Cervical cyst
The content of the article:
-
How cysts form on the cervix
- Features of the mucous membrane
- Closed glands
- Symptoms of a cervical cyst
- Endometriosis of the cervix
- Diagnostics of the cervical cysts
- Treatment of cervical cysts
- Video
A cervical cyst (retention cyst, Nabotova cyst, uterine cyst) is a benign cavity formation of the cervix, which does not pose a threat to the patient's health and is practically asymptomatic. Retention cysts are often found, they are found during a gynecological examination, in the vast majority of cases they do not need treatment, since they do not become malignant. Only very rarely can large cysts deforming the cervix be removed. Why the presence of even multiple cysts is not dangerous helps to understand the mechanism of their formation.
A cervical cyst, or nabotova cyst, is a hollow mass filled with mucus
How cysts form on the cervix
The appearance of retention cystic formations is associated with the structural features and renewal of the mucous membrane of the cervix.
Features of the mucous membrane
The cervix consists of the vaginal and supravaginal parts. The first protrudes into the lumen of the vagina and is visible during a gynecological examination, the second is located above the attachment of the vaginal walls to the uterus and is visually inaccessible. The cervical canal, or cervical canal, connects the vagina to the uterine cavity and is shaped like a spindle.
The mucous membrane of the vaginal part and the cervical canal has a different structure.
| Anatomical and functional structures | Epithelial cover |
| The vaginal part of the cervix (exocervix) | It is covered with flat cells arranged in several rows - stratified squamous epithelium (MPE). |
| Cervical canal (exocervix) | Lined with one row of cylindrical cells - a single-row columnar epithelium (CE), which constantly produces mucus. Thus, each cylindrical cell is a small mucus-producing gland. |
| Transition zone, or transformation zone (ZT). In most women of reproductive age, ST coincides with the external pharynx - the vaginal opening of the cervical canal. In young women, ST is located on the exocervix, in women after menopause, in the lower third of the cervical canal. | The junction, or the junction of stratified squamous and columnar epithelium. All background and precancerous diseases of the cervix arise in this area. The transitional epithelium in the ER is called metaplastic. |
Closed glands
A condition in which, for various reasons, CE from the canal spreads to the exocervix, where it should not be, is called ectopia of the columnar epithelium, or pseudo-erosion. Pseudo-erosion looks like a red spot on a pink background when viewed in gynecological mirrors.
In such a situation, the MPE tries to return to its place, displacing the CE, and creeps into it. The cells of the columnar epithelium often find themselves under the "lid" of the squamous epithelium and continue to produce mucus. Mucus has nowhere to go, as a result, as it accumulates, a cyst will form from the closed gland.
Cysts are single and multiple. Their diameter varies from a few millimeters to a centimeter or more. Histologically, such retention formations are not true tumors. They do not contain atypical cells. The growth of education does not occur due to pathological cell division, but due to an increase in the volume of accumulating mucus.
Symptoms of a cervical cyst
The retention formations themselves do not have clinical signs, but since they appear against the background of ectopia, complaints are possible due to the presence of pseudo-erosion. It should be remembered that uncomplicated pseudo-erosion is also asymptomatic, and complaints appear only when an infection is attached. This becomes possible due to the greater vulnerability of ectopic CE as compared to MBE, which reliably protects the neck.
When the presence of pseudo-erosion is accompanied by inflammation, the patient is worried about:
- leucorrhoea of a different nature, often with an unpleasant odor;
- itching of the external genital organs of varying intensity;
- pain during sexual intercourse;
- burning sensation when urinating;
- contact bleeding from the vagina, provoked by intercourse.
All of the above is not a complaint characteristic of cystic formations and cervical ectopia, these are manifestations of concomitant inflammatory pathology, depending on the nature of the infectious agent.
In addition to retention cysts, a gynecologist, upon examination, can detect endometrioid heterotopies on the cervical surface: brushes, or vesicles, usually up to 5 mm in diameter, blue-purple or dark-purple in color. What it is?
Endometriosis of the cervix
The disease in which the cells of the endometrium - the lining of the uterus, spread beyond its limits, is called endometriosis. The main reason for the defeat of the cervix with this pathology is the introduction of cells of the uterine mucosa, which are in the menstrual blood, into the damaged endo- and exocervix.
On examination and on colposcopic photos, endometrioid foci have the appearance of cyanotic, purple, rounded formations of small size. Their color and volume depend on the day of the menstrual cycle. Complaints may be absent, but if the foci are located superficially, and the hemorrhages are significant, then the integrity of the integumentary epithelium is disrupted. This is manifested:
- spontaneous smearing vaginal discharge before and / or after menstruation;
- contact bleeding that occurs after vaginal procedures, sexual intercourse;
- discomfort during sexual intercourse;
- pulling pains, usually of mild intensity, in the lower abdomen.
The disease is hormone-dependent, therefore, in most cases, it is found in women of reproductive age. After the onset of menopause, the existing endometrioid foci undergo regression.
Diagnostics of the cervical cysts
Identification of cystic formations is not difficult. They are visible when viewed in gynecological mirrors. Nabotovy cysts have the appearance of dome-shaped eminences of milky white or yellow-white color. Their sizes vary from 1-2 mm to 1-1.5 cm. Larger cysts are rare. Endometrioid inclusions are usually represented by cyanotic rounded formations up to 5 mm in diameter, slightly rising above the surface of the mucous membrane.
To establish the final diagnosis, colposcopy is performed - examination of the cervix with a special optical device, which gives an increase of 8 to 40 times. Colposcopy is:
- simple (without the use of medications);
- through colored filters (visualizes blood vessels);
- extended (with mucous membrane treatment with 3% acetic acid solution, 2% Lugol's solution).
To exclude inflammation and atypia of cells, do:
- cytological smears;
- biopsy;
- bacteriological culture of secretions;
- PCR examination of vaginal contents.
The listed activities allow us to study the background on which cysts appeared, the uterus and appendages often also deserve attention: ultrasound of the pelvic organs, determination of the level of sex hormones, because the occurrence of ectopia of CE and the processes of normalization of the epithelial cover of the exocervix have a hormonal component.
Treatment of cervical cysts
Nabot cysts do not require treatment. It is only necessary to visit a gynecologist regularly, at least once a year. Do not believe the stories that the cyst needs to be removed surgically, otherwise it may burst, its contents will fall on the entire neck, fill the canal - they do not correspond to reality.
Retention cystic formations do no harm: small ones regress on their own, large ones very rarely deform the neck. In this case, they can be subjected to electro- or laser coagulation performed on an outpatient basis. But what really requires observation and treatment is the pathological processes accompanying complicated ectopia of CE: viral, bacterial infections, hormonal, immune abnormalities.
The choice of a method for treating endometrioid foci is made taking into account the size of inclusions, the severity of complaints, the age and reproductive plans of a woman. With small formations, the absence of clinical manifestations and complications, it is enough to observe the patients (examination every 6 months). Volumetric heterotopies, accompanied by bloody discharge and pain syndrome, require the appointment of hormonal drugs, immunocorrectors. The ineffectiveness of conservative therapy forces one to resort to electro- or laser coagulation.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
