What Is a Pilonidal Cystectomy?

Reviewed on 10/26/2020

Pilonidal cysts are usually seen along the tailbone.
Pilonidal cysts are usually seen along the tailbone.

Surgical removal of cysts that usually develops in the crease of the buttocks is called pilonidal cystectomy. Pilonidal cysts are usually seen along the tailbone. These cysts may contain hair and skin debris. They may resemble a large pimple and are usually considered painful with swelling and infection. Pilonidal cysts usually occur in people younger than 40 years of age and are more common in men than in women. A pilonidal cystectomy may be done to open and drain an infected pilonidal cyst, or it may be done to remove a cyst.

Procedure:

  • Pilonidal cystectomy is usually performed under local or general anesthesia. Vitals are monitored throughout the procedure.
  • A cut is made to remove the skin with the pores and the underlying tissue with the hair follicles. The sac enclosing the cyst is removed and the pocket is cleaned.
  • If the cyst is infected, the doctor may just make a cut in the skin, remove the hair, and drain any pus that has formed. The doctor 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 doctor may remove the whole cyst and close the cut in the skin with sutures (stitches).
  • Sometimes a tube is placed to drain fluid that collects fluid after surgery. The tube is removed later when the fluid stops draining.
  • The procedure is usually completed within 1-2 hours, depending on the size of the cyst.

Risks:

Recovery: 

Recovery usually differs from patient to patient. Usually, patients may get discharged within 24-48 hours. Many patients return to desk-type work the next day.

  • Patients may need to avoid lifting any objects.
  • Patients may need to avoid fried foods and milk products for a day after surgery.
  • Care instructions for the surgical site, including dressings and bathing, will depend upon the exact location of the cyst and closure of the incision.
  • Pain medications are usually prescribed after surgery. Often, Tylenol and Advil (same as Motrin, Ibuprofen) or Aleve are recommended.
  • It is often suggested to start taking a stool softener and Miralax from the day after the procedure.
  • The area should be always kept clean, and proper hygiene should be maintained.

Will pilonidal cysts return?

Pilonidal cysts develop again even after surgery in most of the patients. A pilonidal cyst is not fatal; however, it can become more difficult to treat and may turn into a severe condition. One can prevent recurrence by washing the area daily with mild soap, making sure all soap is removed, keeping the area completely dry, and avoiding sitting for long periods.

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References
Pilonidal Cystectomy, https://emedicine.medscape.com/article/1830066-overview

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