According to statistics, half of the female population has a particular pathology of the cervix. Among cervical diseases, Nabot cysts are diagnosed in 10–20%, and, as a rule, in women who have given birth (25–45 years). This pathology is not life threatening and rarely becomes malignant, but in some cases can cause a number of trouble. In this regard, women with similar education, it is necessary to put on the dispensary registration and monitor.
Anatomical educational program
The uterus belongs to the internal genital organs and is located deep in the pelvis. The main task of the uterus is to bear and give birth to a child. In order for conception to occur, spermatozoa must enter the uterine cavity. Spermatozoa enter the uterus through the cervix (cervix), which binds the vagina and uterine cavity. In turn, the cervix has an eye visible in the vaginal part and a supravaginal part hidden in the pelvis. In the depths of the cervix is the cervical or cervical canal, which provides the exit of menstrual blood from the uterus to the outside and the introduction of sperm into the cavity.
The visible part of the cervix is covered with stratified squamous epithelium (the same lines the vagina). The cervical canal lines the cylindrical (cubic) epithelium. The junction of both types of epithelia is called the transition zone (transformation zone). Normally, this zone is located in the area of the external pharynx and the cervical epithelium does not reach the vaginal part of the cervix.
The cylindrical epithelium of the cervical canal contains a large number of glands, which are called endo- or paracervical. But much more often they are called nabot glands in honor of the author who described them.
The main task of the nabot glands is the production of mucus. Mucus is necessary for the mechanical removal of pathogenic microorganisms from the cervical canal, and also has antimicrobial properties, which negatively affects the pathological microflora.
The nabot glands are located in the lower third of the cervical canal and look like tubes filled with mucus.
The term "nabotova cyst"
Nabot cysts are called sacculate formations, which are localized on the cervix and formed as a result of blockage of the endocervical glands. The cavity of these cysts contains mucus produced by the glands. The accumulating mucus that does not have the ability to leave the gland, pererastyagivaet it and forms a cyst. Nabot cysts are always a benign formation, but in extremely rare cases, their malignancy (malignancy) is possible. The cysts of the nabot glands are retention, that is, functional entities.
What is the difference between a nabot (retention) cyst and true cysts?
If true cysts increase in size due to the proliferation of the capsule, which contains the secret, then the Nabotov cyst is due to the stretching of the gland walls with the accumulated secret.
Nabot's cyst does not have its own capsule, it is replaced by the walls of the affected gland, which is thinned due to overstretching. True cysts have thick capsules consisting of several layers of cells that divide and thicken the capsule even more.
The diameter of the nabot's cyst of the cervix is not more than 10 mm (very rarely reaches 20 mm). This is due to the impossibility of further stretching the walls of the gland. True cysts can reach gigantic sizes due to constant cell division of the capsule.
In rare cases, Nabot cysts dissolve on their own, and true cysts never.
Rarely there is a single nabot cyst, as a rule, it is a multiple formation (three or more).
Causes and mechanism of development
Two factors may lie in the mechanism of formation of nabot cysts. Either there is a mechanical blockage of the excretory duct of the gland and it begins to "swell" or thickens mucus, which is secreted by the endocervical glands.
In the first case, the cause of the formation of such formations is a violation of the integrity of the tissues of the cervix. In the process of regeneration (healing), a new layer of epithelium is growing, which can block the excretory duct of the nabot gland. Another option for mechanical blockage of the duct is the process of transition of true erosion (open ulcer) into pseudo-erosion or cervical ectopia.
Pseudoerosis is a section of the cylindrical epithelium, which normally covers the cervical canal located on the vaginal part of the cervix (it is in turn lined with a stratified squamous epithelium). In the process of pseudo-erosion formation, the cylindrical epithelium “descends” from the cervical canal, seeking to close the cervical ulcer and overlaps the gland excretory ducts.
In the second case, hormonal disruptions occur in the body, due to which mucus secreted by the glands becomes viscous and thick, which complicates the emptying of the gland and leads to the formation of its cyst.
It should be noted, and the third factor in the mechanism of formation of nabot cysts - the inflammatory process. Local inflammation occurs as a result of pathological microorganisms falling on the cervix. As a result, the cervical epithelium is loosened, and infectious agents penetrate into the cavity of the glands. In response to the introduction of infection, the glands begin to produce mucus in an intensive manner in order to wash the “invaders” from the surface of the cervix. But as a result of inflammation, the mucus itself is infected, it becomes thick and purulent. When the healing of the outer surface of the cervix begins, inflammation inside the glands still remains. The expanding epithelium of the vaginal part of the cervix overlaps the ducts of the glands, in which the inflammatory process is still raging, which leads to the formation of nabot cysts.
The main reasons for the formation of cysts Nabotov glands lead:
- Mechanical injury of the cervix:
- cervical tears in labor
- diagnostic curettage of the uterus,
- install / remove IUD,
- surgery on the neck.
- Hormonal disorders:
- changes associated with age (premenopause)
- endocrine pathology,
- hormonal drugs,
- bad habits (smoking, alcohol, drug use),
- various gynecological hormonal pathology (tumors of the uterus and ovaries, violation of the cycle, polycystic ovary, endometriosis, etc.).
- Inflammatory processes:
- chronic inflammatory diseases of internal genital organs (adnexitis, endometritis),
- cervicitis (endo- and exo),
- frequent change of sexual partners
- Neglect of intimate hygiene rules
- background diseases of the cervix (pseudo-erosion, leukoplakia),
- cervical dysplasia (precancer),
- endometriosis of the cervix.
These formations, as a rule, are asymptomatic and are detected by chance during a gynecological examination or during an ultrasound scan. Nabot cysts are often multiple and have dimensions not exceeding 10 mm. Typical clinical manifestations are associated with the formation of nabot cysts. For example, in case of inflammation of the cervix (cervicitis) and vagina (vaginitis), the patient is worried about complaints of pathological discharge from the genital tract (copious or moderate, greenish or yellowish, with an unpleasant smell). It may cause itching and burning in the vagina, painful and frequent urination with the involvement of the urethra in the process. Also, there is discomfort during intercourse. For nabotovyh cysts characteristic:
- not transmitted during sexual contact (safe for the sexual partner),
- do not violate sex life
- do not provoke disability,
- do not change the quality of life
- do not cause hormonal imbalance,
- do not have a genetic predisposition.
During the gestation period, significant hormonal changes occur that can trigger the growth of nabot cysts. Suppuration of such formations during pregnancy is possible, which is fraught with intrauterine infection of the fetus. In addition, the significant size of cysts can disrupt the opening of the cervix during labor, which will lead to anomalies of labor forces and will require cesarean section. During the period of exile, damage to the cyst is possible, with subsequent ruptures of the cervix, which makes the postpartum period heavier. The rupture of cysts in childbirth does not threaten the occurrence of bleeding, but is fraught with the development of the inflammatory process.
In addition to visual inspection of the cervix in the mirrors in the presence of nabot cyst or suspicion, the gynecologist will definitely appoint additional methods of examination.
From instrumental methods apply:
It consists in examination of the cervix with a colposcope (apparatus with multiple magnification). Cysts are perfectly visualized as white-yellow formations that protrude above the surface of the cervix. The vascular pattern is clearly visible on the cyst, and the vessels branch out and are directed from the periphery to the center. In addition, other background cervical processes (pseudo-erosion, leukoplakia) are diagnosed.
- Ultrasound with vaginal sensor
It allows not only to identify the pathology of the uterus and appendages, but also to diagnose Nabot cysts that are located in the cervical canal and are not visible either when viewed in the mirrors or during colposcopy. Formations of endocervical glands are anechogenic. Using ultrasound, determine the number and size of cysts, their contents and uniformity.
A biopsy of the suspicious part of the cervix and a subsequent histological examination confirm the presence of nabot cysts, their good quality and the presence / absence of an inflammatory process in the gland.
From laboratory research methods prescribe:
- General blood and urine tests
To eliminate the inflammatory process of the reproductive system.
- Blood test for hormones
Needed to detect hormonal imbalance, which could be the cause of cyst development.
Samples are taken from the cervical canal, from the vaginal walls and from the surface of the neck. The definition of microflora, identification of pathogens of the infectious process.
They take smears from the vaginal part of the cervix and from the cervical canal. Helps to identify atypical cells (dysplasia, cervical cancer).
Appointed in case of inflammation of the cervix to exclude hidden genital infections (chlamydia, mycoplasma, HPV and others).
When nabot cysts are found, the treatment is not always carried out, since this is most often an accidental find and the pathology does not bother the woman. If the cysts are small or single, the patient is recommended to regularly visit the gynecologist (every six months) and undergo a colposcopic examination. In other cases, surgical treatment is assigned, the task of which is to remove the nabot cyst.
Indications for surgical treatment:
- there is an increase in the size of cysts / cysts,
- cyst suppuration occurred,
- there is obstruction (blockage) of the cervical canal, which causes pain during menstruation and / or mechanical infertility,
- pain in lower abdomen during exercise or during coitus,
- the patient wants to get rid of the pathology.
If there is a concomitant infection of the cervix or the detection of hidden genital infections, treatment begins with conservative methods. Oral antibiotics are prescribed (cephalosporins, macrolides, fluoroquinolones) depending on the seeded microflora, candles intravaginally (hexicon, betadine, depantol, polygynax, dicloberl), which have a local antimicrobial effect, relieve swelling and irritation of the neck and relieve pain. After the conservative therapy is carried out, the smears are re-collected on the microflora of the vagina and the cervical canal and the colposcopy is repeated. In case of normalization of the vaginal and cervical microflora, elimination of inflammation in the cervix, surgical treatment is started, which can be carried out in various ways depending on the equipment of the clinic.
The essence of the surgery is to puncture the cyst and evacuate its contents, and then cauterize the capsule in one way or another. Surgical intervention, during which cysts are removed, is carried out in the same way as the surgical treatment of cervical pseudo-erosion:
- Diathermocoagulation or DTK (DEK)
A fairly old method and recently rarely used in the treatment of diseases of the cervix. Destroyed cysts are cauterized with an electric coagulator. The method is quite painful and is recommended for treatment only for women who have given birth (causes scar deformity of the cervix, which can lead to complications during childbirth).
- Cauterization of chemicals
After puncture and emptying the cyst, its bed (capsule) is cauterized with chemical preparations (alcohol or solkovagin - a mixture of organic acids).
An effective treatment that virtually eliminates recurrence.
The cyst bed is frozen with very low temperature liquid nitrogen.
The destruction of pathological cells by radio waves (apparatus "Surgitron"). The method has gained popularity recently due to its high efficiency.
Such an operation is carried out in the case of severe deformity of the neck and the presence of many large cysts (10-20 mm). As a rule, cone excision (excision) of the cervix is performed and all cysts are removed. In advanced situations, it is proposed to perform a vaginal amputation of the cervix, and if cervical cancer is suspected, an uterine extirpation (removal of the uterus and cervix) is performed.
Tactics of surgical intervention is determined by the clinical situation, the age of the woman, concomitant gynecological pathology and the patient's desire to preserve reproductive function.
After surgical removal of nabot cysts, the patient is recommended:
- observance of sexual rest for a month so as not to injure the scab formed after treatment,
- restriction of lifting (not more than 3 kg),
- elimination of douching
- control check with the doctor after 2 weeks, then after 6,
- the introduction of vaginal suppositories to prevent infectious complications and reduce inflammation and swelling of the cervix (suporon, terzhinan, depantol),
- taking nonsteroidal anti-inflammatory analgesics for pain and to accelerate the healing of postoperative wounds (nise, ketonal, indomethacin, pentalgin),
- refusal from visiting baths, saunas and bathing for 6 weeks.
Many women are interested in whether it is possible to apply the folk treatment of nabot cysts? Yes, the use of folk remedies for this pathology is not excluded, but only as an addition to the main therapy, since it is impossible to get rid of cysts only by folk methods. Folk remedies can be used in the pre-and postoperative periods. They help reduce signs of inflammation and swelling, eliminate irritation and suppuration of cysts. Of the recommended methods are allowed to use:
- Walnut Septum
Four tablespoons of partitions chop and pour three glasses of boiling water. The mixture is then simmered for 20 minutes. The resulting decoction should be filtered and cooled. Take half a cup three times a day.
Pour 2 tablespoons of freshly picked acacia flowers with a glass of vodka. Mixture insist for two weeks in a dark place, before you start taking the tincture should be filtered. Take a tablespoon of tincture, diluted with two tablespoons of boiled water three times a day. The course of treatment is 30 days.
It has wound-healing properties, it is recommended to take in the postoperative period. From the fresh leaves of burdock squeeze juice. The first 2 days, squeezed juice is taken in a tablespoon twice a day, the next 2 days, the intake is increased to three times a day and lasts for a month.
The introduction of intravaginal tampons with various plants (eg, garlic) and herbs to get rid of nabotovyh cysts is impractical and even harmful.
Before treatment with traditional methods, you should consult with your doctor.
Specific prevention of cervical cysts is not. It is recommended to comply with measures aimed at preventing the development of any gynecological pathology:
- intimate hygiene,
- visiting the gynecologist every six months,
- the use of barrier contraceptives for casual sex,
- pregnancy planning,
- rejection of abortion
- timely and adequate treatment of hidden genital infections.
Yes, suppuration of nabot cyst is one of the complications of this pathology. The inflammatory process in education develops in the case of its large size (10 - 20 mm) and during infection (thrush, trichomonas coleitis, bacterial vaginosis, etc.). In the case of severe inflammation, in addition to local symptoms (pain in the lower abdomen and during intercourse, purulent discharge from the genital tract), general signs of intoxication appear (fever, loss of appetite, weakness). In such a situation, it is necessary to urgently consult a doctor who will prescribe general and local anti-inflammatory treatment, and then Surgical removal of a cyst.
Yes, most likely in pains during menstruation are overgrown cervical cysts, which partially overlap the cervical canal, which complicates the outflow of menstrual blood. You need to be examined (colposcopy, ultrasound with a transvaginal sensor and blood for sex hormones) and surgical treatment of the formations.
Yes.With significant size of cervical cysts, the cervical canal overlaps, which makes it impossible for sperm to enter the uterine cavity and then conceive.
If the cysts are small and did not show themselves before pregnancy, then the risk of their negative impact on the course of this pregnancy is minimal. But in some cases (extremely rarely) an increase in the size of the formations and their suppuration is possible, which can cause a miscarriage. It is necessary to follow all the recommendations of the doctor and preventive measures to prevent cyst suppuration.
Education on the cervix extremely rarely go into cancer, so the prognosis is favorable.
What causes the blockage of the duct
The cervix is a narrow channel lined with a protective layer of cylindrical epithelial cells. The outer part of this channel goes into the vagina. From the mechanical damage and penetration into the tissue of infection, the vaginal part of the cervix is also protected by a layer of epithelium, but its cell shape is flat. Cylindrical and flat (scaly) epithelium differ not only in the shape of cells, but also in their properties. If the squamous epithelium is well tolerated in the weakly acidic environment of the vagina, the cylindrical epithelium is destroyed by the action of the acid. In some cases, flat cells may move to the cylindrical region and vice versa.
The causes of blockage of the ducts of the glands can be:
- Inflammation of the cylindrical epithelium in contact with the acidic environment of the vagina. This happens if the mucous membrane of the cervical canal is on the vaginal part of the cervix.
- Sloughing of the flat cells of the vaginal epithelium and getting them into the region of the cervical canal.
Addition: Nabota ("retention") cysts on the cervix should not be confused with another type of similar formation, with endometriotic cysts. Endometrial cells (uterine lining mucosa) are involved in their formation. In endometriosis, the uterine mucosa grows into the region of the cervical canal and the vaginal part of the uterus, in which cystic cavities are formed. Endometrioid cysts are filled with blood. With endometriosis, women have irregular menstruation (delayed menstruation and spotting blood between them).
Causes, types of nabot cysts
Occlusion of ducts that discharge mucus that forms in the cervical canal occurs for two reasons.
Thickening of mucus. This is facilitated by hormonal changes in the body (age or caused by hormonal drugs, endocrine diseases, metabolic disorders). Changes in the consistency of mucus can result from drug use, smoking, obesity.
Mechanical desquamation epithelial cells and moving them to the next area of the cervix. This condition is called ectopia (pseudo-erosion). The displacement of the cells of the cylindrical and flat epithelium occurs during childbirth, abortion, operations on the cervix and in its cavity (curettage), as well as during sexual intercourse. One reason may be inflammatory disease of the cervix (cervicitis). Such educations are usually found in women giving birth to 25-45 years.
Depending on the location, the cervical cysts are divided into endocervical (inside the cervical canal) and paracervical (on the vaginal part of the cervix).
Consequences and symptoms
Single or multiple Nabot cysts usually range from a few millimeters to 1-2 centimeters. Look like yellowish formations of a round shape. They are usually found in women accidentally when they go to a doctor about treating another disease (cervicitis, for example) or during a check-up.
The danger is that the cyst can inflame, pus is formed in the mucus. The infection easily penetrates the uterus, and from there into the appendages. This causes diseases such as oophoritis (inflammation of the ovaries), endometritis (inflammation of the endometrium of the uterus), salpingitis (inflammation of the fallopian tubes), as well as inflammatory diseases of the vagina, bladder. If pus develops in nabot cysts, a woman will experience the following symptoms: fever, pulling pain in the lower abdomen, and mucous discharge of yellow or green color.
If there are small cysts, there are no obvious symptoms of the disease. A woman may feel discomfort during intercourse due to the dryness of the vagina, as the amount of mucus decreases due to blockage of ducts.
If the cause of the cyst is ectopia of the cervix, then a significant part of the mucus is secreted into the vaginal area, instead of accumulating in the cervical canal. In this case, the woman appears copious mucus from the vagina. When cysts are inflamed, these secretions have an unpleasant odor and a green tint.
Another consequence of the formation of nabot cysts is that they can swell (especially for large sizes). This leads to a narrowing of the cervical canal, which reduces the possibility of sperm entering the uterus. That is, despite the absence of diseases of the uterus and appendages, the normal menstrual cycle, a woman will not be able to become pregnant.
Nabot cysts during pregnancy
Small cysts during pregnancy do not pose any danger. If they are found after the onset of pregnancy, the treatment is carried out only after childbirth, not earlier than 40 days, when the postpartum vaginal discharge disappears completely.
However, the following complications may occur:
- Hormonal shift can cause cyst growth, leading to cervical dilatation and premature birth. In the early stages of pregnancy, this leads to miscarriage.
- During childbirth, a festering cyst can burst, which is dangerous for the child. The cervix will heal for a long time, there will be extensive inflammation. Therefore, a cyst is removed during childbirth.
Recommendation: When planning a pregnancy, it is recommended to undergo a gynecological examination. If Nabot cysts are found, it is better to remove them in advance.
It is possible to detect nabot cysts on the cervix during gynecological examination with the help of mirrors. To clarify their nature, an ultrasound scan is carried out, as well as additional examination by other methods.
Colposcopy. Allows you to view the cyst with optical zoom and special lighting.
Cytological examination mucus (smear) of the vagina, cervix and urethra to determine the type of infection that caused the inflammation.
Bacteriological seeding allows you to determine the sensitivity of bacteria to antibiotics, to prescribe the treatment of inflammatory diseases.
PCR (detection of DNA of viruses) - detection of sexually transmitted infections (chlamydia, Trichomonas, mycoplasmas and others), as well as the presence of human papilloma viruses in the body.
Blood tests: general (on leukocytes to establish the presence of an inflammatory process), on hormones (estrogens, progesterone, and others), on tumor markers, on antibodies to sexually transmitted infections (by ELISA).
Nabotovaya cyst treatment
In the presence of small cysts, treatment is not carried out. A woman should periodically undergo preventive examinations to detect the possible growth of these structures and timely diagnosis of inflammatory processes. Sometimes a large cyst ruptures and then heals on its own.
The treatment is carried out in the following cases:
- there is a significant increase in size of nabot cysts,
- found suppuration of the cyst,
- narrowing or overlapping of the cervical canal occurs, while pregnancy is not possible.
Perforation and cleansing of the cyst is carried out, after which antibiotic treatment is carried out to prevent the inflammatory process. Laser, radiofrequency, cryoscopic, or chemical cauterization is also used. Removal of nabot cyst is performed in the first two weeks of the menstrual cycle.
Homeopathic and folk remedies and methods of physiotherapy (for example, hirudotherapy, or leech therapy) are also used to treat nabot cyst.
A preventive measure against possible complications during growth and inflammation of a nabot cyst is regular gynecological examination with colposcopy and ultrasound.
What are dangerous nabota cyst
Retention cysts do not carry with them a cancer threat - they “do not turn into cancer”, do not cause a jump in hormones, pathologies of pregnancy, miscarriages, and delayed menstruation. However, they often contain viruses and bacteria that can cause inflammation in the uterus, its cervix, vagina, ovaries and fallopian tubes, which can be repeated regularly.
Conception and pregnancy with tassels on the neck
Along with many, the inflammation caused by cystic-dilated glands (KRG) can cause a diagnosis of ectopic pregnancy and infertility.
Large cysts squeeze the cervical canal, and this makes the fertilization process impossible.
If the pregnancy has occurred, naturally or by IVF, single or multiple cysts will not adversely affect its course and childbirth. Treatment (opening of the cyst), if necessary, is recommended to be carried out after childbirth, at the time when the bleeding (lochia) stops lasting for about 40 days.
If a woman decided to put a "spiral" (intrauterine contraceptive device - IUD), then the presence in the history of this diagnosis will not be able to prevent this.
Pregnancy with retention cysts for STIs (chlamydia)
Scientists conducted a study in which 105 women with recurrent chlamydial infection took part. All of them had no children, but planned pregnancy. It became known that this infection can exist for a long time in nabotovyh cysts without showing itself, and therefore the approach to the diagnosis and further treatment of this disease has been changed.
As already mentioned, the size of cysts can vary from about 5 millimeters to 2-3 centimeters and the duration of their existence in the body is not determined. When infected, the secret accumulating inside the cyst becomes a very favorable environment for the life and reproduction of any infection. If the cyst tissue, due to mechanical or hormonal effects (childbirth, pregnancy), is broken, its contents are a source of re-infection, despite the fact that the woman has already undergone treatment.
Scientists with a laser removed cysts for women participating in this study.
Here are the conclusions drawn from the results.
- Chlamydial infection can exist for a long time in the glandular cells of the uterus and its cervix, without giving any symptoms.
- Retention cysts can cause chlamydia to recur in a pregnant woman.
- If a woman had a diagnosis of chlamydia in the past, then when planning pregnancy, endocervical cyst should be removed with a laser.
How to treat nabot gland cysts
What to do with this pathology? The most common approach to treating a disease is surgery.
- laser removal
- endoscopic removal,
- radio wave treatment.
In the case of cysts, deformation and hypertrophy of the cervix, coupled with the pathology of its epithelium, dysplasia, it is recommended to use the method of conization, in which the modified cervical tissue with the apex of the cone is excised.
The effectiveness of cryotherapy is confirmed only in 44% of cases.
Radio wave surgery is used both in the treatment of nabot and endometrioid cysts, as well as for a number of other pathological diseases of the epithelium (leukoplakia, ectopia, papillomas and cervical polyps). Radiowave treatment is prescribed in the absence of effectiveness of such methods as cryodestruction, Solkovagin, diathermoelectroconization.
After cauterization, doctors prescribe antiseptics, anti-inflammatory drugs and antibiotics, often in the form of vaginal suppositories.
Along with surgical methods of treating nabotovyh cysts, there is also a drug, the effectiveness of which reaches 60% - treatment with the drug Solkovagin. This is a local drug that causes tissue necrosis.
The procedure for its application is as follows.
The neck is exposed with the help of mirrors. A cotton swab removes mucous secretions and the cervix is treated with a 3% solution of acetic acid, which helps to better visualize the affected areas, which are then 2 times with an interval of a couple of minutes processed with a swab soaked in Solkovagin. For some time, it provokes the removal of damaged epithelium, without affecting healthy epithelial cells.
As a result of chemical coagulation, a scab that has a gray or yellow-white shade is formed. The affected tissue forms a protective layer and remains on the surface of the cervix for 3-5 days, after which the scab is rejected without causing pain and bleeding, and allows the mucous membrane to be epithelized by healthy cells. At this time, small mucous secretions are possible.
Tissues are restored in 3-4 weeks and, as a rule, treatment is effective after one course.
Treatment of folk remedies
Alternative medicine does not disregard any disease, especially when it comes to women's health. There are many recipes for making decoctions for douching and tampons to get rid of virtually all gynecological problems. But such treatment can only aggravate the disease and complicate its diagnosis. Often, the appearance of cysts is accompanied by an inflammatory process, which only intensifies when douche with herbs decoction and ingestion of them inside.
How nabote cysts are formed
The cause of these cysts is the blockage of the cervical glands (endocervix), which prevents the outflow of fluid. As a result, mucus accumulates, forming bubbles filled with liquid contents. When blocking several glandular ducts occurs multiple cystic lesion, making the cervix bumpy.
nabot cysts of the cervix
"data-medium-file =" https://i1.wp.com/medcentr-diana-spb.ru/wp-content/uploads/2017/09/nabotovyi-kistyi-sheyki-matki.jpg?fit=450% 2C300 "data-large-file =" https://i1.wp.com/medcentr-diana-spb.ru/wp-content/uploads/2017/09/nabotovyi-kistyi-sheyki-matki.jpg?fit=584 % 2C390 "class =" alignnone wp-image-6872 size-full "src =" https://i1.wp.com/medcentr-diana-spb.ru/wp-content/uploads/2017/09/nabotovyi-kistyi -sheyki-matki.jpg? resize = 584% 2C390 "alt =" Nabot's cervical cysts "width =" 584 "height =" 390 "srcset =" // i1.wp.com/medcentr-diana-spb.ru/ wp-content / uploads / 2017/09 / nabotovyi-kistyi-sheyki-matki.jpg? w = 893 893w, https://i1.wp.com/medcentr-diana-spb.ru/wp-content/uploads/2017 /09/nabotovyi-kistyi-sheyki-matki.jpg?resize=450%2C300 450w, https://i1.wp.com/medcentr-diana-spb.ru/wp-content/uploads/2017/09/nabotovyi- kistyi-sheyki-matki.jpg? resize = 768% 2C513 768w, https://i1.wp.com/medcentr-diana-spb.ru/wp-content/uploads/2017/09/nabotovyi-kistyi-sheyki-matki .jpg? resize = 824% 2C550 824 w "sizes =" (max-width: 584px) 100vw, 584px "data-recalc-dims =" 1 "/>
Violation of the outflow from the glands provoke:
- Inflammatory processes in the uterus and vagina, leading to the destruction of the squamous epithelium of the cervix and its replacement with a cylindrical one, which normally should not be there. The cells of the tissue that are not designed to come in contact with the moist acidic environment of the vagina are irritated and inflamed. They violate the outflow of secretion, leading to the appearance of cysts.
- Childbirth and surgical interventions accompanied by neck trauma. The epithelium grows together incorrectly, and the tissue that is supposed to stay inside is outside.
- Erosion of the cervix, which has almost the same mechanism of occurrence. Often these two diseases are combined. Sometimes cysts are formed after the treatment of erosion by outdated methods, for example, electrocoagulation or a surgical method. After radio wave treatment, erosion of such complications does not happen.
Nabotovy cervical cysts and pregnancy
Large cysts interfere with the penetration of sperm into the uterus, causing female infertility. When pregnancy occurs due to hormonal adjustment of the body, leading to an increase in the intensity of mucus secretion, the size of the "bubbles" increases. Education during this period is not removed, so as not to provoke a miscarriage. Treatment is delayed until the child is born.
In the first months of pregnancy, Nabot cysts do not affect gestation, but problems begin later on. Large formations that deform the cervical tissues can provoke early cervical opening and premature labor.
During labor, when a cystic-modified cervix is opened, gaps arise, caused by a decrease in the elasticity of the tissues. Bubbles burst, long non-healing wounds are formed - an open gate for pathogens. Therefore, endocervical cysts must be disposed of at the planning stage of pregnancy.
Treatment of nabot cysts
By themselves, these structures do not dissolve and do not disappear, so the nabot cysts, especially large ones, are removed, getting rid of the source of infection in the genital tract. In addition, in this pathology it is impossible to install the intrauterine device.
Treating Nabotov's cyst folk remedies is meaningless. On the contrary, the introduction of tampons into the vagina and uncontrolled douching lead to the growth of old and the emergence of "fresh" tumors.
Before removal, the nabotovy cyst of the cervix is punctured, allowing the contents to flow out.The remains are removed using laser or radio wave coagulation (sealing of blood vessels), which does not cause pain, severe tissue trauma and bleeding.
Remove similar cell formations with modern techniques:
- electrocoagulation (el. current),
- cryocoagulation (cooling with liquid nitrogen),
- laser excision,
- endoscopic method (microtools equipped with a microscope and illuminated),
- radio wave therapy - the latest technique.
How exactly to remove the cyst decides the gynecologist. The doctor selects the method individually, given the size of the formation and characteristics of the organism. If there is a choice, it is better to prefer a radonoz, since after it there will be no bleeding and complications. The technique is suitable even for nulliparous women.
Since the cervix does not contain nerve endings, the procedure is painless. A small number of patients with sensitivity in the cervical region are given local anesthesia or general anesthesia.
The procedure is carried out after the end of the next monthly. The epithelium is restored before the start of the next menstrual cycle.
After surgery, medication is needed: antibiotics, antiseptics, vitamins and anti-inflammatory drugs.
Symptoms of nabot cysts
According to statistics, in almost 20% of patients of reproductive age there are multiple or single cysts. At the same time their asymptomatic course is noted, the clinical picture is not characterized by specific vaginal discharge or general malaise.
Therefore, the detection of nabot tumors is often the result of a preventive approach to a gynecologist. In addition, they do not affect the menstrual cycle, but can trigger an infectious process in the pelvic organs. For this reason, large sex formations are usually removed.
In most cases, the symptoms of the disease mimic the signs of pseudo-erosion and endocervicitis:
- structural change of secretions, increasing their number,
- bleeding during the menstrual cycle or after sexual contact,
- pulling painfulness in the lower abdomen a few days before the onset of menstruation,
- itching of the genital organs, resembling a manifestation of thrush.
For accurate diagnosis requires careful examination. The most unpleasant option is the presence of an endometrial cyst, which, if delayed in treatment, leads to infertility and extensive deformities of the cervix. Also develops on the background of the inflammatory process.
During the diagnostic manipulation, the doctor will detect the following symptoms of the disease:
- change in the surface of the neck, the appearance of irregularities, roughness,
- whitish formations, oval / round shape, having a different diameter,
- superficial (erosive) epithelium defect.
Symptomatology during pregnancy
Small cystic formations are not accompanied by a pronounced clinic, they are often diagnosed on a scheduled examination. Do not pose a danger to pregnancy, so their therapy is appropriate after childbirth. In larger formations, the symptoms do not differ from the signs of pathology in non-pregnant patients.
However, cysts during pregnancy can provoke some complications:
- Changes in hormonal levels lead to increased growth of hollow tumors, which can provoke premature labor.
- At the time of birth, education containing a purulent secret may burst, which will adversely affect the child. An extensive inflammatory process develops that does not allow adequate healing of the cervix.
- If the risk of these complications has been established, a neoplasm is resected during childbirth.
Nabot's cervical cyst - what is it?
Mature women should be examined by a gynecologist at least once every six months - surely many people know this rule, but not everyone understands why go to a doctor for a person who does not feel unwell? The answer is quite simple - in 20% of women, from 16 to 45 years old, diseases of the reproductive system are diagnosed that are not accompanied by symptoms and changes in health. One of these ailments are Nabot cysts. What it is, how to diagnose and treat them is the topic of today's article.
Nabota cyst of the cervix Depending on the location, the nabot cyst on the cervix (the photo is often confused with erosion of the cervix) of the exodus: what is it?
Speaking of what nabotovy cysts, it is necessary to mention, first of all, about the physiological features of the female body. The cervix is the lower part of the uterus that connects the hollow organ with the vagina through a cervical canal located inside.
This canal consists of a number of glands (named after the scientist nabotnymi), highlighting a special secret - cervical mucus, which performs the following functions:
- Protective. The secret of the vagina has a viscous consistency and forms a kind of plug that closes the canal, thereby protecting the genitals from penetration of infection into the uterine cavity.
- Auxiliary. Depending on the phase of the menstrual cycle, the consistency of the secreted secretion also changes; during the period of ovulation, the mucus becomes fluid and allows spermatozoa to move freely into the uterine cavity.
Cysts located on the cervix are of several types, are classified according to the causes and are divided into:
- Traumatic. Arise as a result of mechanical damage and displacement of cervical tissue.
- Tumor. The reason for the appearance of such follicles are abnormalities in the neoplasms, while it doesn’t matter whether the tumors are malignant or benign.
- Infectious. Cystic cavities formed as a result of the vital activity of pathological microorganisms.
- Congenital Such cysts manifest themselves in the reproductive system even during fetal development for various reasons.
- Retention. These tumors are somewhat different from the above, because they can not degenerate into malignant and appear when the ducts of the glands are blocked.
The overlap of the duct of the gland leads to the formation of a cavity in which mucus accumulates. These tumors are benign, do not affect the hormones of the woman and are called the nabot cysts of the cervix.
Why congestion in the ducts? The fact is that the epithelial cells of the cervical canal are cylindrical in shape, while the cells of the cervical protective layer are flat. The epithelium of the channel is prone to destruction under the influence of an acidic environment, and flat cells can exfoliate. Thus, the nabot gland ducts can be blocked as a result of:
Inflammation and destruction of cylindrical epithelial cells of the cervical canal.
Detachment of flat cells and moving them into the cavity of the cervical canal.
Nabot cysts on the cervix are divided into several types and can be classified according to the following features:
- Depending on the location, the nabot cyst on the cervix (the photo is often confused with cervical erosion) is of several types:
- Single - one or more, located far from each other, cysts. A rather rare, difficult to diagnose phenomenon, not accompanied by characteristic symptoms and discomfort.
- Multiple - neoplasms of small size, located separately or grouped.
- Small - education, not reaching 4 mm.
- Medium - cysts, 5-8 mm in size.
- Large - cavities reaching 2 cm.
Nabot cysts are able to regress.
In addition, these tumors:
- They are not related to genetic features and are not a hereditary disease.
- They are not the result of inflammation or infection, and therefore cannot be transmitted to a partner during unprotected sexual intercourse.
- In most cases, do not have a negative impact on the menstrual cycle and the maturation of the egg.
- Not able to deform the tissue of the uterus, therefore, do not affect the intrauterine development of the fetus.
So, unlike all cystic cavities that form on the cervix, Nabot cysts (photos of which can be found on the Internet) do not in themselves pose a risk and are not treated in Western countries.
Diagnosing the cervix with nabot cysts
Diagnosis of cysts in the reproductive system begins with a pelvic exam using a mirror. The revealed neoplasms are subjected to thorough research by several methods:
- Examination of cysts with optical zoom (colposcopy).
- The collection of biological material and its analysis on the source that caused the inflammation.
- Determination of the sensitivity of identified infections to various drugs using bacteriological culture.
- The collection of material for analysis of sexually transmitted infections.
- Blood sampling for general analysis, analysis of hormones and oncomer.
Speaking about what Nabotovy cyst cervix, it is necessary to consider this diagnosis from the point of view of the international classification of diseases.
Nabotov's cyst - ICD10 code
ICD is an international classification of diseases, presented in the form of a document containing a generally accepted differentiation of diagnoses, intended for comparing international methodological materials and common approaches to the treatment of diseases. To date, the data established during the 10th classification revision are used.
So, to determine the code of this disease, it is necessary to understand its pathogenesis and causes of occurrence. First of all, cystic formations in the nabot glands are located on the cervix, and all the organs of the pelvis belong to the reproductive system. Accordingly, Nabot cysts are diseases of the genitourinary system and have a code in the classification from 0 to 99.
Further, Nabot cysts according to ICD 10 are defined as diseases caused by dysfunction of the ducts, which means that this diagnosis is classified as a non-inflammatory disease of the genital organs and has a code from 80 to 98.
The cysts of the nabot glands are not related to endometriosis, prolapse of the genital organs, polyps, infertility, and other diseases localized in the pelvic organs. Therefore, Nabotov's cyst according to ICD10 is related to other non-inflammatory diseases of the cervix uterus and is numbered 88.
Neoplasms in the nabot glands do not have a history of cervical ruptures, they do not affect its lengthening or insufficiency. So, nabotovy cysts: a code on MKB10 - 88.8.
Nabot cysts: causes
Cysts in the nabot glands arise when the ducts are blocked, and the latter process, in turn, is influenced by such factors as:
- Hormonal disorder. An overabundance or lack of hormones directly affects the consistency of cervical mucus, and the release of too viscous and thick secretion leads to disruption of the glands and the overlapping ducts.
- Diseases of the reproductive system. Pseudo-erosion can lead to the appearance of cystic cavities, during which there is a detachment of cylindrical epithelium cells, their entry into the acidic environment of the vagina and subsequent destruction.
- Natural delivery. In the process of recovery of the body after childbirth, a nabot cyst may form, the cause of which is an increased secretion of cervical mucus.
- Abortion in history.
- Cleaning the uterine cavity.
- Surgical intervention in the cervical tissue.
- Incorrect actions of the doctor when installing the intrauterine device.
- Failure of intimate hygiene.
So, all the causes of cervical cymbal cysts can be divided into 3 categories:
- Hormonal failure, violation of the concentration of estrogen, when taking hormonal drugs, after pregnancy and in diseases of the reproductive system or thyroid gland.
- Mechanical damage to the epithelial tissue of the cervix during surgery.
- The course of inflammatory processes and infectious diseases in the pelvic organs. The fact is that during such diseases, the nabot glands begin to produce much more mucus in order to remove all pathological microorganisms from the cervix.
To date, studies aimed at studying the nabot cysts of the cervix and the reasons for their appearance are not over, so the above list is not exhaustive.
Nabot cysts: signs
As a rule, single or medium-sized multiple cavities do not manifest themselves and are diagnosed during a gynecological examination, in which the signs of nabotovyh cysts of the cervix are revealed:
- In the form of a heterogeneous, bumpy surface of the cervix.
- In the form of yellowish-white or dairy tumors, of various sizes and quantities.
- In the form of cervical tissue erosion.
- Narrowing of the intrauterine canal. This symptom is detected during a gynecological examination and is the result of multiple tumors located on the cervix.
It is not always possible to determine cysts by the structure of the tissues of the vaginal part of the cervix, since the follicles located in the cervical canal are not diagnosed during a routine examination. Signs of tumors, in such cases, can be:
- Chronic diseases of the bladder or urethra. The accumulation of mucus in the follicle can lead to rupture of the membrane and infection of the organs of the urogenital system.
- Inflammatory processes in the uterine cavity. Penetration into cystic formation of staphylococcus or other infections leads to the appearance of pus and the spread of inflammation in all organs of the small pelvis.
- Inflammatory processes in the ovaries.
In most cases, such signs are not associated with cystic cavities, however, women with the above-mentioned diseases are at risk and should be examined regularly.
Nabot's cyst: symptoms
Small cavities are detected only upon examination, and larger formations or penetration of infection into the cyst cavity can lead to the following symptoms:
- Lower abdominal pain. Acute or nagging pains can occur as with multiple cysts overlying the cervical canal, as well as with the infection of single follicles. The narrowing of the canal prevents the exit of menstrual bleeding, and its accumulation in the uterine cavity leads to the appearance of pain.
- Change the color of selections. Inflammatory processes occurring in the cervical canal, lead to a change in the consistency and color of secreted secretions.
- Sharp, peculiar smell of discharge. The presence of inflammatory processes is reflected in the smell of cervical mucus.
- Pain during intercourse. This can be a cyst located on the vaginal part of the cervix, endocervical nabotov cyst symptoms, the treatment involves some other.
- Headaches. Purulent inflammation entails intoxication in the body and a general deterioration of the woman’s well-being, in addition, the acute course of the disease can lead to an increase in body temperature.
- Violation of the vaginal microflora and the scarcity of secretions of cervical mucus. In the case when the ducts of the gland overlap with tissue cells or thick secretion, the secretion of cervical mucus is significantly reduced, which leads to discomfort during sexual intercourse.
- Cervical cysts can cause changes in a woman's sensations. Often, the formed cavities are felt as a foreign body and deliver pain during intercourse.
Diagnosis of the disease rarely relies on the symptoms of nabot cysts, since all of the above symptoms may be accompanied by other diseases of the urogenital system:
- Polyps, accompanied by bloody discharge between menstruation, pain during intercourse, pulling back pain and lower abdomen.
- Erosion, the symptoms of which are menstrual disorders, copious discharge, discomfort during sexual intercourse and discharge with blood after it.
- Endometriosis, which manifests as bloody bloody discharge, lower abdominal pain, and pain in intimate intimacy.
Nabot cysts: ultrasound
Ultrasound examination is a common method necessary to confirm or refute a diagnosis of nabot cysts (on ultrasound photos, not only the size of the cavities, but also their number is clearly defined). The examination is appointed after a gynecological examination and collection of biological material for laboratory tests, and is carried out to study:
- Structural features of the epithelium.
- Circulatory features
- The features of the vaginal microflora.
Nabot's cyst on ultrasound imaging is visualized as thickening or focal consolidation of the epithelium of the cervical canal, accompanied by its slight and uneven expansion. During the course of inflammatory processes, echographically determined hypertrophy and increased echogenicity of the uterus.
The procedure itself has no features and can be carried out both transabdomitally and with the help of a transvaginal sensor. The differences of these methods are that in the first case, ultrasonic waves are sent through the anterior wall of the peritoneum, in the second - through the vagina. The fact is that transabdominal examination can not always get a complete picture of the disease, and a transvaginal sensor can detect even the smallest pathology.
In addition, examination through the anterior peritoneal wall involves the preparation of the patient, namely:
- 3-4 days before the study, the woman must abandon the gas-generating products.
- 1-2 days before the procedure, the patient is recommended to start taking activated carbon.
- The subject should not eat food directly in front of the ultrasound.
- Immediately before the procedure, a woman needs to drink 1 liter of water to fill her bladder.
Ultrasound examination is a fairly accurate method that allows you to diagnose a nabot cyst (an ultrasound photo in both black and white and in a volumetric (4D) version can be viewed on the Internet). However, in some cases, the results of this procedure can be re-checked using a magnetic resonance imager.
Nabotova cyst: MRI
Magnetic resonance imaging is the most informative method for studying tumors in the nabot glands. The indications for the survey are:
- Difficulties in establishing the diagnosis on the basis of inspection, laboratory tests and ultrasound.
- The inconsistency of the clinical picture of the disease and the data obtained from previous surveys.
- The need for a comprehensive study of the organs of the urogenital system for the spread of infectious and inflammatory processes.
To obtain reliable test results, the patient should:
- 2-3 days before the procedure, abandon the gas-forming food.
- Do not take food at least 4 hours prior to the scheduled study.
- Do not empty or overflow urinary. The best option is considered to be a half-filled bubble.
- Examination of the reproductive organs is carried out from the 7th to the 13th day of the menstrual cycle.
Nabot cysts: treatment
Opinions of experts about the treatment of nabotovyh cysts of the cervix of the uterus differ: some believe that the disease does not harm the health of the woman and does not need treatment, others, on the contrary, insist on the use of drugs or surgery. In any case, therapeutic methods are prescribed individually, taking into account all the features of the female body.
Treatment of nabot cyst involves the use of the following methods:
- Conservative. Treatment of neoplasms with drugs.
- Alternative. Treatment of the disease through traditional medicine.
- Surgical. Removal of cystic cavities by surgical intervention.
Single or medium-sized multiple neoplasms do not require treatment - this is the opinion of many specialists, but making a reservation:
- The cysts in the nabot glands should not cause pain or discomfort.
- According to the results of the tests performed, no deviations of the hormone level from the norm were detected.
- The survey revealed no diseases in the reproductive system of women.
- According to the results of the studies, there were no inflammatory and infectious processes occurring in the pelvic organs.
Nabotovy cervical cyst - treatment with medication
Symptoms or an increase in the size and number of follicles suggest treatment of nabot cysts on the cervix.
IMPORTANT! Traditional therapy can not save a woman from neoplasms. Prescribed treatment is aimed at eliminating the causes of nabot cysts and the prevention of possible consequences.
Thus, the doctor's prescriptions are based on the studies conducted and the causes of the disease identified and are:
- Therapy aimed at stabilizing hormonal levels
Hormonal disorder is a common cause of the formation of a nabotovaya cyst of the uterus, the treatment of such a malfunction involves the use of contraceptive drugs and is a complex therapy, including:
- Acceptance of oral contraceptives. The choice of such drugs depends on the individual characteristics of the female body, and they should be used only after consulting the attending physician. The fact is that contraceptive drugs have a rather impressive list of contraindications and side effects, leading to serious consequences.
- Reception of vitamins of group A and E and calcium.
- Hormonal drugs such as Klimadinon (prescribed in cases where the cause of failure is menopause).
As mentioned earlier, bacterial and fungal infections can cause diseases such as nabot cysts. Their treatment, in these cases, is aimed at suppressing inflammatory processes and directly depends on the type of infection itself. As a rule, therapy includes:
- Acceptance of antibiotics. Most often prescribed drugs such as Metronidazole, Clindamycin.
- Treatment with topical agents: gels, creams, candles.
- Acceptance of drugs that have an immunostimulating effect.
- Acceptance of bacteria to restore the vaginal microflora.
- The passage of physiotherapy.
Unlike ectopia (pseudo-erosion), erosion is a rather dangerous disease that can lead to consequences such as oncology. Most doctors are of the opinion that conservative treatment does not always achieve the desired result, and cauterization is the most effective therapy.
The most effective, in the fight against erosion, drugs are:
- Depantol. The course of treatment reaches 2-3 weeks, and the drug is prescribed twice a day. These candles contribute to the restoration of blood circulation and the division of healthy cells. The drug is not recommended for use in pregnant and lactating women.
- Genferon. It is an effective remedy aimed at restoring the regeneration processes of damaged tissues, providing an antiseptic and anti-inflammatory effect. As a rule, the course of treatment with this drug ranges from 10 days to 3 months.
- Suporon The introduction of candles 1 time per day for 1 month allows you to relieve inflammation and restore damaged cervical tissue. This drug is contraindicated for allergy sufferers, since it has a beekeeping product - propolis.
- Terzhinan. The means allowing to restore quickly and effectively the fabrics damaged by erosion. A feature of this drug is the possibility of its use during pregnancy.
- Betadine. The course of treatment with this drug does not exceed 10 days. During this time, antiviral agents and iodine, which are part of the candles, do an excellent job not only with erosion, but also with the causes of the disease.
- Candles are fitorovy. A drug that can cause the process of regeneration of the mucous membrane and resist the microbes that caused erosion. Taking the medicine does not exceed 2 weeks.
Nabotova cyst: treatment, reviews
By itself, such a diagnosis cannot be treated; prescribed therapy is aimed at eliminating diseases and disorders leading to the formation of cystic cavities. Reviews of patients indicate that the timely elimination of the causes of the appearance of follicles allows us to avoid surgery and negative effects on the health of the woman.
Nabot cysts in the cervix: treatment or prevention?
Like any disease, nabote cysts are better prevented than treated. There are several simple rules, the observance of which will allow you to avoid the appearance of tumors and their treatment:
- Intimate hygiene.
- Abstinence from casual sex and frequent change of partners.
- Use of contraceptives.
- Timely treatment of inflammatory and infectious processes.
- A visit to the gynecologist at least once every six months.
Timely diagnosis of the disease and correctly prescribed treatment helps to avoid negative consequences for the woman’s health.
Nabot cysts: effects
New growths in the nabot glands cannot degenerate into malignant ones, and, accordingly, by themselves do not lead to oncology. However, rupture of the cyst's membrane or an increase in their number can lead to the development of more dangerous diseases. So, the effects of nabot cysts can be expressed in:
- Complications in the work of oragnes of the female genitourinary system.
- The development of iron deficiency anemia.
In addition, multiple cavities reaching 10 mm or more, can lead to clogging of the lumen of the cervical canal, that:
- It complicates the outflow of blood during menstruation.
- Interferes with movement of spermatozoa on the cervical channel and their penetration into the uterus cavity. Nabot's cyst before and after conception may adversely affect the course of pregnancy and carry certain risks.
For the most part, these cystic formations do not pose a danger to the health of a woman, however, a nabota cyst after a follicle rupture can lead to such complications as:
- Purulent inflammation. Penetration into the cystic cavities of fungal or staphylococcal infections. With reduced immunity, this process may be accompanied by purulent abscesses and spread not only in the gland, but also in other pelvic organs.
- Genital partner infection. A large cyst, located on the cervix, can burst during intercourse, which will lead not only to the development of inflammatory processes in the uterus and ovaries, but also in the male genital organs.
Nabot's cervical cyst - what is it?
The cervix has a narrow bottleneck configuration facing the vagina. Its lumen is so narrow that the walls of the neck are closed with each other. This anatomical structure protects the uterine cavity from infection from the outside. In the epithelium of the cervix are mucous glands, the secret of which fills the entire lumen, providing additional protection for the genital organ.
The neck in Latin is called "cervix", and the internal glands, respectively, "endocervical." This unbearable name is usually replaced by another, on behalf of the doctor who first described them - the Nabots.
Sometimes the cervical excretory orifices become blocked and mucus accumulates in the cavity, giving them the appearance of rounded bubbles from 0.5 mm to 2 cm in size. There are retention nabotovy cysts. It is more correct to speak about the nabot gland cyst.
The blockage of the duct glands is due to inflammatory processes in the genital area. Causes of inflammation are divided into several groups:
- Trauma of the cervix during childbirth, abortion, instrumental examination or the installation of intrauterine devices,
- Poor genital hygiene,
- Violation of the microflora of the vagina and cervix due to frequent changes of sexual partners,
- Hormonal problems associated with the menstrual cycle.
It is also assumed that cysts can also be congenital.
Possible negative consequences
When cysts reach sizes of a few centimeters, they can block the lumen of the cervix, while:
- prevent the flow of menstrual blood, causing pain during menstruation,
- prevent the upward movement of sperm cells, making it impossible to initiate pregnancy.
There is a version that several cysts in the lumen of the cervix can, on the contrary, expand it - creating conditions for premature birth or miscarriage.
Opening up during childbirth, cysts can cause small wounds to infect the cervix mucosa.
In case of purulent infiltration of a retention cyst, it can support chronic inflammatory processes, creating preconditions for ectopic pregnancy and infertility.
However, there are no confirmations of these assumptions, although in the presence of such problems one has to take into account all possible factors in the development of pathology.
What is nabota cyst of the cervix
Nabotov's (follicular) cyst is a pathology of a benign nature that develops when the ducts of the cervical glands are blocked. As a result, a secret is accumulated. In the absence of its outflow, an increase in the size of the gland occurs and its transformation into a cavity filled with fluid.
The development of mucus is necessary to prevent the entry of infections.
There are the following pathology differences from a true cyst:
- The absence of this capsule. The nabot cysts have a thin sheath, while the true formations have a thick sheath.
- Features of growth. Nabot cysts increase due to the accumulation of fluid, and not as a result of the growth of the capsule, as happens with the development of true formations.
- Dimensions. Cervical follicles and ducts of the gland are small, large Nabot cysts greater than 1–2 cm in diameter are rarely found.
- Amount. Follicular cysts are characterized by a multiple character, isolated formations rarely appear.
- Ability to regress. True pathological formations never regress, unlike nabot cysts.
Causes and factors of occurrence
At the moment, it has been established that the following reasons may lead to the formation of nabot cysts:
- hormonal instability,
- inflammatory processes in the vagina and uterus (adnexitis, colpitis, vaginitis and others),
The following factors contribute to the occurrence of cysts:
- non-compliance with intimate hygiene (including sexual partner),
- injuries of the reproductive system (as a result of sexual intercourse, abortion, childbirth and gynecological examinations),
- frequent change of partners.
Formations are more common in women who have given birth after 40 years, which only confirms the doctors' guess about the effect of changes affecting the epithelium of the cervical canal. At a young age, cyst formation is associated with hormonal background and infections.
At detection of hollow tumors of ovuli naboti of small size, therapy is not carried out, observational tactics are chosen. It will take every 2-3 months to undergo a diagnosis in order to detect their growth in time. In rare cases, the cyst is broken and self-regenerating, without provoking complications.
Treatment of nabot cyst on the surface of the cervix is developed in the following cases:
- the rapid growth of cystic formation, large size,
- the presence of purulent contents in the cavity,
- narrowing of the cervical canal during tumor growth.
In the case of a blockage of the gland on the background of hormonal background, as a rule, this happens with an excess of estrogen, a course of oral contraceptives is prescribed, for oral administration.
They normalize hormones, thus, suppressing the growth of tumors. Regarding side effects, then with the correct selection of a drug by a specialist, they rarely occur. In some cases, patients complain about the following:
- mood swings, depression, decreased libido,
- headache, nausea, fatigue, hot flashes, painful sensations in the mammary glands.
If the symptoms are too pronounced and worsen the quality of life, replace the used drug with another one or hormone therapy stops.
When the cause of violation of the outflow of cervical mucus is an inflammatory process, it is prescribed the use of broad-spectrum antibiotics and anti-inflammatory drugs.
Preparations are prescribed exclusively by the attending physician, individually.
Surgical removal is used for large, single cystic formations that are not related to hormonal disruption in the body.
Standard manipulation involves puncture of a hollow tumor and its purification from accumulated secretion. In addition, the practice of using new techniques that differ in minimal trauma and rapid recovery is practiced.
Surgical excision is prescribed in the presence of severe deformity of the cervix, large, multiple cysts, an increased risk of dysplasia - a precancerous condition. Only the affected area of the epithelium can be removed (excision). If there is suspicion of carcinoma, a zero-stage preinvasive cancer, complete resection of the cervix is performed, to prevent the progression of the malignant process.
With regular visits to the gynecologist, timely detection of cystic tumors, the need for surgery is rare. If removal is recommended, then laser vaporization is almost always resorted to.
The nature of the nabot cysts
The peculiarity of these cystic tumors is as follows:
- are not transmitted through sexual contact, which completely excludes their infectiousness,
- in most cases do not impair the patient’s quality of life,
- do not provoke hormonal changes (develop against the background of existing ones),
- do not have a tendency to go into atypical (malignant) form.
Like any other pathology, retention tumors can be accompanied by complications, especially considering their tendency to appear against the background of the existing erosion:
- birth injury as a result of violation of the opening of the cervix,
- long-lasting infectious focus,
- frequent inflammatory reaction in the vaginal mucosa,
- in rare cases, the epithelium of the cervical canal can reveal the beginnings of a precancerous change.
What is pathology
Nabotov, or retentional, cyst of the cervix is formed due to blockage of the excretory ducts of the glands. As the secret continues to be produced, the gradual filling of the blocked channel leads to its stretching. As a result, the iron begins to protrude to the surface of the mucous membrane.
A nabot cyst looks like a follicle (which is why it is sometimes called a follicular cyst) or a vesicle filled with transparent contents, several millimeters in diameter. In rare cases, the formation reaches the size of two centimeters. Distinguish between single and multiple cysts, the observation and treatment tactics depend on their number.
Nabot cysts never malignant (do not turn into a cancerous tumor). But their prolonged existence contributes to the maintenance of the inflammatory process in the epithelium of the cervix.
Such formations differ from true cysts:
- the lack of a capsule. The true formation of the capsule is thick, consisting of several layers capable of cell division. The retention cyst has only a thin sheath,
- features of growth. True cyst increases due to the proliferation of the capsule, Nabotova - due to the accumulation of fluid, stretching the shell,
- multiplicity. A single nabot cyst is a very rare occurrence.
Causes of pathology
The cervical canal of the cervix, that is, its vaginal part, is lined with a cylindrical epithelium. This is a single-layer row of cylindrical cells. Between them are the excretory ducts of the glands. Their main function is the production of cervical mucus, which protects against foreign bacterial and viral agents, preventing them from penetrating from the vagina into the uterus and higher into the small pelvis.
With the development of inflammation of the epithelium becomes edematous. It is difficult to evacuate mucous secretions produced by the glands. In chronic course, the ducts completely overlap, Nabot's cysts are formed.
Microorganisms continue to exist inside the clogged glands, supporting the pathological process. Therefore, untreated nabote cyst increases the risk of inflammation of the internal genital organs and often causes infertility.
Factors contributing to the development of such neoplasms:
- chronic colpitis and cervicitis,
- cervical erosion,
- wearing intrauterine device,
- diagnostic curettage of the uterus,
How to treat the disease: is it always necessary to remove cysts
Not all nabote cysts are treatable. After 45 years, in the case of single cysts of small sizes, they adhere to expectant tactics, since most often they do not increase in size at this age, and also do not develop into malignant tumors.
There is no need to eliminate education if:
- this is a single cyst of no more than a centimeter,
- It does not cause discomfort.
Up to 45 years old, Nabotov's cysts are subject to compulsory treatment in order to avoid negative consequences in the future.
There are two methods of therapy:
- operational - the main way to eliminate formations
- conservative, which is used as an auxiliary because it does not eliminate cysts.
Such therapy must be prescribed before surgery. Most often used:
- treatment with antibiotics after determining the type of microorganisms taking into account their sensitivity (in the presence of concomitant inflammatory gynecological diseases),
- local therapy with Dikloberl candles and tampons with ichthyol ointment. These drugs relieve cervical edema, reduce pain and signs of irritation.
After the cysts are removed by any of the methods, vaginal suppositories are prescribed to speed up the healing of the tissues, as well as reduce puffiness and reduce the risk of infection:
Nutrition and Lifestyle
The patient should understand that the obligatory condition that will help prevent the disease in the future is a change in the usual way of life. It is necessary to exclude factors that can trigger the development of the pathological process.
The doctor may recommend remedial gymnastics, physical education, some changes in the diet. It is necessary to limit the use of salt and spices, to refuse alcoholic drinks and smoking.
Prognosis and prevention
After treatment, complications practically do not occur. The epithelium of the cervix is rapidly recovering. However, there is a possibility of re-blockage of the glands with the formation of cysts. This is due to persistention (long-term preservation in the body) of infection. That is, if the inflammation was not treated with an appropriate antibiotic, the problem may arise again.
Therefore, the main way to protect against the formation of retention cysts is the prevention and timely treatment of inflammatory changes in the internal genital organs. For this you need:
- maintain genital hygiene,
- exclude unprotected sexual intercourse with unexplored partners,
- undergo a check-up at the gynecologist at least once every 6 months,
- plan pregnancy - eliminate abortions,
- at the slightest suspicion of inflammatory diseases (colpitis, cervicitis, salpingo-oophoritis), do not self-medicate, but promptly seek qualified help.
Despite the seeming simplicity of this pathology, it undoubtedly deserves careful attention. Since Nabot cysts can maintain inflammation in the genitals and cause infertility for years, it is better to eliminate this disease in time.
Causes of nabot cysts
The mechanism of formation of nabot cyst is simple. The surface of the neck is lined with flat epithelial cells arranged in several layers. The vagina mucosa has a similar structure. The mucosa lining the cavity of the cervical (cervical) canal has a different structure: it is represented by one layer of cylindrical epithelial cells. Stratified squamous and single-layered cylindrical epithelium “occurs” in the area of the external pharynx (physiological constriction at the junction of the cervical canal into the vaginal cavity), it is called the transitional or transformation zone.
In the epithelium of the cervix there is a huge amount of glandular structures. The glands constantly produce a secret to protect the mucous from a potential infection. It not only mechanically “flushes” undesirable microflora from the surface of mucous membranes, but is also capable of destroying it due to the pronounced antibacterial activity.
The Nabot's glands (or follicles) are represented by multiple accumulations in the lower third of the cervical canal, outwardly they resemble small tubes filled with mucous secretion. Their openings open in the area surrounding the outer pharynx outside. A nabot gland cyst is the result of blockage of its opening when the contents of the gland cease to evacuate and accumulate, stretching its walls. If the outflow of the contents of one nabot gland is disturbed, a single cyst is formed, if there are several, there are multiple Nabot's cysts. Their location depends on the location of the cyst: if the anterior cyst is blocked from the external pharynx, the nabot's cyst is well visualized upon external examination.
For what reasons do the ducts of the nabot glands stop functioning normally? The most common causes are:
- Mechanical damage to cervical tissue (abortion, childbirth, instrumental manipulation with therapeutic or diagnostic purposes).
When the cervical tissue loses its integrity, during the process of physiological regeneration, the newly formed epithelial layer can mechanically block the outlet openings of the nabot glands.
Nabot cysts are frequent companions of ectopia (pseudo-erosion) of the cervix, especially when it is traumatic in origin. After injury, a wound (ulcer) remains on the surface of the cervix - true erosion. The process of its physiological healing is carried out from the reserve of multilayered epithelium. Sometimes this process occurs differently - the cylindrical epithelium of the cervical canal descends onto the ulcer area and closes it, that is, cervical ectopia is formed. The cylindrical epithelium, displaced, can block the ducts of the nabot glands and provoke the formation of cysts.
- Hormonal disorders. Cervical glands function according to cyclic hormonal fluctuations. When hormonal dysfunction cervical mucus becomes thick, poorly evacuated to the outside and therefore can cause blockage of the duct gland.
- Local infectious inflammation. In response to infectious aggression, the cervical glands respond with enhanced secretion in order to “flush” unwanted microflora from the mucous membrane. The epithelium of the cervix becomes looser, and the infection can partially penetrate into the underlying structures, including the glands themselves. By affecting the cervical glands, the pathological microflora infects their discharge: it becomes thick, sometimes purulent. When the acute period of inflammation subsides, recovery processes begin on the surface of the cervix, but the infection in the glands still remains. As a result, when the surface of the mucous neck begins to regenerate, it closes the channels of the nabot glands, multiple Nabot cysts are formed, filled with infected contents.
Infrequently, the nabot's cyst of the cervix may occur as a result of cervical endometriosis, when the outlet duct of the nabot cyst overlaps with endometrioid tissue.
Symptoms and signs of nabot cysts
Every tenth woman of reproductive age (most often in giving birth), Nabot's cysts are found on the neck, but they are not always clinically manifested.
Since the wall of the excretory duct of the nabot gland cannot stretch too much, large (more than 2 cm) Nabotovy cysts are infrequent. In most cases, there is not one but a few nabot cyst of small (less than 1 cm) size on the neck. Often they are asymptomatic for many years present on the neck and are diagnosed by chance. Uncomplicated small nabot cysts are completely harmless, therefore many experts consider their presence on the neck a variant of the norm and do not recommend special treatment.
The presence or absence of a clinical picture in nabot cyst depends on the cause of their development. If cysts are formed due to infectious inflammation, the patient has typical manifestations of colpitis and / or endocervicitis: abundant serous or serous-purulent leucorrhoea with unusual unpleasant odor, discomfort in the vagina as a burning sensation, moderate pain and / or itching.
The combination of nabot cysts and ectopia manifests itself clinically only with concomitant inflammatory process, and in its absence it is diagnosed only on examination.
The diagnosis of nabot cysts is extremely simple. As a rule, more often on the neck, during visual inspection, multiple small, dense hemispherical formations with a thin wall are found paracervically located, through which the yellowish contents shine through. With concomitant infectious inflammation, hyperemia of the mucous membranes, their edema and a large number of pathological secretions are visualized.
Pseudo-erosion looks like a bright red spot located around the cervical canal, well distinguished on a pale pink background of the unchanged cervical mucosa.
Despite the good external visualization of nabot cysts, colposcopy is necessary for all patients to study the state of the cervical epithelium and to discover the cause of the development of nabotovy cysts. At high magnification, inflammatory changes are considered in more detail, and the type of pseudo-erosion (if present) is also determined. In the process of colposcopy, a material (smear) is taken from the mucous necks for cytological examination.
In addition to colposcopy, the diagnostic list includes the study of the microbial composition of the vagina. According to the results of a laboratory study (smears, bakposevy), the question of the need for anti-inflammatory therapy and its features is solved.
Sometimes cysts are localized outside of visibility - inwards from the external pharynx. Ultrasound scans with a vaginal probe can detect them. Often, multiple cysts in the cervical cavity provoke an increase in the size of the cervix and the inflammatory process.
There is a widespread opinion among patients about the close connection between nabot cysts and infertility. Indeed, multiple cysts that are located near or inside the lumen of the cervical canal may partially overlap it and impede the progress of sperm, but this situation happens very rarely. As a rule, the occurrence of infertility and nabot cysts has a common cause - an infectious process.
Treatment and removal of nabot cyst
The question of the need to treat nabot cysts is not always resolved positively. For a dynamic observation of asymptomatic small cysts, annual examination with colposcopic control is sufficient.
If there is an asymptomatic nabot cyst without concomitant inflammation, its removal is recommended only if there are large sizes, since there is a risk of infection of its contents and transformation of the cyst into a purulent abscess.
If infectious inflammation is at the origin of nabot cysts, their removal will not be effective, since the infection will provoke the formation of new cysts, and surgical intervention will only aggravate inflammation. According to the laboratory data obtained, an effective antibacterial therapy is selected first.
Ectopia of the cervix and nabot cysts are treated at the same time, as the medical methods of these pathologies coincide.
Regardless of the reason for the formation of nabot cysts on the neck, they can only be removed surgically. An Nabot cyst is opened by puncturing, followed by evacuation (drainage) of the contents, and the remnants of the destroyed capsule are removed by one of the existing methods:
- Cauterization of nabot cysts. Perhaps with the help of thermal exposure to electric current (diathermocoagulation). Chemical moxibustion of nabot cysts with various preparations is also possible.
- Freezing (cryodestruction) when exposed to liquid nitrogen on the cyst tissue.
- Destruction (destruction) of a cyst using a laser or radio waves.
Traditional medicine is not able to eliminate the cyst, but can be used as an additional method for anti-inflammatory treatment.
Spontaneous regression of nabot cysts is possible, but only in the absence of complications.