painful pap smears and should be removed immediately. If the mucus bursts out and discharges it may give a foul smell and bleed, then it is important to consult a doctor. There is also a possibility of increased chances of inflammatory diseases. Moreover, the genital system may get susceptible to different infections.

References

  1. https://www.patienthelp.org/diseases-conditions/nabothian-cyst.html
  2. https://www.mayoclinic.org/cervical-cysts/expert-answers/faq-20058495
  3. https://medicalfoxx.com/nabothian-cyst.html
  4. https://www.healthline.com/health/nabothian-cyst#causes2
  5. http://allcysts.com/cervical-cyst-causes-and-symptoms-removal-and-treatment-of-folk-remedies/
  6. https://www.patienthelp.org/diseases-conditions/nabothian-cyst.html

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