Naboth Cysts: History, Risk Factors, Causes, Symptoms, Diagnosis, Treatment, Prognosis and Prevention

It is a cyst filled with pale yellow mucus secreted by the cervical glands that become blocked due to the growth of tissue present on the surface of the cervix.

The cervix is ​​the narrow, low part that extends to the vagina.

It occurs mainly in women during the reproductive stages, but does not cause any serious danger to health.

Nowadays they are quite common and can be found more in women whose skin of the cervical area is thin. It is related to chronic cervicitis, which is a long-term cervical infection.

Most often they occur when the stratified squamous epithelium of the ectocervix (to the vagina) grows over the simple cylindrical epithelium of the endocervix (into the uterus). This tissue growth can block the cervical crypts (subdermal pockets usually 2-10 mm in diameter), trapping the cervical mucus inside the crypts.

Terminology

The Naboth cyst also has are known by other names, such as:

  • Naboth follicles.
  • Cervical cyst
  • Mucinous retention cyst.
  • Epithelial inclusion cyst.

History

They are named after the German anatomist Martin Naboth (1675-1721), who wrote about them in a 1707 treatise entitled De sterilitate mulierum.

However, they were previously described by the French surgeon Guillaume Desnoues (1650-1735). As it is a derived term, Naboth is not written with a first capital letter.

Causes

The mucus-producing gland in the cervix is ​​covered with cells and clogs of the skin. Physical trauma and childbirth cause extra cells of the skin to grow in the mucous gland and trap the mucus, which results in the formation of the cyst.

Infection : the cervical glands produce mucus in large quantities to protect the area from all types of infections and inflammations. One can understand this process as the body’s natural way of washing 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 cysts formations as well. Therefore, infections and inflammations can cause the growth of Naboth cysts.

Hormonal changes : hormonal changes have a direct role in the formation of such cysts, for example, menopause is a stage in which a woman can experience thinning of the skin of the cervix. It leads to inflammation of the cervix causing cervical infection.

The cervix connects the two most important parts of the female reproductive system. Therefore, hormonal changes will have a direct effect on him.

These cysts develop mainly at the time of pregnancy, childbirth or menopause. Therefore, the development of these cysts could be the result of changes in hormone levels.

Trauma : The injury or scarring of the tissues lining the cervix could cause the formation of Naboth cysts. The body tries to grow new tissues to repair and heal the wounded area, but sometimes there may be an overgrowth of the tissues.

Pregnancy : Normally, the cervix remains open to allow the movement of the sperm from the vagina to the uterus and the flow of menstrual fluid from the uterus to the vagina.

However, during pregnancy, the body mechanism closes the cervix to ensure the development of the fetus inside the uterus. The new tissues grow on the mucous gland after delivery due to the metaplasia process.

In case of excessive growth of these tissues, they could block the glands and prevent the mucus from flowing and thus lead to the development of Naboth cysts.

Cervical problems : Women who undergo menopause may experience thinning of the skin of the cervix. Inflammation of the cervix is ​​a common effect of cervicitis.

These problems along with other cervical sexually transmitted infections could lead to the development of cysts on the surface of the cervix.

symptom

This type of cysts forms tiny structures in the form of a crypt in the external cervical wall. Their diameter varies and they are yellow or pale yellow and have a smooth surface.

However, they may even have larger forms, in reality, they do not affect your health or body and, therefore, do not require any treatment. In case the diameter of the cysts grows, there is a possibility that it is a uterine tumor or cervical cancer.

Cysts are neither painful nor itchy. Most patients remain unconscious until they are discovered accidentally during the gynecological examination.

The size varies between 2 mm and 10 mm in diameter, but a large tumor or multiple cysts can vary up to the size of 3-4 cm in diameter.

It is likely that cysts that have a diameter of more than 8 cm have symptoms of uterine tumor or cervical cancer. They are soft, solid, raised bumps and are yellow or white, but do not cause any pain or any type of discomfort.

Large cysts can cause rectal or anal symptoms that occur due to compression of the rectal region when it grows later.

Therefore, only by examining your pelvic girdle can the doctor discover this. Severe symptoms include irregular periods, unusual discharge and pain in the pelvis.

As these cysts are asymptomatic, sometimes, if they have abnormal vaginal bleeding, except menstrual periods or pain in the pelvic area or vaginal discharge, then they should go and get checked by a gynecologist.

Diagnosis

In general, these cysts do not require any treatment, as they appear and disappear on their own.

Many times even neglect the eye of the victim if they are very small. For some, these cysts appear only when a woman is in her periods, and then disappear after the periods end.

However, if you are not sure if it is a cyst or something else, visit your doctor to confirm it. The cysts become clearly visible as lumps during an examination and examination of the pelvic area.

Pelvic or cervical ultrasound : shows if the cyst is close to the endocervical canal and if this region is enlarged. If the cyst is benign in nature, it is identified by color Doppler examination that does not provide an allied color flow.

Pelvic magnetic resonance image : detects whether the cyst is a single laceration or is composed of cervical trauma.

Computed tomography : the focal region of low attenuation may be noted within the cervical area when the size of the cyst is small.

Colposcopy : accurate and accurate diagnosis is made by colposcopy, where a colposcope (an instrument connected with magnifying lenses and color filters) is used to examine the cervix and vaginal walls through pelvic vaginal ultrasound .

Even if after all this, there is still confusion about whether they are Naboth cysts or any other form of cyst, the doctor suggests a colposcopy, which involves examining the area of ​​the cervix thoroughly with a magnifying glass and confirm.

In rare cases, a biopsy is performed, tests to detect sexually transmitted diseases and check hormone levels to verify if the cysts are cancerous or not. Although seemingly harmless, these cysts often need to be eliminated before they can cause additional complications in the body.

The two processes by which this can be done are cryo-freezing and electrocautery. The doctor will choose between these two according to the stage of the cysts.

Treatment for the Naboth cyst

As they are asymptomatic, treatment is usually not required and, being benign, these cysts recover on their own. But to be on the safest side, a routine check is essential to constantly monitor the shape and size of the lumps.

Little by little, they stop being visibly visible. However, the removal of them is possible through surgery, but the additional risk of their appearance is always maintained

But if the size of the cyst increases, it can affect the shape of the cervix to a certain extent, making it difficult for a doctor to inspect the cervix normally.

If the cyst measures more than 1 cm, extraction is needed so that the cervix can be seen completely, to prevent the body from feeling uncomfortable and having harmful effects. As the visual inspection of the cervix is ​​important for any test to know the reproductive health of any woman.

There are three methods to eliminate the Naboth cyst:

Cleavage : the blade or scalpel can be driven by excessive growth of the cyst. It involves the removal of the cyst and its surrounding tissues with an endoscope.

Electrocautery : electrocautery ablation involves the use of high frequency electric currents, the electric current produces heat that your doctor runs over the cyst to eliminate the abnormal mass of the cervical region and also in some cases, your doctor can drain the fluid.

They can recommend this method because of the minimal blood loss that occurs during this procedure.

Cryotherapy : Your doctor may use cryotherapy to remove a cyst. This procedure is less invasive than excision or ablation, your doctor uses liquid nitrogen to freeze, reduce it, break the cyst and destroy it.

Radio waves : includes the use of radio waves to remove the capsule from the cyst.

Laser therapy : uses lasers to reduce the chances of complications, ie, bleeding or infections and, therefore, eliminate the cyst quickly and safely.

Naboth cysts are not related to spontaneous abortions or cervical cancer and they do not bleed either. So do not worry about these things.

Talk with your doctor about which treatment works best for you, depending on the size and distribution of the cysts on your cervix.

Risk factor’s

The duration of reproductive age begins from puberty to the beginning of menopause, in rare cases, the cyst may appear in 40 or 50 years. If a person has a malignant adenoma condition, then it is likely to have a similar type of cyst.

How dangerous is Naboth’s cyst?

As mentioned earlier, these cysts are prone to happen to women belonging to reproductive age, especially during pregnancy and childbirth. However, the risk continues as much as the time of menopause, that is, between 40 and 50 years of age.

There are also several other factors that can lead to these, such as malignant adenoma. In such a state, another complication called neoplasia may arise that also affects the production of mucus in the cervix.

If the cysts form inflammations, there may be cancer or tumor possibilities, in which case a doctor should be consulted immediately.

The cyst is similar to the tumor but it is not dangerous, however, there are some risks. It can lead to an increase in the risk of genital system susceptibility and inflammatory disease.

Stagnation of the fluid in the uterus can cause infertility and if the cyst becomes inflamed, it can rupture and release the suppurating mass from the adjacent tissue.

Naboth cyst during pregnancy

Most Naboth cysts are accidentally discovered during routine pregnancy exams. It is common for these cysts to form during pregnancy.

Normally, your cervix is ​​open to allow your menstrual 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 in the womb.

After your child is born, new tissue grows on the mucous glands. In a process called metaplasia, the skin cells are produced in excessive amounts and block the mucus when leaving the glands.

Over time, the cysts form as mucus deposits in the glands.

If the Naboth cyst increases significantly in size during pregnancy, it can be dangerous for both the mother and the child. The growth of a tumor that distorts the cervix can cause a miscarriage or a 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, it is likely that premature birth occurs, so after diagnosis, doctors generally recommend spending time alone, reduce physical work and give up time to have sex.

Talk to your doctor if you are concerned that you have an abnormally large cyst on your cervix while you are pregnant. You may notice pain during intercourse, abnormal bleeding or discharge.

Your doctor may suggest appropriate treatment if you discover a cyst that needs to be removed.

Forecast and associated conditions

Naboth cysts are considered harmless and usually disappear on their own, although some will persist indefinitely. Some women notice that they appear and disappear in relation to their menstrual cycle.

Other growths can be polyps, warts, fibroids , tumors or ulcers. Unless you have pain, unusual bleeding or discharge, you do not need to perform special tests when diagnosed with a Naboth cyst.

If a woman has pain or pressure from a large Naboth cyst, it can be drained. If any growth obstructs the flow of menstrual blood, fluids or infections may regress to the uterus, but that is not common.

If a woman is not sure that the abnormality she has found in the cervix is ​​a Naboth cyst, a visit to a doctor is recommended to rule out other conditions.

Rarely, Naboth cysts have a correlation with chronic cervicitis, an inflammatory infection of the cervix.

Naboth cysts are not considered problematic unless they grow very large and have secondary symptoms. A doctor may wish to perform a colposcopy or a biopsy on a Naboth cyst to detect cancer or other problems.

Two methods to remove these cysts include electrocautery and cryofreezing, although new cysts may be formed after the procedure.

Complications

There is no severe difficulty due to the naboth cyst, but hysterectomy can be a complication. However, it does not cause any serious threat to health. Too many cysts or large cysts in the cervix cause pap smear.

These cysts are full of mucus and can burst. It is not uncommon to have discharge, odor and bleeding when they break. If the odor and secretion persist, consult your doctor.

In a rare case, a large Naboth cyst was mistaken for a malignant tumor and caused a woman to be referred to another clinic for a hysterectomy. Fortunately, growth was correctly identified as a Naboth cyst using ultrasonography, and the cyst was successfully drained and eliminated.

Neither this case nor any other case of Naboth cysts have resulted in accidental or unnecessary surgeries. Even the largest cysts can be removed and treated without causing more medical problems.

Talk to your doctor about specialized tests to identify Naboth cysts if one or more cysts are discovered during an exam:

  • It may appear as a complication of hysterectomy.
  • Having too many cysts in the cervix can create difficulties in reproductive care.
  • The cysts may break and result in release or discharge, odor and bleeding.
  • Larger cysts can be confused with malignant tumors and cause the patient to undergo unnecessary surgeries.
  • Large or multiple cysts can cause infertility or difficulty conceiving by allowing fluid to pool in the uterus.
  • Greater possibilities of inflammatory diseases.
  • It makes the genital system more susceptible to various infections.
  • Pus can form within the cyst if the cyst ruptures and the contents can infect the surrounding tissues.

If the mucus bursts and discharges can give a foul odor and bleed, then it is important to consult a doctor.

There is also the possibility of greater possibilities of inflammatory diseases. In addition, the genital system may be susceptible to different infections.

Can Naboth’s cyst be cancerous?

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

When to visit a doctor?

Naboth cysts are usually benign and do not pose a threat to life. However, the symptoms may include intense pain and discomfort that creates difficulty in performing daily activities.

In addition, some people may experience the formation of multiple or large cysts that cause serious complications such as infertility. Therefore, it is advisable to consult a doctor when the individual begins to experience the symptoms of the cyst, as soon as possible.

If you do not have any symptoms, your doctor may not recommend treatment or elimination.

Once your doctor has discovered these cysts, continue to visit your gynecologist for regular checkups to make sure any Naboth cysts that can grow are resolved before they cause problems.

If your cysts are large or cause pain, discomfort or discharge, your doctor will suggest that you treat or remove the cyst. In the rare event that your cyst indicates a more serious condition, subsequent diagnosis and treatment can take months.

The procedures for removing cysts usually take less than a day and you will recover from these minor procedures in a matter of days or, at most, within a few weeks.

The prognosis for Naboth cysts is extremely positive. There is no known way to prevent Naboth cysts. But these growths are benign and generally very small. They do not represent any threat to health in the short or long term.

As long as Naboth cysts do not impede your ability to lead a normal life and do not cause pain or discomfort in the cervix or abnormal pelvic exams or cytology, there is no need to worry about this type of cyst.

Prevention of Naboth cysts

Naboth cysts appear more frequently as firm protrusions on the surface of the cervix. A woman may notice the cyst when she inserts a diaphragm or a cervical cap, or when she examines the cervix as part of fertility awareness.

How to prevent it?

  • Maintain good personal hygiene
  • Use protection while participating in sex.
  • Use other contraceptive methods to avoid unwanted pregnancies or abortions that increase the risk of cysts.
  • Undergo a routine preventive gynecological exam twice a year.
  • Undergo treatment for inflammatory diseases of the genitourinary system.

A health care provider may notice cysts during a pelvic exam.