Tailbone Cyst Removal (Pilonidal Cystectomy)

What is removal of a tailbone cyst?

Removal of a tailbone cyst (pilonidal cystectomy) is a procedure for draining or removing a cyst near the tailbone. A tailbone cyst is also called a pilonidal cyst.

When is it used?

This procedure may be done to open and drain an infected pilonidal cyst. A pilonidal cyst is an abnormal saclike structure in the skin. It usually happens in the crease between the buttocks, near the tailbone. It often contains hair and small pieces of skin. It can get infected and cause an abscess, which is a pocket of infected fluid (pus) with a thick wall around it. The cyst may become painful and leak pus.

This procedure may also be done even if a cyst isn’t infected. The procedure can relieve pain caused by the cyst and keep it from getting infected.

How do I prepare for this procedure?

  • Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
  • Tell your provider if you have any food or medicine allergies.
  • Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
  • Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
  • You may or may not need to take your regular medicines the day of the procedure, depending on what they are and when you need to take them. Tell your healthcare provider about all medicines and supplements that you take.
  • Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
  • Follow any instructions your healthcare provider may give you.

What happens during the procedure?

You will be given a local or general anesthetic to keep you from feeling pain during the procedure. Local anesthesia numbs part of the body while you stay awake. You may also be given medicine to help you relax. General anesthesia relaxes your muscles and you will be asleep.

If the cyst is infected, your healthcare provider may make a cut in the skin, remove any hair, and drain any pus that has formed. Your provider may try to remove the whole cyst or may just leave the cyst open to allow it to drain completely. If there is no infection, the provider may remove the whole cyst and close the cut in the skin with stitches.

What happens after the procedure?

You may go home that day or stay in the hospital for 1 to 2 days, depending on the procedure and your condition. Keep the area as clean as possible. It may take as long as 6 months or more for the area to fill in completely with scar tissue if it was left open. If it was closed with stitches, the stitches may stay in as long as 2 to 3 weeks.

The wound will need 1 to 2 months to heal. In some cases it may take up to 6 months to heal.

Follow your healthcare provider's instructions. Ask your provider:

  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

What are the risks of this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

  • Anesthesia has some risks. Discuss these risks with your healthcare provider.
  • The cyst may come back.
  • The cyst could get infected again if it was not removed.
  • You may need more surgery to try to control the problem.
  • You may have an infection or bleeding.

There is risk with every treatment or procedure. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.

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