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Nabothian cysts are filled with mucus that is secreted by the cervical glands. Sometimes the tiny bumps are called cervical cysts, mucinous retention cysts, or epithelial cysts.
Nabothian cysts are fairly common. They aren’t a threat to your health, and they aren’t a sign of cervical cancer.
Nabothian cysts form when the mucus-producing glands in your cervix are coated with skin cells and become clogged. The skin cells plug the glands, which causes mucus to accumulate. This causes a cyst to form on the cervix that looks like a small, white bump.
Childbirth and physical trauma to the cervix can cause nabothian cysts in some women. During childbirth, excess skin cells can grow on the mucus gland and trap mucus, causing cysts to form. Physical trauma around the cervix can cause excess tissue to develop on top of mucus glands during the healing process and trap mucus, which can also cause these cysts to occur. Cysts caused by physical trauma are especially common during recovery from chronic cervicitis, in which cervix tissue is inflamed.
You’re most likely to develop these cysts if you’re pregnant or of childbearing age. Childbearing age lasts from puberty until the onset of menopause, which in some cases can happen as late as your 40s or 50s.
You might also be at risk for developing similar cysts if you have a condition called adenoma malignum. This condition is a type of neoplasia that affects mucus production in your cervix, and these cysts are often identical to nabothian cysts. Talk to your doctor about being screened for adenoma malignum if you’re concerned that your nabothian cyst might be a result of this condition rather than other causes.
Nabothian cysts range in size from a few millimeters to 4 centimeters in diameter. They’re smooth and appear white or yellow in color. Your doctor may notice one or more cysts during a routine pelvic examination. These cysts don’t cause pain, discomfort, or other symptoms, so it’s likely that your doctor will discover any cysts while examining your cervix for other problems.
Nabothian cysts can be screened and diagnosed during a pelvic examination. They can sometimes be seen on a pelvic ultrasound, MRI, or CT scan that looks at the cervix. After discovering these small white bumps on your cervix, your doctor may break a cyst to confirm the diagnosis.
Your doctor can also use a colposcopy to make an accurate diagnosis. This involves magnifying the area to distinguish nabothian cysts from other types of bumps.
Your doctor may take a biopsy of a cyst if they suspect that you might have a type of neoplasia affecting mucus production. This condition, called adenoma malignum, is very rare and is not a cause for concern.
Nabothian cysts are benign and usually don’t require treatment. In rare cases, the cysts may become large and distort the shape and size of your cervix. If it’s severe, it can make a routine cervical examination difficult or impossible. In this case, your doctor may recommend removal of the cyst in order to examine your cervix.
It’s important that your doctor perform a complete examination of the cervix during routine visits. These examinations can ensure your reproductive health and help your doctor identify problems with your cervix early.
Nabothian cysts that need treatment can be removed through an excision or through a process called "electrocautery ablation." During an excision, your doctor uses a scalpel or blade to remove the growth.
During electrocautery ablation, your doctor uses an electric current to remove the cyst. The electric current produces heat that your doctor runs back and forth over the cyst. In some cases, your doctor may drain fluid from a cyst. They may recommend this method because of the very minimal blood loss that happens during this procedure.
Your doctor may use cryotherapy to remove a cyst. In this procedure, your doctor uses liquid nitrogen to freeze and shatter the cyst. This procedure is less invasive than excision or ablation.
Talk to your doctor about what treatment works best in your case, depending on the size and distribution of cysts in your cervix.
There are no serious complications of nabothian cysts. Cysts can form as a complication of a hysterectomy, but they typically pose no serious threat to your health.
In some cases, Pap smears can become painful or even impossible because of large cysts or having too many cysts on the cervix. If this happens, talk to your doctor about having cysts removed immediately so that you can continue your regular reproductive care.
These cysts are full of mucus and can burst. It’s not uncommon to have discharge, odor, and bleeding when they rupture. If the odor and discharge persist, do see your doctor.
In one rare case, a large nabothian cyst was mistaken for a malignant tumor and caused a woman to be referred to another clinic for a hysterectomy. Fortunately, the growth was correctly identified as a nabothian cyst using ultrasonography, and the cyst was successfully drained and removed. Neither this case nor any other case of nabothian cysts has ever resulted in accidental or unnecessary surgeries. Even the largest cysts can be removed and treated without causing further medical issues.
Talk to your doctor about specialized tests for identifying nabothian cysts if one or more cysts is discovered during an examination.
Most nabothian cysts are discovered accidentally during routine pregnancy examinations. It’s common for these cysts to form during pregnancy.
Normally, your cervix is open to allow your menstruation fluid to pass from your uterus to your vagina, and for sperm to enter the uterus from the vagina. During pregnancy, the cervix closes to keep a developing baby inside the uterus. After your child is born, new tissue grows over the mucous glands. In a process called metaplasia, skin cells are produced in excessive amounts and block mucus from exiting the glands. Over time, cysts form as mucus pools in the glands.
Talk to your doctor if you’re concerned that you have an abnormally large cyst in your cervix while you’re pregnant. You may notice pain during intercourse, abnormal bleeding, or discharge. Your doctor will likely suggest an appropriate treatment if they discover a cyst that needs to be removed.
If you don’t have any symptoms, your doctor likely won’t recommend treatment or removal. Once your doctor has discovered these cysts, continue to visit your gynecologist for regular check-ups to ensure that any nabothian cysts that might grow are taken care of before they cause problems. If your cysts are large or causing pain, discomfort, or discharge, your doctor will suggest that you treat or remove the cyst. In the rare case that your cyst indicates a more serious condition, further diagnosis and treatment may take months.
Procedures for cyst removal usually take less than a day, and you’ll recover from these minor procedures in a matter of days, or at the very most, a few weeks.
The outlook for nabothian cysts is extremely positive. There’s no known way to prevent nabothian cysts. But these growths are benign and usually very small. They don't pose any short- or long-term health threats. As long as nabothian cysts don’t hinder your ability to live a normal life and don’t cause pain or discomfort in your cervix or abnormal pelvic exams or Pap smears, there’s no need to worry about this type of cyst.
Written by: Erica Roth, Valencia Higuera, and Tim Jewellon: Aug 22, 2017
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