Retention cysts of the cervix
The content of the article:
-
The mechanism of formation of retention cysts
- Features of the mucous membrane
- Closed gland formation
- Symptoms
- Diagnostics of the retention cysts
- Treatment of retention cysts of the cervix
- Video
Retention cysts of the cervix (nabotov cysts, ovuli Nabothi) are benign cavity formations containing mucus. Formed as a result of blockage of the ducts of the cervical glands and the accumulation of their mucous secretions. Are asymptomatic, in most cases do not require treatment, do not become malignant. They are found on the vaginal part of the cervix by a gynecologist during a visual examination, in the cervical canal - during an ultrasound examination with a vaginal sensor.
Retention cysts usually form in the transition zone of the cervix
The mechanism of formation of retention cysts
It is easier to understand how nabotovy cysts are formed, having an idea of the structural features of the epithelial cover of the cervix.
Features of the mucous membrane
The vaginal part of the cervix is covered with stratified squamous epithelium, which is constantly exfoliated and renewed. Its main function is protective. The cervical canal is lined with a single-row prismatic, or cylindrical, mucus-secreting epithelium. Each prismatic cell is, in fact, a small gland that produces mucus secretions. Cervical mucus serves as a barrier between the vagina and the uterine cavity, protecting the latter from the penetration of infectious agents.
The junction area of the two types of epithelium is called the transition zone, or the transformation zone (ZT). The epithelium of this zone is called metaplastic. The reserve cells of which it consists can differentiate into both stratified squamous and single-row columnar epithelium under the influence of various factors.
The transformation zone is a vulnerable area, it is here that the processes of atypical cell changes occur. The location of the transformation zone in relation to the external pharynx (vaginal opening of the cervical canal) varies depending on age, namely, the occurrence of retention cysts is associated with it.
| Age period | Location of ZT | Features of structure and functioning | Localization and nature of pathological processes |
| Girls | On the vaginal part of the cervix (exocervix) | In the prenatal period, the transition zone is shifted to the exocervix - this is the effect of the mother's hormones. Congenital ectopias may persist until puberty. As the organism grows and develops, the ectopia decreases, the ST shifts closer to the external pharynx. | Vulvovaginitis (inflammatory diseases of the external genital organs and vagina) are more common. |
| Women of reproductive age | Coincides with the external pharynx | Every menstrual cycle changes occur in the cervix, regulated by ovarian hormones: from 8-9 days, the canal expands, mucus appears in it, by 13-14 days this process reaches a maximum, in the second half of the cycle the amount of mucus decreases, the cervix becomes dry. | Inflammatory processes of the cervical canal, inflammatory and proliferative processes of the mucous membrane of the vaginal part of the cervix. |
| Postmenopausal women | In the cervical canal (cervical canal) | In connection with the extinction of the hormonal function of the ovaries, the mucous membrane of the neck atrophies, mucus is practically not produced, degenerative processes develop in the underlying stroma associated with a deterioration in microcirculation. |
Against the background of age-related estrogen deficiency, atrophic processes of the exocervix, the development of malignant neoplasms in the tissue of the cervical canal are observed. |
Closed gland formation
For various reasons (trauma, inflammation, hormonal imbalance), the columnar epithelium can spread from the cervical canal, the place of usual localization, to the vaginal part of the cervix, displacing the transformation zone. This process is called ectopia of the columnar epithelium. As a result, pseudo-erosion is formed, which, upon visual gynecological examination, look like bright red spots on a general pink background. This effect is due to the stromal vessels shining through one row of prismatic cells.
Stratified squamous epithelium strives to restore lost positions and replaces the columnar epithelium. In this case, creeping of squamous epithelium onto a cylindrical one is possible. Cylindrical cells trapped under a kind of lid continue to produce mucus, which accumulates, forming a retention cyst.
Retention cysts are single and multiple. Their size varies from a few millimeters to a centimeter or more. Histologically, such formations are not true tumors, since they do not contain atypical cells. The growth of nabotovye cystic formations occurs not due to pathological cell division, but due to the fact that the liquid - mucus, accumulates and fills the lumen of the glands.
Symptoms
Neoplasms are not accompanied by clinical manifestations. Patients may present complaints, but they are not caused by retention formations, but by the background on which they arose. Most often, such a background is a complicated pseudo-erosion. It is complicated, since uncomplicated is asymptomatic, and complaints appear only when an infection is attached: unlike stratified squamous epithelium, ectopic cylindrical does not so reliably protect the vaginal part of the neck from various pathological influences.
When the presence of pseudo-erosion is accompanied by inflammation, the patient is worried about:
- itching sensation in the external genital area;
- vaginal discharge, possibly foul-smelling;
- discomfort when urinating;
- soreness during intercourse;
- bloody vaginal discharge after sexual intercourse.
All of the above are not complaints typical of cystic formations and cervical ectopia, these are the consequences of concomitant inflammatory pathology, the severity of which depends on the nature of the infectious agent.
Diagnostics of the retention cysts
Detection of neoplasms is not difficult. They are visible when viewed in gynecological mirrors. Retention cysts of the exocervix have the appearance of dome-shaped elevations of milky white or yellow-white color. Their sizes vary from 1 mm to 1–1.5 cm. Larger formations are rare.
Cysts in the cervical canal, formed due to blockage of cylindrical epithelial cells that secrete mucus, are not visible on examination, they are often detected by a doctor by performing an ultrasound with a vaginal probe.
Intravaginal ultrasound is used to diagnose nabotny cysts
The final diagnosis is facilitated by colposcopy - examination of the cervix with a special optical device, which gives an increase of 8 to 40 times. Colposcopy is:
- simple (without treatment with solutions);
- through colored filters (details the vascular network);
- extended (with the treatment of the mucous membrane with 3% or 5% acetic acid solution, 2% Lugol's solution).
Modern colposcopes enable the gynecologist to demonstrate the procedure to the patient on a computer screen and make color photos and videos.
To exclude inflammatory pathology and cellular atypia, they also do:
- cytological smears, which make it possible to assess the structure of epithelial cells;
- biopsy to examine tissue samples taken from suspicious areas under colposcopic control;
- bacteriological seeding of secretions, identifying the causative agent of inflammation and its sensitivity to bacterial preparations;
- PCR study of vaginal contents, which determines the type of pathogen by its DNA.
Considering that the occurrence of ectopia of the columnar epithelium, the formation of retention cysts and the processes of normalization of the epithelial cover of the exocervix have a hormonal component, sometimes ultrasound of the pelvic organs and determination of the level of sex hormones in the blood serum are required.
Treatment of retention cysts of the cervix
Nabot cysts do not need to be treated, it is enough to regularly undergo annual preventive examinations. Do not believe the stories that such cysts are a serious pathology and require removal, otherwise they may rupture or become infected.
Retention cystic formations do no harm: small ones regress on their own, very large ones can only change the shape of the neck. In this case, they can be subjected to electro- or laser coagulation on an outpatient basis. Viral, bacterial infections that complicate pseudo-erosion, and hormonal, immune disorders that contribute to its appearance need treatment.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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