A purulent coccyx cyst is an inflammatory process under the skin in the sacrococcygeal region, most often found in young men. A cyst in the sacrococcygeal region appears as a result of exposure to various factors:
- A congenital anomaly that occurs when embryonic development is disrupted in the early stages of pregnancy.
- The anomaly is formed during growing up due to improper escalation of hair.
- It can develop with a sedentary lifestyle.
- Weak immunity can cause illness.
- Hereditary predisposition, trauma and other factors.
Treatment of pathologies of the sacrococcygeal region is carried out in the coloproctology department of the Yusupov Hospital. Yusupov Hospital is a multidisciplinary medical center, which includes several clinics, a clinical laboratory, diagnostic and rehabilitation centers, and a hospital. The hospital performs surgical operations in operating rooms equipped with innovative equipment. The latest world developments in the field of medicine and medications certified in Russia are used to treat patients. Consultations and treatment of patients are carried out by experienced doctors: doctors of science, professors, highly qualified doctors, patients are provided with various types of medical care.
Causes
An abnormal pathology forms in the sacrococcygeal region - a passage under the skin that opens outward with one or more small holes in the midline between the buttocks. The length of the epithelial coccygeal tract is about 3 centimeters. The epithelial coccygeal tract may not manifest clinical signs throughout life; the patient may become aware of the presence of an anomaly during the development of an inflammatory process, the development of a purulent cyst of the coccygeal tract. The cause of the development of suppuration of the coccyx cyst is various injuries, hypothermia, infections, and failure to comply with hygiene rules. The epithelium lining the cavity of the pilonidal cyst of the coccyx has the same properties as human skin - it secretes waste products and sweat.
Waste products are excreted through pinpoint openings in the epithelial tract. If injury or infection occurs, the primary epithelial tract is blocked, and an acute process begins, which leads to the development of complications. The walls of the epithelial coccygeal duct are destroyed, and inflammation spreads to the surrounding tissue. As a result of the inflammatory process in the coccygeal passage, phlegmon, purulent fistulas, and an abscess of the sacrococcygeal region can develop. A dermoid cyst of the coccyx is a congenital pathology that is formed in utero when elements of the germ layers are displaced under the skin, in the superficial layers of the skin. A dermoid cyst differs from the epithelial coccygeal duct in that it has a clear capsule; the epithelial coccygeal duct, unlike a dermoid cyst, has a point exit on the surface of the skin.
This type of cyst may not bother the patient for a long time, manifesting itself only in discomfort and pain when sitting for a long time. The development of the inflammatory process leads to cyst breakthrough, fistula formation, increased temperature, and severe pain when changing body position.
Causes of the disease
Coccydynia is a disease in which a person is regularly bothered by pain of varying degrees of intensity in the tailbone. Sometimes pain radiates to the rectum, perineum, genitals, and sacrum.
Kazieva Aminat Ziyavovna
Neurologist
Rostov State Medical University
Experience since 2012
The pain is chronic, intensifies in a sitting position, with load on the lower spine. They are of neurological origin, so upon examination no organic abnormalities are detected.
Due to prolonged sitting, static deformation of the coccyx occurs.
Causes of pain syndrome:
- trauma: fracture, crack, bruise, dislocation, vertebral displacement, sprain;
- diseases of the spine: osteochondrosis of the lumbosacral region, spondylosis, spondyloarthrosis, protrusions, hernias;
- coccyx cyst;
- tumor processes: benign tumors, metastases, primary cancer;
- pinched sciatic nerve;
- scars and adhesions after surgery;
- pinched and injured nerves during childbirth;
- inflammation of the pelvic organs;
- ischemia (deterioration of blood supply) of the coccygeal region;
- prolapse of the perineum.
It is the injury that occurs in the coccyx area that is the most common cause of coccydynia. This area of the spinal column is quite traumatic. The tailbone can be damaged by falling on the buttocks, while riding a horse, kicking against a hard object, and even during childbirth.
Many complications arise from coccyx injuries
Chronic pain syndrome does not occur immediately after injury, but several months or even years later. A person manages to forget about the injury, so he looks for the cause of the pain elsewhere. Only from the results of the examination does it become clear that the pain is a consequence of the injury.
Kazieva Aminat Ziyavovna
Neurologist
Rostov State Medical University
Experience since 2012
Predisposing factors for coccydynia include:
- physical inactivity, weakness of the musculo-ligamentous apparatus;
- excessive physical activity;
- constant and prolonged sitting on a soft surface, which is typical for office workers and drivers;
- obesity;
- ankylosing spondylitis syndrome;
- tumors in the pelvic area;
- chronic constipation;
- exacerbation of chronic diseases of the pelvic organs;
- hypothermia.
Coccygeal pain can be constant, but more often it is periodic. It occurs after exercise, sexual intercourse, defecation, gynecological or rectal examination, or without a reason. Painful sensations impair the quality of life, performance, and disrupt gait.
In severe cases, the pain is so severe that a person cannot bend his legs at the hip joint, spread them apart, or sit down. There is no need to wait for coccydynia to progress. The problem is solvable. Medical specialists specialize in the treatment of neurological diseases. You can make an appointment with a neurologist by calling +78633332174.
Symptoms
With the development of the inflammatory process, symptoms of the disease appear:
- Body temperature rises.
- There is a feeling of discomfort in the coccyx area.
- Swelling and redness of the skin in the sacrococcygeal region.
- The patient feels severe pain while sitting.
- Purulent discharge appears from the openings of the coccygeal passage.
A tunnel-like swelling appears in the midline between the two buttocks; the openings of the coccygeal passage may not be observed due to swelling. As the purulent process develops, pus begins to leak out of the holes. If the suppuration of the cyst is not treated in a timely manner, the purulent process leads to the appearance of fistulas, large phlegmon or an extensive abscess is formed.
Methods for diagnosing coccydynia and pain in the coccyx area
For a person who experiences severe pain in the tailbone, only a specialist can help determine the cause of the disease. The doctor will find out whether there was injury to this area or hypothermia, and will establish a possible connection with various diseases. And depending on this, he will prescribe any examination method: ultrasound, MRI, radiography of the coccyx and sacrum, computed tomography, etc. Often it is computed tomography, as well as magnetic resonance imaging, that makes it possible to identify various inflammatory processes. X-rays, in turn, provide a lot of information about the nature of the bones and their damage.
Treatment
Inflammation of the epithelial coccygeal duct is treated in the Yusupov multidisciplinary hospital, in the coloproctology department. Diagnosis of the disease begins with examination and interview of the patient. The proctologist listens to the patient’s complaints, determines the nature and duration of the complaints, finds out whether there were injuries in the coccyx area, whether there are functional disorders in the pelvic organs. The doctor examines the condition of the skin of the buttocks, sacrococcygeal region, perineum, conducts a rectal examination for hemorrhoids, rectal prolapse, fistulas, anal fissures, tumors. The proctologist at the Yusupov Hospital can prescribe sigmoidoscopy, fistulography, and ultrasound of the sacrococcygeal area. Suppuration of a coccyx cyst is treated surgically.
The indication for sending a patient to a hospital is acute inflammation of the epithelial coccygeal duct, planned treatment of the pathology. Depending on the classification and severity of the disease, surgical treatment tactics are selected. The operation to remove the cyst is carried out as planned or emergency, depending on the patient’s condition.
There are several methods of surgical treatment of the epithelial coccygeal tract:
- The method used for a coccyx cyst complicated by an abscess is a two-stage operation. The first stage is opening the abscess and cleaning the cavity. The patient receives antibacterial therapy for seven days. Then the second stage is carried out with the removal of the affected tissues of the coccygeal tract.
- Complicated course of the disease - the abscess is opened, the purulent contents are removed, to eliminate the risk of recurrence of the fistula, the edges are sutured to the bottom of the wound. The method has the disadvantage of an extended rehabilitation period.
- Basque method. The coccyx cyst is excised under the skin. The primary coccygeal passages are sutured, and drainage is placed in the secondary passages for the outflow of secretions.
- Karydakis method. During the operation, the inflamed area with a flap of skin is removed. The wound surface recovers faster, the rehabilitation period is short.
- Sinusectomy. Removal of the cyst can be carried out in the absence of a purulent process. A substance (methylene blue) is injected into the opening of the epithelial coccygeal duct, which determines the number of openings of the coccygeal duct and location. Then, using an electrocoagulator and a probe, resection is performed. No sutures are required.
- Removal of a cyst with a laser. The operation to remove a coccyx cyst is performed using a beam of radiation. The patient can go home on the day of surgery, if there are no complications.
- If multiple coccyx cysts complicated by fistulas are diagnosed, plastic surgery is performed using a displaced flap. Not only the epithelial coccygeal duct with its branches is excised, as well as the surrounding fatty tissue. The cavities that formed after removal of the cyst are closed with displaced skin flaps.
Indications for coccyx blockade
Injections of medications into the spine are prescribed if other conservative treatment methods, such as medications and physical therapy, are ineffective. With their help, it is possible to interrupt the pathological nerve conduction of the pinched areas, thereby relieving the patient of chronic pain.
Kazieva Aminat Ziyavovna
Neurologist
Rostov State Medical University
Experience since 2012
If desired, a coccyx block can be completed at a medical clinic. The main indication for the procedure is the treatment of coccydynia.
Features of pain in this disease:
- dull, aching, bursting or pulling, in severe cases the pain is burning, sharp;
- accompanied by pressure and a feeling of heaviness in the lumbar region;
- pain radiating to the perineum, buttocks, sacrum, rectum;
- worsens in a sitting position, after rising from a chair, during physical activity, constipation, can occur during sexual intercourse, coughing, sneezing;
- decrease while walking, after defecation.
Soreness is not the only symptom of coccydynia. Due to constant pain, a person becomes more careful in his movements and tries to sit on a chair so as to experience the least discomfort. The patient sits on one buttock, thereby moving the body weight to one side. As a result, muscle overstrain occurs, curvature of the spine and joint deformation are likely.
This is how a patient with coccydynia sits
Constant severe pain provokes nervous tension, sleep problems, leads to rapid fatigue, and the development of irritable bowel syndrome. They cause deterioration in physical and psycho-emotional condition.
Relieving the patient of constant debilitating pain and returning him to normal life is the main goal of the neurologists at the SmartMed clinic. It is important to understand that coccydynia is a chronic disease, so its treatment requires a professional approach.
Classification according to ICD 10
Pilonidal cyst in the international classification of diseases ICD 10 is coded:
- L00-L99 class 12 - Diseases of the skin and subcutaneous tissue.
- L05- Pilonidal cyst.
- L05.0 – Pilonidal cyst with abscess.
- L05.9 - Pilonidal cyst without abscess.
- L00-L08 - Infections of the skin and subcutaneous tissue.
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Clinic, diagnostics, treatment in Moscow
If an acute process develops in the sacrococcygeal region, you should immediately consult a doctor. The Yusupov Hospital offers patients cozy inpatient rooms. Patients will be able to receive consultations from multidisciplinary doctors, undergo examinations using modern diagnostic equipment, take tests and receive effective treatment. Operations in the coloproctology department are carried out as planned and urgent; after the operation, patients are cared for by attentive and experienced medical staff. You can make an appointment with a doctor by calling the hospital.
Modern methods of treating pain in the coccyx
The effect of treating pain in the coccyx largely depends on what caused the development of the disease.
If this disease appeared after some kind of injury, or hypothermia, then most likely the tailbone is really involved. Treatment begins with a set of therapeutic measures - rest, exclusion of physical activity, physiotherapy, orthopedic pillows (Fig. 5). Quite effectively and quickly, pain in the coccyx area is treated using shock wave therapy. Where, using various operating modes of the device, the doctor can relieve inflammation and pain in the coccyx area. The procedure itself is quite painless and does not last long. The course on average takes about 6-7 sessions with an interval of 3 to 8 days.
In case of severe pain, medicinal blockades are applied to the coccyx area. Additionally, various anti-inflammatory ointments and patches can be prescribed, which accelerate the healing effect. Surgical treatment has to be resorted to very, very rarely; it consists of removing the coccyx. But such operations are carried out only in advanced cases and only when the methods of coservative treatment of pain in the coccyx are completely ineffective. Therefore, the sooner a patient sees a doctor, the easier it is to treat him and the faster he can achieve results.
| Rice. 5. Orthopedic pillow that allows you to relieve the coccyx area. |
COCCYGYDYNYA DISEASE: WHAT TO TREAT IN MEN
Specific pain can occur with prostatitis, narrowing of the urethra, and oncology. Discomfort is felt in the entire area: lower back, gluteal area. This is a signal to contact specialists: a functional diagnostics doctor, a urologist, an oncologist and a neurologist. It often happens that after relieving a spasm in the pelvic area, for example, using a special technique for administering botulinum at the Doctor Ost MC, blood flow and lymphatic drainage are normalized. Swelling and inflammation in the affected area go away and this is often enough for the secondary disease of the internal organs caused by damage to the spine to recede.