What is a pilonidal cystectomy?

A pilonidal cystectomy is a procedure in which the doctor removes a cyst over your tailbone.

When is it used?

The cyst is caused when hair burrows into the skin and develops into a cyst. The cyst may become infected and painful, leak pus, and smell.

An alternative is to choose not to have treatment, recognizing the risks of your condition. You should ask your doctor about this choice.

How do I prepare for a pilonidal cystectomy?

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow instructions provided by your doctor. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water. Do not take aspirin for one week before the operation.

No preparation is needed for local anesthesia.

What happens during the procedure?

You will be given a local or general anesthetic. A local anesthetic is a drug that should keep you from feeling pain during the operation. A general anesthetic will relax your muscles and make you feel as if you are in a deep sleep. It will prevent you from feeling pain during the operation.

The doctor opens the cyst, removes the hair, and drains any pus that has formed. The doctor may try to remove the whole cyst or may leave the cyst open to allow it to drain completely. If there is no infection, the doctor may sew the cyst closed.

What happens after the procedure?

You may go home that day or stay in the hospital for 1 to 2 days, depending on your condition. Keep the cut as clean as possible. It may take as long as 6 months or more for the cyst to fill in with scar tissue. The doctor may recommend changes in your lifestyle to help prevent or postpone a cyst reforming.

Ask your doctor what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

You no longer have a painful, smelly, or leaky cyst if it is completely removed.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• A local anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia.

• The cyst may return.

• The cyst could become infected again or another cyst could form.

• This operation may need to be repeated to try to control the problem.

• There is a risk of infection and/or bleeding.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You have a fever.

• You have uncontrollable pain.

• You notice extensive drainage from the operation site.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.