From the Guidelines
Nabothian cysts typically don't require treatment as they are benign, normal findings on the cervix that develop when mucus-producing glands become blocked with secretions. Most nabothian cysts are asymptomatic and discovered incidentally during routine pelvic examinations. If a nabothian cyst is large or causing symptoms such as abnormal bleeding or discomfort, treatment options include simple observation, cryotherapy, electrocautery, or surgical excision. For symptomatic cysts, a gynecologist may perform cryotherapy using liquid nitrogen to freeze and destroy the cyst tissue, or electrocautery to burn away the cyst, as outlined in various treatment methods for cervical lesions 1. Some key points to consider when treating nabothian cysts include:
- Asymptomatic cysts do not require treatment
- Symptomatic cysts can be treated with cryotherapy, electrocautery, or surgical excision
- Regular gynecological check-ups are recommended to monitor any changes in existing cysts or development of new ones. It's essential to note that while nabothian cysts may occasionally be confused with more serious conditions, they are not precancerous or cancerous, and treatment should focus on alleviating symptoms while minimizing the risk of complications, as there is no direct evidence-based guideline for the treatment of nabothian cysts in the provided study 1.
From the Research
Treatment Options for Nabothian Cysts
- Laparoscopic excision is a valid option for treating large and complex Nabothian cysts, allowing for a fast recovery for patients 2.
- CO2 laser surgery is a feasible and cost-effective treatment for Nabothian cysts, with advantages over traditional surgery including reduced patient discomfort and improved short- and long-term outcomes 3.
- Loop electrosurgical excisional procedure (LEEP) is a technique that can be used to treat cervical lesions, including those associated with Nabothian cysts, with a low risk of affecting childbearing ability 4.
Diagnostic Considerations
- Careful preoperative examination, including the use of imaging methods such as ultrasonography and MRI, is crucial for diagnosis and differentiation of atypical presentation of benign Nabothian cysts from other differential conditions of malignancies 2.
- Nabothian cyst content can be mistaken for tumor diathesis pattern associated with invasive carcinoma on Pap test cytology, highlighting the need for careful interpretation of cytology results 5.
Comparison of Treatment Methods
- A systematic review of benefits and harms of cryotherapy, LEEP, and cold knife conization to treat cervical intraepithelial neoplasia found that recurrence rates were lower after cold knife conization, but complications occurred more often with this method 6.
- LEEP and cryotherapy had similar recurrence rates and complication frequencies, but cold knife conization was associated with a higher risk of premature delivery 6.