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Pilonidal cysts are the name we give specific cysts that are usually located near the tailbone at the top of the cleft of the buttocks. Pilonidal cysts, also known as pilonidal cyst disease, intergluteal pilonidal disease, or pilonidal sinus disease, present a condition that may manifest either as an acute, one-time issue, or as chronic, recurrent cysts. These abnormal pockets often occur due to the presence of an ingrown hair provoking inflammation in the cleft. With time, hair and debris accumulate in the pocket, which can become infected and cause a painful abscess.
There are two ways to have an infected pilonidal cyst treated – drainage or surgical removal. If the cyst is left untreated, it risks developing into a type of skin cancer called squamous cell carcinoma. If you think you may have this type of cyst, it is best to consult your doctor immediately to get your pilonidal cyst diagnosed.
The complete removal of a pilonidal cyst is called a pilonidal cystectomy. While this is a fair bit more complicated than an incision and drainage procedure, it is considered more likely to be successful in the prevention of future recurrence. A doctor may recommend a pilonidal cystectomy over drainage if you’ve already had a drainage procedure before and your cyst came back, or if your infected cyst is very complex or severe. Talk with your doctor to see if a pilonidal cystectomy is right for you.
All surgical procedures, whether they be big or small, carry risks. For pilonidal cystectomy surgery, these typically include:
Risks of Surgery
Before your procedure, our staff will explain our surgery guidelines in detail. You may need to take antibiotics before surgery. Routine blood work is usually not needed but may be ordered prior to surgery based on the patient's age and the presence of any existing medical problems. You may be advised to stop smoking or go off certain medication before your surgery.
A pilonidal cystectomy is done on an outpatient basis (you will be able to go home after the surgery is completed) at our private clinic in Montreal. Before your surgery, a nurse or doctor will plan the site, clean the affected area, and consult with you for any questions you may have. Then, you will be brought to the operating room and be put under general anesthesia by our anesthetist.
The pilonidal cyst surgical procedure usually takes around 45 minutes to perform. Typically, your doctor will give you a heads up on how long the procedure should last. The procedure
The procedure starts with the surgeon taking a scalpel and using it to cut and excise the cyst and sinus, including the surrounding skin, pores, and underlying tissue around the infection. The area will be cleaned and all liquids will be suctioned away. If a lot of tissue has been removed, the surgeon may pack the wound with gauze. Moreover, if the wound is large, the surgeon may opt to close it up using stitches.
The procedure starts with the surgeon taking a scalpel and using it to cut and excise the entire cyst and pilonidal sinus, including the surrounding skin, pores, and underlying tissue around the infection. The area will be cleaned and all liquids will be suctioned away. If a lot of tissue has been removed, the surgeon may pack the wound with gauze. Moreover, if the wound is large, the surgeon may opt to close it up using stitches.
Recovery time for a pilonidal cystectomy will vary, but you should feel back to normal within a few days to weeks depending on whether or not you received stitches. Be sure to keep the area clean and dry to avoid the possibility of infection. Itchiness or soreness is common, however let your doctor know if you experience swelling or excessive pain.
You will need to arrange for a ride home the day of your surgery and we recommend someone stay with you for the first 24 hours at home. When you leave the facility after surgery, we will want you to go home and rest. Avoid making any other plans on the day of your surgery. Starting the following day, you can increase your activity as you feel up to it.
You will likely be given a prescription for pain medication following your surgery. The recovery nurse will discuss a pain control plan following surgery specific to you and your needs including activities like ice applied over incisions and a medication regimen. Oftentimes we will recommend taking Tylenol and Advil (same as Motrin, Ibuprofen) or Aleve in addition to the narcotic pain medication.
Unfortunately, there is always a chance that pilonidal cysts come back after surgery. Studies show recurrence rates can be as high as 30 percent. In such instances, it is best to keep all follow-up appointments with your doctor.
Did you know we have a support group?
Your questions and concerns have most likely been asked and answered in our support group. Moderated by our dietitians, nurses, and staff. We provide you with reliable patient education and resources to help you throughout this life-changing process.