From the Research
Nabothian cysts are typically harmless and require no treatment, but if they become large or cause symptoms, treatment options such as cryotherapy, electrocautery, or surgical removal may be considered, with the most recent and highest quality study suggesting that laparoscopic excision is a valid option for large and complex cysts 1.
Overview of Nabothian Cysts
Nabothian cysts are mucinous retention cysts formed through the accumulation of cervical mucus inside blocked cervical crypts, leading to non-neoplastic mucinous cystic lesions in relation to the uterine cervix. They are a common gynecological benign condition in women of reproductive age.
- They form when cervical glands become blocked with mucus, usually after childbirth, inflammation, or trauma to the cervix.
- They appear as small, white, yellow, or clear bumps on the cervix and can range from 2 to 10 mm in size.
- Most women with nabothian cysts experience no symptoms, though occasionally they may cause mild discomfort or abnormal vaginal discharge.
Treatment Options
If a nabothian cyst becomes unusually large or causes symptoms, treatment options include:
- Cryotherapy (freezing the cyst)
- Electrocautery (burning it off)
- Surgical removal, with laparoscopic excision being a valid option for large and complex cysts, as shown in a case report where a 44-year-old patient with a large nabothian cyst was successfully treated with laparoscopic excision 1.
- Local cystectomies or hysterectomies may also be considered for symptomatic nabothian cysts, as suggested by a case report of a 46-year-old woman with a large nabothian cyst causing chronic urinary retention, who was treated with hysterectomy 2.
Importance of Accurate Diagnosis
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, but large and complex, nabothian cysts from other differential conditions of malignancies, consequently avoiding unnecessary hysterectomy 1.