From the Research
Nabothian cysts typically require no treatment as they are benign, asymptomatic cervical lesions that occur naturally when mucus-producing glands become blocked. These small, fluid-filled cysts are considered normal variants found during routine pelvic examinations and Pap smears. For the vast majority of patients, reassurance that these are normal physiological findings is all that's needed. No medications, procedures, or follow-up specific to the cysts themselves is necessary. If a nabothian cyst is unusually large (greater than 4 cm) or causing symptoms like abnormal bleeding or pain, which is rare, a gynecologist might consider drainage or removal. This would typically involve a simple outpatient procedure such as cryotherapy, electrocautery, or surgical excision, as seen in a case report where a large Nabothian cyst was successfully treated through laparoscopic excision 1. The decision to intervene should be based on symptoms rather than the mere presence of cysts. Nabothian cysts form when squamous epithelium grows over columnar epithelium at the transformation zone of the cervix, trapping mucus underneath. This process is related to normal cervical metaplasia and healing after inflammation or childbirth, explaining why they're common in women of reproductive age.
Some studies have reported cases of large Nabothian cysts causing symptoms such as chronic urinary retention 2 or compressing the rectum 3. In these cases, treatment may be necessary to alleviate symptoms. However, for asymptomatic Nabothian cysts, no treatment is necessary, and patients can be reassured that these are normal physiological findings. It's also important to note that Nabothian cyst content can be mistaken for tumor diathesis on Pap test cytology, leading to potential misdiagnosis of invasive carcinoma 4.
In terms of diagnosis, vaginal sonographic imaging can be used to detect Nabothian cysts, including deep-located cysts that may not be visible on superficial examination 5. However, the clinical significance of these cysts in the field of sterility diagnostics is still unclear. In general, the management of Nabothian cysts should be based on symptoms and size, with asymptomatic cysts requiring no treatment.