What are the reasons for pilonidal cyst drainage. How is the drainage procedure performed. What should patients expect after pilonidal cyst drainage. How can recurrent infections be managed.

Understanding Pilonidal Cysts: Causes and Symptoms

Pilonidal cysts, more accurately termed pilonidal sinuses, are small openings in the skin that can lead to significant discomfort. These sinuses typically form in the upper cleft of the buttocks, near the tailbone. They develop when hair, dead skin cells, and debris become trapped beneath the skin, creating an ideal environment for bacterial growth.

Common symptoms of pilonidal cysts include:

• Pain and tenderness in the affected area
• Swelling and redness
• Drainage of pus or blood
• Fever (in cases of severe infection)

The Need for Pilonidal Cyst Drainage

When a pilonidal sinus becomes infected, it can develop into a pilonidal abscess. This abscess is a pocket of pus that forms within the tissue, causing increased pain and inflammation. As the infection progresses, the pressure within the abscess can become unbearable, necessitating drainage.

Why is drainage necessary for pilonidal cysts?

1. To relieve pain and pressure
2. To remove infected material
3. To promote healing
4. To prevent further complications

While some pilonidal cysts may drain on their own, this process can be slow, messy, and potentially embarrassing. Professional drainage performed by a healthcare provider offers a controlled and hygienic solution to managing the infection.

The Pilonidal Cyst Drainage Procedure: Step-by-Step

Pilonidal cyst drainage is typically an outpatient procedure performed in a doctor’s office or clinic. Understanding the steps involved can help patients feel more prepared and less anxious about the treatment.

1. Initial Examination

The healthcare provider will first conduct a thorough examination to confirm the diagnosis of a pilonidal cyst. This is crucial as other conditions, such as anal fistulas or dorsal dermal sinuses, can present with similar symptoms.

2. Area Preparation

Once the diagnosis is confirmed, the affected area will be cleaned and sterilized. A local anesthetic will be administered to ensure the patient’s comfort during the procedure.

3. Incision and Drainage

After the area is numb, the doctor will make a small incision in the cyst. This allows the accumulated pus and blood to drain from the abscess cavity. The healthcare provider may gently manipulate the surrounding tissue to ensure complete drainage.

4. Debris Removal

Using specialized surgical tools, the doctor will carefully remove any hair, dead skin cells, or other debris from within the sinus tract. This step is crucial for preventing immediate recurrence of the infection.

5. Packing the Wound

Instead of closing the incision with stitches, the doctor will pack the wound with sterile gauze. This packing serves several purposes:

• It helps keep the wound open to allow for continued drainage
• It promotes healing from the inside out
• It prevents premature closure of the skin, which could lead to reinfection

Post-Drainage Care and Recovery

Proper aftercare is essential for successful healing and prevention of recurrence. Patients should follow their healthcare provider’s instructions carefully to ensure optimal recovery.

Pain Management

Over-the-counter pain medications are usually sufficient for managing discomfort after the procedure. In some cases, the doctor may prescribe stronger pain relievers if necessary.

Antibiotic Treatment

While antibiotics are not always prescribed following pilonidal cyst drainage, some patients may receive a course of oral or topical antibiotics. It’s crucial to complete the entire prescribed course to prevent antibiotic resistance and ensure the infection is fully eradicated.

Wound Care

Proper wound care is critical for healing and preventing reinfection. Patients will typically need to:

• Remove the initial gauze packing after a few days (as instructed by their doctor)
• Clean the wound daily with warm water or a prescribed cleansing solution
• Repack the wound or apply a clean bandage as directed
• Consider using a sitz bath to keep the area clean and promote healing

How long does it take for a pilonidal cyst wound to heal? The healing process can vary, but it typically takes between one to four weeks for the wound to close completely. During this time, it’s essential to maintain proper hygiene and follow all care instructions provided by the healthcare provider.

Preventing Recurrent Pilonidal Cyst Infections

While drainage can provide immediate relief, it’s important to take steps to prevent future infections. Some preventive measures include:

• Maintaining good hygiene in the affected area
• Regularly removing hair from the region (through shaving or other hair removal methods)
• Staying physically active to reduce pressure on the tailbone area
• Avoiding prolonged sitting or activities that put pressure on the affected area
• Wearing loose-fitting clothing to reduce friction and irritation

Can pilonidal cysts be prevented entirely? While it’s not always possible to prevent pilonidal cysts, especially in individuals with certain risk factors (such as a family history or specific body types), these preventive measures can significantly reduce the likelihood of recurrence.

When Drainage Isn’t Enough: Surgical Options for Recurrent Pilonidal Cysts

For some patients, drainage alone may not be a long-term solution. If pilonidal cysts recur frequently or fail to heal properly after drainage, more extensive surgical interventions may be necessary.

Excision Procedures

In cases of chronic or recurrent pilonidal disease, a surgeon may recommend excision of the entire sinus tract. There are several techniques for this:

1. Wide excision: The entire affected area is removed, and the wound is left open to heal by secondary intention.
2. Excision with primary closure: The sinus tract is removed, and the wound is closed with stitches.
3. Excision with flap reconstruction: After removal of the affected tissue, nearby healthy tissue is used to cover the wound.

Minimally Invasive Techniques

In recent years, less invasive procedures have been developed to treat pilonidal disease:

• Pit picking: A minimally invasive technique where only the pilonidal pits are removed
• Endoscopic pilonidal sinus treatment (EPSiT): Uses an endoscope to remove infected tissue with minimal scarring
• Laser therapy: Employs laser energy to destroy the sinus tract and promote healing

Which surgical option is best for treating recurrent pilonidal cysts? The choice of procedure depends on various factors, including the extent of the disease, the patient’s overall health, and the surgeon’s expertise. A thorough discussion with a healthcare provider is essential to determine the most appropriate treatment approach.

Living with Pilonidal Disease: Long-Term Management and Quality of Life

Dealing with pilonidal disease can be challenging, both physically and emotionally. Patients may experience anxiety about recurrence, embarrassment about the condition, and frustration with ongoing treatment needs. However, with proper management and support, it’s possible to maintain a good quality of life.

Psychological Impact

The psychological effects of pilonidal disease should not be underestimated. Patients may benefit from:

• Counseling or support groups to address anxiety or depression related to the condition
• Open communication with healthcare providers about concerns and treatment options
• Education about the condition to feel more in control of their health

Lifestyle Adaptations

Making certain lifestyle changes can help manage pilonidal disease and reduce the risk of recurrence:

1. Maintaining a healthy weight to reduce pressure on the tailbone area
2. Choosing appropriate seating options (such as donut cushions) for comfort
3. Adapting exercise routines to avoid excessive friction in the affected area
4. Being mindful of clothing choices to reduce irritation

How can patients effectively manage pilonidal disease in the long term? A combination of preventive measures, prompt treatment of flare-ups, and ongoing communication with healthcare providers is key to successful long-term management. Patients should remain vigilant for signs of recurrence and seek medical attention at the first indication of infection.

Advances in Pilonidal Cyst Treatment: Current Research and Future Prospects

The field of pilonidal disease management is continually evolving, with researchers and clinicians working to develop more effective and less invasive treatment options. Some areas of current research and development include:

Biological Therapies

Investigators are exploring the use of biological agents to promote healing and prevent recurrence:

• Platelet-rich plasma (PRP) injections to stimulate tissue repair
• Stem cell therapies to enhance wound healing
• Growth factor treatments to accelerate tissue regeneration

Advanced Wound Care Technologies

Innovative wound care products are being developed to improve healing outcomes:

1. Negative pressure wound therapy devices for complex pilonidal wounds
2. Advanced dressings with antimicrobial properties
3. Bioengineered skin substitutes for challenging cases

Genetic Research

Scientists are investigating genetic factors that may contribute to pilonidal disease susceptibility. This research could lead to:

• Better understanding of why some individuals are more prone to pilonidal cysts
• Development of targeted preventive strategies
• Personalized treatment approaches based on genetic profiles

What promising developments are on the horizon for pilonidal cyst treatment? While many of these research areas are still in early stages, they offer hope for improved outcomes and quality of life for patients with pilonidal disease. As research progresses, patients and healthcare providers can look forward to a wider range of effective treatment options in the future.

In conclusion, pilonidal cyst drainage is an important first-line treatment for infected pilonidal sinuses. While it may provide immediate relief, patients must be aware of the potential for recurrence and the importance of proper aftercare. By understanding the drainage procedure, following post-treatment instructions, and taking preventive measures, individuals can effectively manage pilonidal disease and minimize its impact on their daily lives. As research continues to advance, the outlook for those affected by this condition continues to improve, offering hope for more effective and less invasive treatments in the years to come.

Important Information About Pilonidal Cyst Drainage

You’ve been afflicted by a pilonidal cyst. Pain, inflammation and bleeding have become part of your daily life. Your poor backside can’t go on like this. It’s time for a trip to the doctor.

If this is your first experience with a pilonidal cyst, better referred to as a pilonidal sinus, your physician is likely to recommend a drainage procedure. This quick treatment can relieve the pressure and pain that you’re experiencing.

Take a look at this overview of pilonidal cyst drainage so that you can show up at your doctor’s appointment informed and ready for the procedure.

Reasons for Cyst Drainage

A pilonidal sinus is an opening in your skin that leads to a small pocket within the tissue. This cavity can collect debris like hair, dead skin cells and environmental dirt. Some of the oil secreted by your skin can end up in there as well.

This becomes an ideal place for bacteria to multiply, leading to an infection. Once a pilonidal sinus becomes infected, it turns into a pilonidal abscess.

As the infection takes hold, the abscess may become full of pus. This fluid is a mix of white blood cells, skin cells and germs.

The amount of pus may multiply more and more. This can place a great deal of pressure on the walls of the pilonidal sinus. As a result, you may notice increased pain and inflammation. If the pus goes away, you’ll start to feel a lot better.

Sometimes a pilonidal infection will drain on its own. The pus may ooze out little by little, or the cyst may burst all at once. Waiting for the infection to drain by itself can be a slow process that leaves you feeling damp, uncomfortable and embarrassed. A pilonidal cyst that pops isn’t preferable; it can be terribly messy, and the fluid that escapes is likely to have a foul smell.

Instead of leaving your cyst drainage up to chance like this, your doctor can use an in-office lancing procedure to clean out the cavity under controlled conditions.

Overview of a Drainage Procedure

Before draining your abscess, the doctor will perform an exam to confirm that you do, in fact, have a pilonidal sinus. Conditions like anal fistula and dorsal dermal sinuses can produce similar symptoms, so it’s good to get an official diagnosis before beginning treatment.

If pilonidal cyst drainage is in order, the first step will be to prepare the area. A member of the medical staff will clean the site and inject it with a local anesthetic so you can’t feel the procedure.

Once you’re sufficiently numb, the doctor will make an incision in your skin. Blood and pus will drain out. Gently manipulating the tissue may be helpful for fully draining the cavity. The doctor may also use surgical tools to pluck debris out of the opening.

You won’t need stitches afterward. Instead, the doctor will place gauze in the opening.

You can learn about gauze packing in this video:

What to Expect After Drainage

Unless otherwise instructed, take over-the-counter pain medication after your procedure. If your doctor prescribes a prescription pain reliever, take that instead.

Antibiotics aren’t always given after cyst drainage. If your doctor does give you a prescription for oral or topical antibiotics, it’s important to follow the dosing instructions and complete the full course of medication.

Be sure to follow all directions about wound care as well. You’ll need to remove the original gauze packing after a few days. You may be instructed to repack the wound or to cover it with a bandage. Ask a friend or family member for help if you can’t reach the spot well.

Once the first round of gauze has been removed, you’ll need to wash the area daily. Your doctor might instruct you to allow warm water to flow over the surgical site or to use a cleansing formula that’s designed for wound care. You can also ask your doctor about the option of resting your backside in a warm sitz bath each day.

It can take a while for the wound to heal — often one to four weeks. Keep up with all wound-care instructions during that time.

Followup for Repeated Infection

After a drainage procedure, there’s a chance that you’ll be done with this condition for good. Keeping the area clean, removing unwanted hair and staying active may help prevent a recurrence of the infection.

Unfortunately, cyst drainage may be only a short-term solution. Because the sinus tract remains in the tissue, it can become infected again. When that happens, a second drainage procedure may be a possibility. However, surgical removal of the pilonidal sinus may be a better, more effective option.

There are a number of procedures used for the excision or closure of a sinus tract. Some of these involve cutting the cyst and the surrounding tissue out of the body. Although excision is often successful at treating the condition, you’ll be facing a more significant recovery time than you had with the drainage procedure.

Laser ablation is an alternative treatment to try. With this procedure, a neoV Laser is used to seal the sinus tract shut. This can be an effective means of preventing future pilonidal infections.

Drainage is usually the first medical invention to try in the treatment of pilonidal disease. Pilonidal cyst drainage is a quick in-office procedure that can ease the pain and pressure of an infected sinus. Recovery can take a few weeks, but the relief you’ll feel may be worth it.

If you develop repeated infections, it may be time to move on from drainage procedures. Instead, talk to your doctor about ablation with the neoV Laser.

As with all medical issues, your physician is the ultimate source as to what procedure best fits your needs. Discuss all options and get a second opinion if you have any doubts. These articles are intended to be a source of general information only.

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  in
  
  Pilonidal Cysts
  
  
  by Brian Chandler
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  January 27, 2020

What to Do if Your Pilonidal Cyst Pops

Inflamed pilonidal cysts can be excruciating. Whether you lie still or move around, you may be in terrible pain. If the cyst suddenly pops, you may feel relief, but you’ll also have a mess on your hands.

Knowing what to do if your pilonidal cyst pops will help you address the mess and figure out what to do next.

Understanding the Contents of a Pilonidal Cyst

An infected pilonidal cyst often looks like a tender, swollen lump near the cleft of the buttocks. The main issue, however, is down deep below the surface of your skin. A pilonidal cyst is an unnatural channel that leads from the skin to a hollow area within the tissue.

The condition is more aptly known as a pilonidal sinus rather than a pilonidal cyst. But no matter which name you use, it describes a problem that can be quite uncomfortable.

Over time, the pilonidal cavity can accumulate an assortment of debris. Bits of hair are quite common. Dead skin cells may gather there too, and oil from the skin can make its way in.

Bacteria may take up residence in the cyst as well. As the bacteria multiply, a serious pilonidal infection can begin. The space may fill up with fluids like blood and pus.

When your pilonidal sinus pops, all of that debris, from pus to hair, may burst out of the opening.

In the video below, you can see a medical team draining a pilonidal abscess during an in-office procedure. This can give you a good idea of how much material may drain from your pilonidal sinus.

It’s always best to have your pilonidal cyst professionally drained like this instead of letting it pop at home. If yours hasn’t yet popped, seek medical care before that happens.

Keeping the Site Clean

One of the biggest concerns with a pilonidal sinus that pops at home is the risk of spreading infection. This is why you should never intentionally pop a cyst at home, and you should try to seek medical attention before yours bursts spontaneously.

If yours does suddenly pop, it’s important to do the best that you can to clean up the mess. To begin with, rinse off in the shower. Use soap and warm water to gently clean up.

Keeping up with hygiene until you can see a doctor is very important. You may want to soak regularly in a warm bath. Not only is this helpful for keeping clean, but the warm water may also feel soothing. Some people recommend adding Epsom salt to the bathwater.

After washing, be sure to dry yourself thoroughly before getting dressed. A damp wound is an ideal breeding ground for infection.

You may want to take extra steps to address the issue of bacteria. Some doctors advise applying hydrogen peroxide to the wound. Doing so may help reduce bacterial growth, minimize odor and remove debris.

Make sure that all affected clothing goes straight into the wash. When dealing with infectious material, experts usually recommend washing items on the warmest possible cycle for the fabric. Standard laundry detergent is sufficient; bleach is not necessary.

Absorbing Drainage

A popped pilonidal cyst may continue to drain blood and pus for quite a while. Being proactive with a plan to catch these leaks can help prevent unsightly wet spots and stained clothing.

Placing a sanitary napkin or an incontinence pad inside your underwear is usually the easiest way to address this issue. The doctor may eventually choose to pack the wound with gauze, but an absorbent pad will work for now.

The material that comes out of a pilonidal cyst usually has an unpleasant odor. Keep in mind that sanitary pads may not fully address this issue. If possible, you may want to lie low for a few days until there is some resolution to the smell.

Following Up with Your Doctor

Although you now know what to do if your pilonidal cyst pops, these at-home care tips aren’t a substitute for seeking medical treatment. After your pilonidal sinus bursts, call your care provider for an appointment.

If a large amount of liquid and debris came out of your ruptured cyst, you might assume that the cavity is completely empty now. That’s probably not the case though. You may still have a good deal of hair and dead cells trapped under the skin. A doctor can clean out the sinus more effectively, reducing the chance that a new infection will develop.

The doctor may also pack the wound with gauze to absorb additional drainage. You may be taught how to remove this dressing and replace it as needed. Don’t try to pack the wound on your own without first being instructed how to do so; otherwise, you may use too much gauze.

It’s possible that your doctor will recommend additional treatment, such as pilonidal cyst surgery. Such procedures are often advised for people who have experienced repeated pilonidal infections.

If surgery is in your future, ask your doctor about the possibility of laser ablation with the neoV Laser. This treatment boasts a high rate of effectiveness yet a shorter recovery time than traditional excision surgeries for pilonidal sinuses.

Although it’s best for a pilonidal sinus to drain only under the supervision of a medical professional, you now know what to do if your pilonidal cyst pops.

With your doctor’s help, you can learn to care for the wound, prevent future recurrences and, if necessary, make a plan for surgical pilonidal sinus treatment, such as laser ablation.

As with all medical issues, your physician is the ultimate source as to what procedure best fits your needs. Discuss all options and get a second opinion if you have any doubts. These articles are intended to be a source of general information only.

causes of inflammation, treatment, surgery to excise the passage

In 2019, the surgeon diagnosed me with epithelial coccygeal passage.

Valery Trusevich

cured the epithelial coccygeal tract

Author’s profile

I was going to study at the university, and for admission I had to pass the military medical commission – VVK.

The last doctor on my list was a surgeon. She noticed a large pimple just below the sacrum. I myself noticed it three months before the physical examination, and after that the pimple either disappeared for several weeks, then appeared again. He didn’t particularly bother: I have had problem skin since childhood, so even when blood flowed from a pimple, I didn’t attach any importance to it. The doctor said that it was possibly an epithelial coccygeal passage and advised me to contact a proctologist for advice.

As a result, in order to cure the epithelial coccygeal passage, I went through five operations. I’ll tell you why some pimple has become such a big problem and what mistakes could have been avoided.

With this paper, the doctor of the VVK sent me to clarify the diagnosis

What is the epithelial coccygeal tract

Epithelial coccygeal tract – ECC – a disease of the skin and subcutaneous tissue in the upper part of the intergluteal fold. With ECC, an inflamed passage appears in this area, from which mucus, pus or blood can be released. The move ends blindly in soft tissues. Sometimes additional ones are separated from the main course, they can also blindly end under the skin or open onto its surface.

Epithelial coccygeal tract, PubMed article

ECC occurs in about three out of 10,000 people: this is a fairly rare disease. Men get sick two to four times more often than women. The average age of patients is about 20 years.

The causes of the coccygeal duct

The causes of the epithelial coccygeal tract are not fully known.

It is believed that the disease occurs due to accidental detachment of hairs in the intergluteal region. Other hairs and skin particles get into the wounds that form at the place of separation. Friction and increased pressure on the skin in this area pushes the debris deep into the subcutaneous tissue, which increases the depth of the stroke over time. If an infection gets into this funnel, inflammation occurs.

Factors predisposing to the appearance of an epithelial coccygeal passage:

1. Overweight.
2. Injuries in the upper part of the intergluteal fold.
3. Sedentary lifestyle.
4. Coarse hair in the crease between the buttocks.
5. Cases of illness in the family.

Epithelial coccygeal passage, article in UpToDate

ECX on and inside the skin. Source: UpToDate Source: Coloproctology Clinic of PMSMU. I. M. Sechenov

Symptoms of the coccygeal passage

The disease can be asymptomatic, acute or chronic.

Asymptomatic. ECX does not disturb the patient: the stroke does not hurt, no contents are emitted from it.

Sharp shape. During movement or sitting there is a sudden severe pain in the intergluteal region. Mucus, pus or blood may come out of the coccygeal passage. Sometimes the temperature rises.

Chronic form. Patients experience persistent or recurring pain in the intergluteal region. Fluid is periodically released from the coccygeal passage, sometimes several passages open on the skin surface at once. It was the same in my case, but I found out about it only in the course of treatment.

The chronic form may be complicated by squamous cell carcinoma. This is a malignant neoplasm of the skin. Therefore, in some cases, doctors take some of the contents of the ECC to rule out a tumor.

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Diagnosis of the coccygeal passage

As in my case, the disease is usually detected by the surgeon during the examination. No additional examinations are usually required.

ECXs that do not disturb the patient do not cure. It is believed that operating in this case is more dangerous than living with ECC without symptoms.

Acute and chronic forms of ECC are treated only surgically. The doctor cuts the skin of the intergluteal fold and cleans the contents of the coccygeal passage. The wound is usually not immediately sutured – after the operation it must be washed and bandaged. Within two to three weeks, new skin appears at the incision site – healing occurs.

Can ECC reappear

Epithelial coccygeal passage is difficult to treat and often reappears. In 40% of cases, a second operation is needed immediately after the first one. This happens if an excessive amount of skin appears in the wound area – it has to be removed additionally.

In this case, even some time after the operation, the coccygeal passage may occur again. This happens in 10-50% of cases.

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To reduce the risk of recurrence, doctors advise removing hair in the intergluteal area in any convenient way and be sure to wash every one or two days.

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How to treat the coccygeal passage

I realized that the disease should be treated as soon as possible: the problem so far was only of an aesthetic nature, but I didn’t want the ECC to become very inflamed and get sick. I turned for help to my relative, who works as a head in a polyclinic. She assured me that the problem was a trifle, and her subordinate surgeon would be able to perform the operation without general anesthesia.

I was admitted to the polyclinic without a queue, the surgeon examined the neoplasm and confirmed the diagnosis of a doctor with VVC. An operation was scheduled.

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I can’t judge the doctor’s competence, but in one day I ended up on the operating table three times. The first time they damaged a blood vessel, which was sewn up only the third time. I almost fainted from blood loss.

One of the passages was removed and cleaned for me. There was hope that everything would be back to normal. It was necessary to go for dressings every day, and at the same time to reduce any active movements of the legs to a minimum. It turned out to be hard: I really couldn’t do anything, I had to lie on my side a lot. Every movement was painful and stiff.

Conclusion of a doctor from a polyclinic. In it, he indicated the diagnosis and the operation he performed – excision of the coccygeal passage

For dressings, I used surgical plasters, bandages and Levomekol ointment. In total, it took 350 R, of which Levomekol took 150 R. One tube of it was enough for one and a half to two weeks.

350 R

I spent on dressings

I spent two and a half weeks in this state. When the surgeon removed the stitches, it didn’t hurt, but I couldn’t walk normally for another three or four days: in the time since the operation, I had already got used to moving like a penguin.

Another week later, I went for a follow-up appointment with an IHC surgeon. She disappointed me: a characteristic small pimple began to ripen on the skin again. The doctor advised me to go to a specialized coloproctology hospital.

How I prepared for a second operation

The new coccygeal tract did not bother me, so I made an appointment with the doctor by phone. I was scheduled for a checkup in two weeks.

For a consultation, I took a standard set of documents for issuing a medical card: a passport, SNILS and a medical policy.

Coloproctological hospital No. 9 in St. Petersburg looks like this

The proctologist at the hospital listened carefully to my story and was surprised that the surgeon at the polyclinic agreed to the operation. According to this doctor, the recurrence occurred because it was not enough to remove the tissues lying on the surface. During the illness, an extensive network of passages formed under the skin. To cure ECX, you need to remove them all.

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Before the second operation, I had to pass a standard set of tests: biochemical and general blood tests, blood clotting, hepatitis, urine, feces, and determine the blood group. I also did an ECG and fluorography. I also had to get a referral to the hospital from a therapist. Since I already had a conclusion, I just made an appointment with the local doctor at the clinic for the next free time and took a referral without any problems.

To save time, I took biochemical and general blood tests in a private laboratory. He passed the rest of the tests in his clinic on a first-come, first-served basis, except for ECG and fluorography. I decided to pay for the ECG at the clinic, because there was a queue two weeks ahead, and I didn’t want to wait that long. I paid 600 R for an ECG, and 450 R for a fluorography at a tuberculosis dispensary. The results were handed out immediately. I spent 4020 R on blood tests in the laboratory, in total the preparation for the operation cost me 5070 R.

5070 Р

I spent on preparing for the operation

How I went to the hospital

A couple of hours after I arrived at the hospital and settled in the ward, a surgeon came to us. It was he who performed the operation on me and accompanied me until recovery. The doctor examined me and said that after some time the anesthesiologist would come, and the operation would be the next day in the morning.

The anesthetist showed up an hour later and asked if I was allergic to any medications. I tried to give him 5000 R as a thank you, because my mother considers it a good omen, but the doctor politely refused.

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After dinner, I stuck to my laptop and got ready for bed. In the evening, a nurse came into the room. She reminded me that I had an operation tomorrow and I had to refuse breakfast, took my temperature, gave me some pills, and I went to bed.

This is what each meal looked like. It turned out to be torture: I didn’t need a special diet, and a complex lunch in the hospital buffet cost as much as 350 R

How was the operation to excise the epithelial coccygeal passage

The next morning the doctor gave me an injection, asked me to undress and lie down on a gurney. I was taken to the operating room. They put a catheter in my arm, connected a tube with some kind of solution, and I slowly fell into a drug-induced sleep.

The operation lasted only 15-20 minutes, but I watched scary cartoons. There was a feeling that the brain was resisting the state it was in. I felt pain and fatigue, but not physically, but mentally. For half a day after the operation, I lay in a cloudy state, barely moving my limbs.

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How I recovered after the operation

After the operation, a long road of recovery awaited me. The wound healed for about six weeks. To prevent infection from getting there, the nurses bandaged her every day. Almost all the time I was lying on my stomach or on my side.

In the first days I practically did not feel pain, but after three days the wound began to bother me. At night I was injected with painkillers. Liquid was constantly coming out of the wound, and I had to walk around with a thick gauze bandage and put oilcloth on the bed.

In this mode, I spent a little over two weeks in the hospital. After that, the doctor said that the condition of the wound was stable and I could be discharged. I had to make an appointment with a surgeon at the clinic and go for dressings every day. It took me a total of six weeks to recover from the operation: two in the hospital and four at home.

All this time I worked from home, every morning I went to the clinic for examination and dressings to the surgeon.

Two weeks later, I realized that the healing process was being delayed, and I turned to a physiotherapist. She advised me to go to her for laser physiotherapy three times a week. I paid her 3000 R for eight sessions. After every two or three sessions, the physiotherapist noted that the wound looked better. Whether she could have healed in the same time without physiotherapy, I don’t know.

3000 R

I paid for 8 sessions of laser physiotherapy

The rest I spent money on Levomekol, postoperative patches and dressings. “Levomekol” in a pharmacy near the house cost 185 R for a tube of 40 g. It took 400 R a week for a pack of plasters and bandages.

During this period, my family helped me a lot. Relatives bought the necessary funds, food and so on. It was hard for me to cover long distances, each trip to the clinic took a lot of time and effort, so I rode a taxi lying in the back seat.

They didn’t add to my joy at work either: I worked four or five hours a day lying down, because I couldn’t sit. When the money for the sick leave came, I was even more sad: it turned out to be only 897 R per month. If not for my family, it would be hard for me to get out of this situation.

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Discharge statement from the hospital. With it, you can visit the surgeon without a queue at the polyclinic

Complications of ECX after surgery

When the wound healed up and stopped bothering, a furuncle appeared next to it. At first I wasn’t too worried because he was alone and small. After a couple of days, the boil went away, but two days later another one appeared. The temperature has risen. Luckily, it was Sunday morning. I decided not to wait for a miracle and went to a private clinic to see a surgeon.

The surgeon’s examination cost me 3000 R. He said that furunculosis could be a symptom of a recurrence of ECC, and offered to cut out the boils. At the same time, the surgeon offered to perform the operation immediately and free of charge. I agreed, and within five minutes I was lying on the operating table. It turned out that two boils appeared around the scar at once, a large one and a smaller one. The doctor gave a painful injection of an anesthetic, after which he began to cut out the first boil. To say that it was painful is to say nothing: my girlfriend, who was waiting in the corridor, heard the screams.

3000 R

I paid for the surgeon’s examination

After finishing with the first boil, the surgeon asked if I could give another injection of painkillers. I refused, because I could not understand what hurt more: an injection or an incision. Perhaps it was the wrong decision, because then it still hurt a lot, I screamed again. After that, the doctor issued a conclusion and advised him to go to the hospital to rule out another relapse.

The surgeon at the polyclinic prescribed dressings with turundas for me every day for a week. It was a very painful procedure: under great pressure, disinfecting solutions were injected into a deep wound, and then a cotton swab folded into a tube was thrust into it. By the end of the week, I prayed to all the gods that the torment would end soon.

During the recovery period after the operation, there were no new boils. It pleased.

How it all ended

After a week of dressings, I went to a follow-up appointment at the coloproctology hospital. An examination by a coloproctologist and a sigmoidoscopy cost me 2100 R. They could see me for free only after two weeks, but I did not want to wait.

The doctor examined the scars from the operation, assured me that there were no new boils, and performed a sigmoidoscopy on me. As the doctor said, this is a mandatory procedure at the control examination, which allows you to determine whether new formations have appeared in the walls of the rectum. You need to prepare for it – I bought the laxative Microlax in advance for 393 R. There were four enemas in the pack, I did two with an interval of a couple of hours before going to bed.

/vychet-lechit/

How to return money for treatment

Sigmoidoscope is a device for examining the rectum. This tube is inserted into the anus and the walls of the rectum are examined. It’s unpleasant, but I didn’t experience pain. Source: review of equipment for sigmoidoscopy (rectoscopes)

The doctor did not find hints of a recurrence of the epithelial coccygeal tract. He said that it was necessary to monitor for new boils, carefully monitor hygiene in this area, and in which case, immediately go to the hospital.

A year has passed, and during this time I have not had any new symptoms. The incisions from boils are overgrown, three scars have formed in the intergluteal fold, which remind me that I need to be attentive to my health.

The final conclusion of a doctor from the hospital. Now I have to do sigmoidoscopy once a year, as a ritual, I also try not to sit on a chair for a long time, sometimes I work standing up. I wear only cotton underwear and always wash myself with cold water

I spent 17,563 R in total on treatment

Examinations and analyzes for admission to surgery

5070 R

Dressings, plasters and Levomekol

4000 R

Physical iotherapy in polyclinic

3000 Р

Doctor’s examination and removal of boils

3000 Р

Coloproctologist examination and sigmoidoscopy in hospital

2100 P

Enemas for sigmoidoscopy

393 R

Total

17563 R

paid with nerves, pain and money.

Here are the conclusions I drew from this situation:

1. When discomfort and signals from the body appear, it is better to play it safe and immediately go to the doctor. I ignored the pimple in the crease between the buttocks for three months.
2. Go to the doctors you are sure of. For the first time, I relied on unfamiliar people, for which I paid with time and money. I had no one to find out about a good proctologist. I had to step on all the rakes on my own.
3. Don’t be shy about asking for help, even with such sensitive issues. My roommates had problems much worse than mine, and the medical staff showed care and attention to each case. Coloproctologists generally have a great sense of humor, so each examination was accompanied by jokes that did not offend, but reassured. In the end, even the most awkward situation can be turned into a good article for T-Z.

Epithelial coccygeal passage, also known as “coccygeal cyst”

Komsomolskaya Pravda

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HEALTHDelicate health with Global clinicDelicate health with Global clinic: Proctology

December 21, 2012 14:15

Do you feel pain in the sacrum or coccyx? Noticed a neoplasm between the buttocks? Or maybe just swelling and induration?

Epithelial coccygeal passage, also known as “coccygeal cyst”.

We were inspired to touch upon this topic by a letter from a patient:

Hello! A couple of months ago, there were severe pains in the coccyx. I noticed a small bump between the buttocks, and near it a small depression. I haven’t found any splits yet. Could it be a coccyx cyst, and which doctor should I contact? Sincerely, Sergey»

What kind of disease with a long and complicated name epithelial coccygeal passage, or, as people say, “coccygeal cyst”, we learn from coloproctologist, candidate of medical sciences Maxim Vladimirovich Zubenkov (Global Clinic Medical Center):

– Unfortunately, it is impossible to make an accurate diagnosis based only on the verbal description of the symptoms without at least a visual examination. But, nevertheless, I will say that this problem is really very similar to the presence of an epithelial coccygeal passage. Sergei needs to see a proctologist to get an accurate diagnosis. And, if this disease really takes place, then the fistula must be excised, since otherwise the cyst may fester and it will have to be opened first, and only then a radical excision of the coccygeal passage should be carried out.

– What is the epithelial coccygeal duct?

– Epithelial coccygeal duct (abbreviated as ECC) is a congenital disease that appears at 12 weeks of fetal development due to close soldering of the neural tube with the skin. As a result of this process, the epithelium sinks inwards, forming a passage under the skin in the form of a narrow tube in the region of the gluteal fold, not connected with the coccyx and having the so-called primary openings. Outwardly, the epithelial coccygeal passage is open with one or more primary openings. This disease can manifest itself at any age, more often at 15-25 years old, when hormonal changes in the body occur during the active growth of hair follicles. In this case, blockage of the holes of the epithelium is possible, which is why inflammation begins.

– How does the epithelial coccygeal duct manifest itself?

– As a rule, patients do not even suspect that they have an epithelial coccygeal passage, since the disease basically does not manifest itself in any way. Pathological symptoms appear only as a result of the inflammatory process. An epithelial coccygeal passage manifests itself in the form of inflammation in the region of the sacrum or coccyx, accompanied by pain, purulent discharge, sometimes fever and the formation of a purulent fistula.

Maxim Vladimirovich Zubenkov, coloproctologist, Candidate of Medical Sciences.

Distinguish between primary and secondary holes. Primary holes appeared as a result of a natural process, and secondary holes – as a result of inflammation and opening of abscesses.

– How is epithelial coccygeal passage diagnosed?

– Epithelial coccygeal tract can be diagnosed with 90% accuracy by visual examination, but probing and staining of fistulous tracts is often necessary for an accurate diagnosis. In some cases, local ultrasound and radiographic diagnostics are necessary.

– What is the treatment for epithelial coccygeal duct?

– Treatment of the epithelial coccygeal passage is carried out only promptly and only when it occurs and depends on the state of the disease. If at the time of contacting the clinic, the patient has a purulent process, then often the festering passage is opened first and the streaks are carefully removed to alleviate the patient’s condition. After the removal of inflammation, a radical excision of the epithelial passage and primary openings within healthy tissue is performed. In some cases, according to the results of the diagnosis, the doctor performs a radical excision even in a state of inflammation. If the patient comes during the subsidence of the inflammatory process, radical treatment is carried out immediately after passing the necessary tests. During excision, a special suture is most often applied to the edges of the wound to its bottom in the so-called “staggered” order.

– What are the restrictions and recommendations after the operation?

– After the operation, the patient often does not have to sit for 1-2 weeks. This time is very individual and no heavy lifting. After removing the sutures, it is necessary to conduct daily thorough hygiene with washing of the intergluteal fold and observe thorough epilation.

– Is it possible to relapse the disease?

– Since the method is still radical, relapses are rare and can occur only in case of incomplete removal of the primary and secondary holes, purulent cavities and streaks.

– What can be the consequences of not getting timely medical attention?

– If the epithelial coccygeal tract is not treated, the purulent process can spread under the skin, thereby forming additional fistulous openings that can occupy a significant part of the sacral region and perineum.

I also want to warn you that there are cases when a festering epithelial coccygeal passage breaks by itself, while the patient begins to feel much better. But this does not mean that there has been a recovery. Untimely access to a doctor in the case of this disease can lead to a relapse, to an even greater spread, and as a result to more difficult treatment and a long recovery. If the operation is performed at the initial stages of the disease, then the complete healing of the wound occurs in a few weeks. In the case of a late visit to the doctor, complete healing occurs in 3-4 months. Of course, it is necessary to be observed by specialists until complete recovery.

– Many people find it difficult to decide on an operation. Are there alternative treatments?

– I understand my patients that it is difficult for them to decide to even come to an appointment with a proctologist, because this is a very intimate and delicate problem, and even more so to agree to an operation. But please listen to my words: not a single pharmacy remedy, not a single folk method will help you recover, but rather make the healing process more difficult and lengthy. Take care of yourself, trust your health only to experienced and competent specialists, and not to grandmother’s recipes and dubious medicines.

Coloproctologist, Maxim Vladimirovich Zubenkov Poltavskaya, house 39 . You can make an appointment for a consultation or examination by calling (831) 428-08-18 (24/7) or by filling out the “make an appointment” form, you can ask your question here.

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