Наботова киста cervix: лечение,deletion

Update: October 2018 According to statistics, half of the female
population has one or another pathology of the cervix. Among the diseases
uterine cervix nabotovyh cysts are diagnosed in 10 – 20%, and, as
typically, women who have given birth (25 – 45 years). This pathology is not
life threatening and rarely malignant, but in some cases
can bring a series of trouble. AT связи с этим женщин, имеющих
similar formations, it is necessary to put on the dispensary account and
watch.

Anatomical educational program

The uterus belongs to the internal genitals and is located in
deep pelvic floor. The main task of the uterus is to bear and
birth of a child. For conception to occur, penetration is necessary
into the uterine cavity of the sperm. Sperm go into the uterus
through her neck (cervix), which binds the vagina and uterine
cavity. AT свою очередь, шейка матки имеет видимую глазом
the vaginal part and the supravaginal part hidden in the pelvis. AT
cervix or cervical canal is located at the depth of the cervix,
which provides the exit of menstrual blood from the uterus to the outside and
introduction of sperm into her cavity.

ATидимая часть шейки матки покрыта многослойным плоским эпителием
(the same lines the vagina). Cervical canal lining
cylindrical (cubic) epithelium. Place of junction of both types
epithelium is called the transition zone (transformation zone). AT норме
this zone is located in the area of ​​the external os and the cervical epithelium
does not go to the vaginal part of the neck.

AT цилиндрическом эпителии шеечного канала содержится большое
number of glands, which are called endo- or paracervical.
But more often they are called nabot glands in honor of the author,
described them.

The main task of the nabot glands is the production of mucus. Slime
necessary for the mechanical removal of pathogens from
cervical canal and also has antimicrobial properties that
negative effect on 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
localized on the cervix and formed as a result of blockage
endocervical glands. AT полости таких кист содержится слизь,
produced by glands. Accumulating mucus that does not have
ability to leave the gland, pererasyagivaet it and forms a cyst.
Nabot cysts are always a benign education, but in
extremely rare cases, their malignancy (malignancy) is possible.
The cysts of the nabot glands are retention, that is
functional entities.

Main characteristics

What is the difference between nabotova (retention) cyst and true
cysts:

  • Growth

If true cysts increase in size due to
proliferation of the capsule, which is a secret, then nabota cyst
due to the stretching of the walls of the gland accumulated secret.

  • Capsule

Nabota cyst does not have its own capsule, it is replaced by the walls
affected gland, which due to overstretching becomes thinner.
True cysts have thick capsules consisting of several layers.
cells that divide and thicken the capsule even more.

  • Dimensions

AT диаметре наботова киста шейки матки не больше 10 мм (очень
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.

  • Regression

AT редких случаях наботовы кисты самостоятельно рассасываются, а
true cysts never.

  • amount

Rarely there is a single nabot cyst, as a rule, it is
multiple education (three or more).

The reasons и механизм развития

AT механизме образования наботовых кист могут лежать два фактора.
Or there is a mechanical blockage of the excretory duct of the gland and
it begins to swell or thickens mucus, which
secrete endocervical glands.

AT первом случае причиной формирования подобных образований
serves as a violation of the integrity of the tissues of the cervix. AT процессе
regeneration (healing) is growing new layer of epithelium, which
can block the excretory duct of the nabot gland. Another option
mechanical duct blockage serves as a process of transition true
erosion (open ulcer) in pseudo-erosion or cervical ectopia.

Pseudo-erosion is called 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
stratified squamous epithelium). AT процессе формирования
pseudo-erosion cylindrical epithelium “descends” from the cervical
channel, seeking to close the cervical ulcer and overlaps the excretory ducts
glands.

ATо втором случае в организме возникают гормональные сбои, ввиду
which mucus secreted by the glands becomes viscous and thick,
which complicates emptying the gland and leads to its formation
cysts.

It should be noted, and the third factor in the mechanism of education
nabot cysts – inflammatory process. Local inflammatory
process arises as a result of hitting cervix
pathological microorganisms. Consequently, the cervical epithelium
loosened, and infectious agents penetrate into the cavity of the glands. AT
response to the introduction of an infection the glands begin in a heightened mode
to produce mucus to clean the “invaders” from the surface of the neck.
But as a result of the inflammation, the mucus itself is also infected;
becomes thick and purulent. When does the healing of the external
surface of the cervix, inflammation inside the glands still remains.
The expanding epithelium of the vaginal part of the cervix overlaps the ducts
glands in which the inflammatory process still rages, which leads
to the formation of nabot cysts.

The reasons

The main reasons for the formation of cysts nabotovyh
lead:

  1. Механическая травма cervix:
    • abortion;
    • neck ruptures in labor;
    • diagnostic curettage of the uterus;
    • установка/deletion ATМС;
    • hysteroscopy;
    • surgery on the neck.
  2. Hormonal disorders:
    • changes associated with age (premenopause);
    • endocrine pathology;
    • pregnancy;
    • hormonal drugs;
    • bad habits (smoking, alcohol, drinking
      drugs);
    • various gynecological hormonal pathology (tumors
      uterus and ovaries, cycle disorder, polycystic ovary, endometriosis
      And so on).
  3. ATоспалительные процессы:
    • chronic inflammatory diseases of internal genital organs
      (adnexitis, endometritis);
    • cervicitis (endo- and exo);
    • colpitis;
    • 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.

Clinical picture

These formations, as a rule, are asymptomatic and
found by chance during a gynecological examination or in
the process of ultrasound. Nabot cysts are often multiple and have
dimensions not exceeding 10 mm. Characteristic clinical manifestations
associated with the formation of cysts nabotovyh glands. For example, in
case of inflammation of the cervix (cervicitis) and vagina (vaginitis) patient
concerned about complaints of pathological discharge from the genital tract
(heavy or moderate, greenish or yellowish, with no
pleasant smell). ATозможно возникновение зуда и жжения во
vagina, painful and frequent urination with involvement in
urethral process. Also, there is discomfort during intercourse.
For nabotovyh cysts characteristic:

  • not transmitted during sexual contact (safe for
    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 pregnancy

AT период гестации происходят значительные гормональные
changes that can trigger nabot cysts.
ATозможно нагноение подобных образований в процессе беременности,
which is fraught with intrauterine infection of the fetus. Besides,
large cysts can disrupt the neck opening
uterus in labor, which will lead to anomalies of labor forces and will require
perform cesarean section. AT период изгнания возможно повреждение
cysts with subsequent ruptures of the cervix, which makes it heavy for
postpartum period. The rupture of cysts in labor does not threaten the occurrence
bleeding, but is fraught with the development of the inflammatory process.

Diagnostics

In addition to visual inspection of the cervix in the mirrors in the presence of
nabot cysts or suspicion the gynecologist will definitely appoint
additional research methods.

From instrumental methods apply:

  • Colposcopy

It consists in examination of the cervix with a colposcope (apparatus with
multiple magnification). Cysts are well visualized as
white-yellow formations that protrude above the surface of the neck.
The vascular pattern is perfectly visible on the cyst, and the vessels branch and
directed from the periphery to the center. Besides, диагностируется
other cervical background processes (pseudo-erosion, leukoplakia).

  • Ultrasound with vaginal sensor

Allows not only to identify the pathology of the uterus and appendages, but also
diagnose nabot cysts that are in the cervical
channel 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
homogeneity.

  • Histological examination

Biopsy of the suspect cervical region and subsequent
histological examination confirms the presence of nabot cysts,
their purity and the presence / absence of inflammatory
process in the gland.

From laboratory research methods prescribe:

  • General blood and urine tests

To eliminate the inflammatory process of reproductive
system.

  • Blood test for hormones

Essential for detecting hormonal imbalances that could
cause cysts.

  • Swabs on microflora

Samples are taken from the cervical canal, from the vaginal
walls and from the surface of the neck. The definition of microflora,
detection of infectious agents.

  • Cytology smear

They take smears from the vaginal part of the cervix and from the cervical
channel. Helps to identify abnormal cells (dysplasia, cervical cancer
uterus).

  • PCR diagnostics

Appointed in case of cervical inflammation to exclude
hidden genital infections (chlamydia, mycoplasma, HPV and others).

Treatment

When nabot cysts are found, treatment is not always carried out.
because it is most often a random find and pathology does not bother
woman If the cysts are small or single patient
recommend regularly visit the gynecologist (every six months) and
undergo colposcopic examination. In other cases
assigned surgical treatment, whose task is
removal of nabot cysts.

Indications for surgical treatment:

  • there is an increase in the size of cysts / cysts;
  • cyst suppuration has occurred;
  • there is obstruction (blockage) of the cervical canal that
    causes menstrual pain and / or mechanical sterility;
  • pains in the lower abdomen during physical exertion or during
    time coitus;
  • the patient wants to get rid of the pathology.

If there is a concomitant infection of the cervix
or the identification of hidden genital infections treatment begins with
conservative methods. Antibiotics are prescribed orally
(cephalosporins, macrolides, fluoroquinolones) depending on the inoculated
microflora, intravaginal suppositories (hexicon, betadine, depantol,
polygynax, dicloberl), which have a local antimicrobial
action, relieve swelling and irritation of the cervix and relieve pain. After
Conservative therapy is repeated fence
smears on the microflora of the vagina and the cervical canal and is repeated
colposcopy. In case of normalization of vaginal and cervical
microflora, the elimination of inflammation in the cervix proceed to the operational
treatment that can be done in various ways in
depending on the equipment of the clinic.

Surgery

The essence of the surgery is to puncture the cyst and
evacuating its contents, and then cauterizing the capsule of one or another
in a way. Surgical intervention, during which removed
cysts, is carried out in the same way as the surgical treatment of pseudo-erosion
cervix:

  • Diathermocoagulation or DTK (DEK)

Old enough method and rarely used recently
in the treatment of diseases of the neck. Destroyed cysts are cauterized.
electric coagulator. The way is quite painful and
recommended for treatment only women who have given birth (causes
cicatricial cervical deformity, which can lead to complications in
childbirth).

  • Cauterization of chemicals

After прокола и опорожнения кисты ее ложе (капсулу) прижигают
chemical preparations (alcohol or solkovagin – mixture
organic acids).

  • Laser vaporization

An effective treatment that virtually eliminates
recurrence.

  • Cryodestruction

The cyst bed is frozen with very low liquid nitrogen.
temperature

  • Radio wave surgery

Destruction of pathological cells by radio waves (apparatus
�”Surgitron”). The method has gained popularity recently due to
high efficiency.

  • Surgical excision

This operation is performed in case of severe deformity.
cervix and the presence of many large cysts (10 – 20 mm). Usually,
conical excision is performed (excision) of the cervix and
all cysts are removed. In advanced situations it is proposed to hold
vaginal amputation of the cervix, and if cervical cancer is suspected
extirpation of the uterus (removal of the uterus and cervix).

Tactics of surgical intervention is determined by clinical
situation, age of the woman, the accompanying gynecologic
pathology and the patient’s desire to preserve reproductive
function.

After оперативного вмешательства

After хирургического удаления наботовых кист пациентке
recommend:

  • 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 a doctor after 2 weeks, then after 6;
  • the introduction of vaginal suppositories for the prevention of 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);
  • Rejection of visiting baths, saunas and bathing for 6
    weeks.

Folk methods

Many women wondered whether popular treatment can be applied.
nabot cysts? Yes, the use of folk remedies is not excluded.
with this pathology, but only as an addition to the main therapy,
because getting rid of cysts only by folk methods is impossible.
Folk remedies can be used in pre-and postoperative
periods. They help reduce the signs of inflammation and swelling,
eliminate irritation and suppuration of cysts. From recommended
methods allowed use:

  • Walnut Septum

Four tablespoons of partitions chop and pour three
glasses of boiling water. Then the mixture is boiled over low heat for
20 minutes. The resulting decoction should be filtered and cooled. Take
half a cup thrice a day.

  • Acacia flowers

Pour 2 tablespoons of freshly picked acacia flowers with a glass.
vodka. Mixture insist for two weeks in a dark place before
the beginning of reception tincture should be filtered. Take по столовой
spoon tincture, diluted with two tablespoons of boiled water
three times a day. The course of treatment is 30 days.

  • Burdock leaf juice

It has wound-healing properties, it is recommended to take in
postoperative period. From the fresh leaves of burdock squeeze juice.
The first 2 days of squeezed juice take a tablespoon twice a day,
the next 2 days the reception is increased up to three times a day and
lasts for a month.

Introduction of intravaginal tampons with various plants
(eg garlic) and herbs to get rid of nabot cysts
impractical and even harmful.

Before treatment by popular methods should consult
with a doctor.

Prevention

Specific prevention of cervical cysts is not. Recommended
comply with measures aimed at preventing the development of any
gynecological pathology:

  • intimate hygiene;
  • visiting the gynecologist every six months;
  • use of barrier contraceptives for occasional
    sexual intercourse;
  • pregnancy planning;
  • rejection of abortion;
  • timely and adequate treatment of hidden genital
    infections.

Question answer

ATопрос: Может ли наботова киста нагноиться и как
does it manifest itself?

Yes, the suppuration of nabot cysts 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 with infection
(thrush, Trichomonas colpitis, bacterial vaginosis, etc.).
In case of marked inflammation other than local symptoms (pain below
abdomen and sexual intercourse, purulent discharge from the genital tract)
general signs of intoxication appear (fever,
loss of appetite, weakness). In this situation, it is urgently needed
consult a doctor who will prescribe general and local
anti-inflammatory treatment and then surgical removal
cysts.

ATопрос: На осмотре у гинеколога полгода назад врач
обнаружила наботовы cysts. They did not bother me and gynecologist
advised only to be observed. But in the last 3 months of me
painful periods (no pain before). Is it connected
it with cysts and what to do?

Yes, most likely in the pains during menstruation are overgrown
cervical cysts that partially overlap the cervical canal that
complicates the flow of menstrual blood. You need to be examined
(colposcopy, ultrasound with a transvaginal sensor and genital blood
hormones) and surgical treatment of formations.

ATопрос: Могут ли наботовы кисты стать причиной
infertility

Yes. With significant size of cervical cysts overlap occurs.
cervical canal making penetration impossible
sperm into the uterine cavity and the subsequent conception.

ATопрос: У меня небольшой срок беременности (6
weeks) and multiple nabot cysts, can they complicate
during pregnancy?

If the cysts are small and did not show themselves before pregnancy,
then the risk of their negative impact on the current
pregnancy is minimal. But in some cases (extremely rare)
may increase the size of formations and their suppuration, which may
cause miscarriage. Observe all recommendations.
physician and preventive measures to prevent cyst suppuration.

ATопрос: Какой прогноз при данном заболевании?

Education on the cervix extremely rarely go into cancer, so
favorable prognosis.

Like this post? Please share to your friends:
Leave a Reply

;-) :| :x :twisted: :smile: :shock: :sad: :roll: :razz: :oops: :o :mrgreen: :lol: :idea: :grin: :evil: :cry: :cool: :arrow: :???: :?: :!: