Coccyx cyst refers to multiple types of congenital epithelial pathologies that develop in the form of a cyst, that is, in the form of a subcutaneous cavity filled with purulent discharge due to inflammatory processes occurring inside.
A coccyx cyst is often called an epithelial coccygeal duct, dermoid sinus, pilonidal cyst, or coccyx fistula. They differ in the place of origin and stages of development: a dermoid cyst is located close to the surface of the skin, the epithelial coccygeal tract is in the deep subcutaneous layers, the pilonidal sinus occurs as a result of abnormal ingrowth of hair under the skin, and a coccyx fistula occurs when any of the previous types of cysts suppurate.
Occurrence and development of the disease
A coccyx cyst is a congenital pathology that occurs as a result of a hormonal or other disruption during the development of the embryo in the womb. After conception, the embryo goes through several stages of development, one of which is the formation of bone tissue. It is at this moment that the embryo forms a tail, which stops development due to hormonal influences. If at this stage a hormonal imbalance occurs, then the muscle tissue develops further, turning into the epithelial coccygeal tract.
Content:
- Occurrence and development of the disease
- Causes of coccyx cysts and symptoms of the disease
- Diagnosis and treatment methods for the disease
- Removal of coccyx cyst
- Recovery period, prognosis and possible complications after surgery
- Finally
This pathology is a small cavity lined from the inside with epithelium. This formation is not associated with either the coccyx or the vertebral region.
Since the epithelium tends to secrete sebum, a small hole is formed in this place on the surface of the skin, which serves to remove sebum from the inside. This lumen is located approximately seven to ten centimeters above the anus.
Often, when it becomes clogged, inflammatory processes occur, which are the cause of a coccyx cyst. The cyst looks like a small oval capsule, which also has its own opening, usually several times larger than the previous one.
With the progression of the infectious-inflammatory process inside the cyst, such a formation degenerates into a dermoid sinus, or dermoid cyst. This formation has clearer boundaries than a regular cyst, as well as a compacted capsule. It is clearly visible and palpable by the doctor during a visual examination. One of the most characteristic signs of the occurrence of such a formation is the appearance of purulent discharge.
In a neglected state, such a cyst can open, which will briefly bring relief to the patient. But the disease becomes chronic; the inflammatory process affects nearby healthy tissue, which forms a large affected area.
Contraindications
Removing a coccyx cyst using a laser is not always possible. Contraindications for this research method include:
- tumor formations of various localizations;
- a history of diseases of the hematopoietic and immune systems;
- cardiovascular pathology;
- renal and liver failure;
- coccyx cyst complicated by an abscess;
- acute infectious and inflammatory diseases.
Causes of coccyx cysts and symptoms of the disease
Although this disease is congenital, it can develop under the influence of various external factors:
- as a result of injury;
- with a significant decrease in immunity;
- due to insufficient care and poor personal hygiene;
- when the body is hypothermic;
- as a result of infectious and inflammatory processes;
- due to a sedentary lifestyle.
Both male and female embryos are susceptible to the occurrence of congenital pathology to the same extent, however, according to statistics, coccyx cysts develop predominantly in the male population. This figure exceeds the possibility of developing pathology in women by five times. This is due to the specific structure of the male and female body: the epithelial passages of the stronger sex are most susceptible to inflammatory processes.
If you constantly postpone a visit to the doctor, this disease almost always turns into a chronic form, which is characterized by exacerbation and temporary lull. When severe purulent processes are untreated, a fistula forms in the cyst, through which dead epithelial cells are discharged out along with pus.
From birth, this formation develops exclusively in the subcutaneous fatty layers of the epithelium. In the early stages, it is quite difficult to identify it, since it has no visible symptoms. Very rarely, discomfort or slight itching may occur in the tailbone area. Under the influence of certain external factors, the opening of the coccyx becomes clogged and a cyst appears. In such cases, the inflammatory process has the following distinctive features:
- constant sharp pain in the tailbone area, especially severe just above the anus;
- in a sitting position or when walking, the pain increases significantly;
- the skin in the affected area is characterized by noticeable redness and severe swelling;
- severe headaches occur;
- constant drowsiness is felt;
- the formation of an infiltrate in the gluteal fold, which is an accumulation of epithelial cells with lymph and blood in adipose tissue, very sensitive to touch and palpation;
- Fever and chills occur.
WHY DOES A FISTULA APPEAR?
The pathology is associated with a malfunction that occurs during the development of the embryo. The disease also manifests itself in patients who have a genetic predisposition to a specific form of the intergluteal fold and sacrococcygeal region.
There are certain factors that can trigger the activation of the disease. A fistula on the coccyx tends to appear against the background of:
- weakened immune system;
- lower back injuries;
- inflammation of the follicles;
- presence of infections in the body;
- increased hair growth in the sacrum area.
In some cases, the pathology is associated with a sedentary lifestyle, sedentary work, and poor personal hygiene. Sometimes the disease manifests itself after severe hypothermia.
Diagnosis and treatment methods for the disease
When such a pathology occurs, medical assistance is simply necessary, since this disease tends to become chronic and also cause unnecessary complications.
A competent and qualified proctologist can make a diagnosis during the initial examination, based on the clinical symptoms of the disease. However, in some cases, an x-ray of the pelvic area may be required to exclude other similar diseases: osteomyelitis of the coccyx and sacrum, as well as rectal fistula.
To treat this disease, both conservative methods and surgical intervention are used.
In the first case, therapy is only preventive in nature and is often used to relieve acute inflammatory processes, as well as as preventive measures during the postoperative recovery period.
The only way to completely get rid of this disease is through surgery. Moreover, the sooner this is done, the lower the risk of developing unwanted complications and the much faster the rehabilitation process after surgery.
Conservative treatment uses medications to help relieve inflammation, relieve acute pain, and generally alleviate the patient’s condition. These drugs include non-steroidal anti-inflammatory drugs:
- aspirin;
- ibuprofen;
- piroxicam;
- ketoprofen;
- diclofenac.
Also, traditional medicine recipes are often used at home to relieve the patient’s unpleasant symptoms. For these purposes, various decoctions, tinctures and ointments are used.
Calendula decoction
To prepare you will need:
- calendula flowers - one tablespoon;
- water - one glass.
Boil the ingredients and cook for two to three minutes. Leave the resulting broth for half an hour, then moisten a cloth in it and apply it to the affected area, changing it every three to four hours.
Compress with propolis
This compress is good for severe suppuration. It is necessary to moisten a piece of clean cloth in an alcohol solution of propolis. Apply this compress to the area of inflammation and change it every three hours.
Tar ointment
For preparation you will need:
- tar - one tablespoon;
- butter - two tablespoons.
Mix the ingredients well and apply the resulting ointment to the affected area overnight, covering the top with a plastic bag or cling film.
Remedy for severe pain
For severe pain in such cases, toothpaste with pine needle extract helps well. The affected area must be lubricated and held for two to three minutes, then rinse thoroughly with warm water and gently wipe the skin with a dry towel.
Removal of coccyx cyst
The operation to remove such pathology is carried out using various methods. The option most suitable for the patient is determined by the proctologist based on the symptoms and severity of the disease. Surgery is performed under local anesthesia.
There are several options for removing a coccyx cyst:
- Open wound method. This operation is considered one of the most difficult and is characterized by a long rehabilitation period, which can last up to two months. This technique is most often used in advanced disease states, in the event of fistulas or severe suppuration, when the inflammatory process has already spread to nearby healthy tissue. During the operation, the surgeon completely drains the cyst, and the edges of the resulting wound are sutured to its bottom. Afterwards, drainage is installed to drain lymph and pus. Full recovery occurs in approximately two to three months. With this intervention, possible repeated tumors and relapses are completely excluded.
- Closed wound method. During this operation, the coccyx cyst is also excised by the surgeon, but only a small hole remains in it, from where the contents of the formation are drained through drainage. In such cases, the rehabilitation period requires about two to three weeks. This technique is used to carry out planned operations to remove the cyst, as well as to minimize the risks of the disease returning.
- Bascom method. The skin in the affected area is removed from the primary openings to the secondary openings resulting from the fistulas. In this case, the affected area shifts to the gluteal fold.
- Karydakis method. With this intervention, the affected area also shifts to the center of the intergluteal line. The skin affected by inflammation is removed, due to which the recovery period is significantly reduced and the postoperative wound heals faster.
- Sinusectomy method. This intervention is possible only in the absence of purulent processes in the cyst cavity. In this case, a probe is inserted into the canal, connecting both openings - primary and secondary. The cyst is excised using an electric current. This method does not require sutures.
- Laser removal. This technique also involves excision of the cyst, but instead of a knife, a laser beam is used. At the same time, the rehabilitation period takes very little time, and in some cases the patient can go home even on the day of the operation. However, you should know that this method has not been sufficiently studied in our country, so you should make sure that the operation will be performed by a qualified and experienced proctologist, and it is also advisable to insist on hospitalization in order to exclude possible negative consequences or complications.
Surgical treatment of the coccygeal ducts at GMS Hospital
The Center for Operative Proctology at GMS Hospital specializes in such operations. Our experienced doctors have performed many successful interventions. In just a week you will forget about the problem and return to your normal life, and pain and discomfort will remain only a memory.
The main advantages of surgical treatment of the coccygeal tract at the GMS clinic:
- the operation lasts only about 20 minutes;
- minimal surgical trauma;
- painlessness;
- hospital stay is limited to no more than 24 hours;
- 100% sterility;
- minimizing complications;
- short recovery period;
- minimal likelihood of relapse.
Thanks to the use of minimally invasive surgical techniques, the postoperative period proceeds with minimal pain and takes little time. You can learn more about surgical treatment methods by scheduling a consultation with our coloproctologist surgeon, by phone or online.
Recovery period, prognosis and possible complications after surgery
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After removal of the formation, it is necessary to treat the postoperative wound every day and change the dressings. The sutures are removed on the tenth to fourteenth day after removal. After this, it is recommended to treat the wound with a solution of chlorhexidine or iodine to prevent the development of infectious processes.
In the first month after surgery, any physical activity is prohibited, it is undesirable to sleep on your back, and it is also necessary to avoid sitting on hard surfaces. The patient returns to a normal rhythm of life and full performance after five to six weeks.
This disease has a favorable prognosis. Surgical intervention performed by a qualified specialist eliminates the possible occurrence of relapses. Even a late visit to a doctor does not entail dire consequences, and a coccyx cyst in advanced stages can also be treated, as in the early stages of the disease. However, in this case, the longest rehabilitation period may be required, and the patient’s time in hospital is significantly increased.
Complications with this disease occur in very rare cases and may include:
- purulent-inflammatory damage to adjacent tissues;
- acute inflammation that has spread to healthy cellular tissues with the formation and discharge of pus, without clearly defined boundaries;
- multiple or single fistulas;
- skin eczema.
History knows of cases where a coccyx cyst has developed into an oncological neoplasm. But these are isolated cases when the development of pathology lasted more than twenty years and during this time the patients never sought medical help. Although this disease caused the appearance of numerous suppurations and fistulas.