What causes multiple cervical cysts?

Multiple cervical cysts—commonly referred to as Nabothian cysts—are, like cervical ectropion (formerly termed “cervical erosion”) and cervical polyps, a frequent manifestation of chronic cervicitis. During the healing process of cervical ectropion, newly formed squamous epithelium may cover the openings of cervical glands or grow into the glandular ducts, thereby obstructing them. Additionally, fibrous connective tissue proliferation or scar formation around the glands may compress the ducts, causing narrowing or complete obstruction. As a result, glandular secretions cannot drain properly and accumulate, forming retention cysts known as Nabothian cysts. So, what exactly are multiple cervical cysts? The following section addresses this question.

What Are Multiple Cervical Cysts?

Multiple cervical cysts arise from the presence of functional glandular tissue within the cervix, which contributes mucus to vaginal discharge (leukorrhea). When the openings of these cervical glands become obstructed, secretions cannot be expelled and gradually accumulate, eventually forming visible Nabothian cysts. Thus, Nabothian cysts result fundamentally from obstruction of the cervical glandular ducts, most commonly due to chronic cervicitis. Typically, they are asymptomatic and carry an extremely low risk of malignant transformation; hence, most are incidentally detected during routine gynecological examinations. On visual inspection, multiple small, whitish, fluid-filled cysts of varying sizes protrude from the cervical surface. These cysts contain mucus—some are as small as a grain of rice, while others may reach the size of a corn kernel. Occasionally, larger cysts may significantly bulge beyond the cervical surface—even extending to the vaginal introitus—and may be pedunculated, often coexisting with cervical hypertrophy.

Knowledge Extension: How Should Cervical Cysts Be Managed?

1. Pharmacologic Therapy

This approach is generally reserved for patients with mild cervical cysts. Chemical cauterization using agents such as silver nitrate or potassium dichromate may be employed. Prior to application, the cervical surface is thoroughly cleaned, and the vaginal mucosa and vaginal walls are protected with sterile gauze. After topical application to the affected area, the site is repeatedly irrigated with normal saline. Due to the strong corrosive properties of these agents, their use must strictly follow physician guidance.

2. Physical Therapies

Common modalities include electrocautery, laser ablation, cryotherapy, and ultraviolet irradiation—all requiring prior clinical evaluation and physician approval. Alternatively, advanced techniques such as loop electrosurgical excision procedure (LEEP) or radiofrequency ablation (e.g., using a coagulation knife) may be used. These are particularly effective for patients with extensive or recurrent, refractory cervical cysts, offering favorable outcomes with minimal postoperative side effects.

3. Surgical Intervention

Surgery is indicated primarily for patients with large cervical glandular cysts or those experiencing significant symptoms. Common procedures include cyst unroofing (marsupialization) and hysteroscopic electroresection. Additionally, traditional Chinese medicine approaches—such as fire needle therapy—may be considered. This technique directly targets the cysts, disrupting hyperplastic connective tissue, opening glandular orifices, facilitating drainage of inflammatory exudates, and promoting resolution of inflammation.

The above provides an overview of the nature and management of multiple cervical cysts. We hope this information proves helpful.