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A cyst of the coccyx is called multiple varieties of congenital epithelial pathologies that develop in the form of a cyst, that is, in the form of a subcutaneous cavity filled with purulent secretions due to inflammatory processes occurring inside.
A coccyx cyst is often referred to as an epithelial coccygeal tract, dermoid sinus, pilonidal cyst, or coccyx fistula. They differ in the place of origin and stages of development: the 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 the coccyx fistula occurs when any of the previous types of cysts are suppurated.
The onset and development of the disease
A coccyx cyst is a congenital pathology that occurs when a hormonal or other failure occurs during the development of an embryo in the womb. The embryo after conception goes through several stages of development, one of which is the formation of bone tissue. It is at this moment that the tail is formed in the embryo, which stops development due to hormonal influences. If at this stage a hormonal failure occurs, then the muscle tissue develops further, turning into an epithelial coccygeal passage.
Such a pathology is a small cavity lined from the inside with an epithelium. This formation is not associated with either the coccyx or the vertebral region.
Since the epithelium is characterized by the secretion of sebum, a small hole forms on the surface of the skin in this place, which serves to remove the fat from the inside. Such a gap is located about seven to ten centimeters above the anus.
Often, when it is clogged, inflammatory processes occur, which are the cause of the coccyx cyst. The cyst looks like a small oval capsule, which also has its own opening, usually many 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 a dermoid cyst. Such a formation has the most clear boundaries than an ordinary 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 sick person. But the disease at the same time becomes chronic, the inflammatory process affects nearby healthy tissues, which forms a large area of damage.
Causes of coccyx cysts and symptoms of the disease
Although such a 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;
- with hypothermia of the body;
- as a result of infectious and inflammatory processes;
- due to a sedentary lifestyle.
Both male and female embryos are equally susceptible to the occurrence of congenital pathology, however, according to statistics, the coccyx cyst develops predominantly in the male population. This figure exceeds the possibility of developing pathology in women by five times. This is due to a certain structure of the male and female body: the epithelial passages of the stronger sex are most susceptible to inflammatory processes.
With the constant postponement of a visit to the doctor, this disease almost always turns into a chronic form, which is characterized by exacerbation and temporary calm. With untreated strong purulent processes, a fistula forms in the cyst, through which dead epithelial cells are brought out along with pus.
From birth, this formation develops exclusively in the subcutaneous fat layers of the epithelium. In the early stages, it is quite difficult to identify it, since it does not have any visible symptoms. Very rarely, discomfort or slight itching may occur in the coccyx area. Under the influence of certain external factors, the opening of the coccyx is clogged and a cyst occurs. In such cases, the inflammatory process has the following distinctive features:
- constant sharp pain in the coccyx, especially severe just above the anus;
- in a sitting position or when walking, the pain is significantly increased;
- the skin in the affected area is characterized by noticeable redness and severe swelling;
- there are severe headaches;
- there is constant drowsiness;
- 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 feel;
- fever and chills occur.
Diagnosis and methods of treatment of the disease
If such a pathology occurs, medical assistance is simply necessary, since this disease tends to flow into a chronic one, as well as cause unnecessary complications.
A competent and qualified proctologist can make a diagnosis already at the initial examination, based on the clinical symptoms of the disease. However, in some cases, an x-ray of the pelvic region may be required to exclude other similar diseases: osteomyelitis of the coccyx and sacrum, as well as rectal fistula.
For the treatment of such a disease, both conservative methods and surgical intervention are used.
In the first case, therapy is only prophylactic in nature and is often used to relieve acute inflammatory processes, as well as as preventive measures in the recovery postoperative period.
Completely get rid of this disease is possible only by surgery. Moreover, the sooner this is done, the less the risk of developing unwanted complications and the rehabilitation process after the operation is much faster.
In conservative treatment, medications are used 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 at home, traditional medicine recipes are often used to relieve unpleasant symptoms in a patient. For these purposes, various decoctions, tinctures and ointments are used.
Calendula decoction
For preparation it will be required:
- calendula flowers – one tablespoon;
- water – one glass.
Boil the ingredients and cook for two to three minutes. Infuse the resulting broth for half an hour, then moisten a cloth in it and apply it to the affected area, changing every three to four hours.
Compress with propolis
Such a compress is good for severe suppuration. It is necessary to moisten a piece of a clean cloth with an alcohol solution of propolis. Apply such a compress to the area of inflammation and change every three hours.
Ointment from tar
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
With severe pain in such cases, toothpaste with pine needles extract helps well. The affected area must be lubricated and kept for two to three minutes, then rinse thoroughly with warm water and gently wipe the skin with a dry towel.
Removal of a coccyx cyst
The operation to remove such a pathology is carried out by 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. Such an 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 conditions of the disease, in the event of fistulas or severe suppuration, when the inflammatory process has already passed to nearby healthy tissues. During the operation, the surgeon completely dries up the cyst, and the edges of the resulting wound are sutured to its bottom. After that, drainage is installed to drain lymph and pus. Full recovery occurs in about two to three months. With such an intervention, possible repeated neoplasms and relapses are completely excluded.
- Closed wound method. With such an 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 the drainage. In such cases, the rehabilitation period takes about two to three weeks. This technique is used to carry out planned operations to remove the cyst, as well as in order to minimize the risks of the return of the disease.
- Bascom method. The skin in the affected area is removed from the primary holes to the secondary ones resulting from fistulas. In this case, the affected area is shifted to the gluteal fold.
- Karidakis method. With such an 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 holes – primary and secondary. With the help of electric current, the cyst is excised. This method does not require sutures.
- laser removal. With this technique, the cyst is also excised, but a laser beam is used instead of a knife. At the same time, the rehabilitation period takes a very short time, and in some cases the patient can go home even on the day of the operation. However, you should be aware 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.
Recovery period, prognosis and possible complications after surgery
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 that, it is recommended to treat the wound with a solution of chlorhexidine or iodine in order to exclude the development of infectious processes.
In the first month after the operation, any physical activity is prohibited, it is undesirable to sleep on your back, and it is also necessary to exclude sitting on hard surfaces. The patient returns to the normal rhythm of life and full working capacity 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 an untimely visit to the doctor does not entail terrible consequences, and the coccyx cyst in advanced stages is also subject to treatment, as well as in the early stages of the disease. However, in this case, the longest rehabilitation period may be required, and the patient’s term in the hospital is significantly increased.
Complications of this disease occur in very rare cases and can be:
- purulent-inflammatory damage to neighboring tissues;
- acute inflammation that has passed to healthy cellular tissues with the formation and release of pus, which does not have clearly defined boundaries;
- multiple or single fistulas;
- every eczema.
There are cases in history when a coccyx cyst has developed into an oncological neoplasm. But these are isolated cases when the development of the pathology lasted more than twenty years and during this time the patients never asked for medical help. Although such a disease caused the appearance of numerous suppurations and fistulas.
In conclusion
The coccyx cyst is a congenital disease that progresses under the influence of various external factors. Most often it develops in the male population, but it also occurs in women. Usually, such a pathology in the early stages proceeds imperceptibly and asymptomatically, therefore it is extremely important for any minor discomfort to seek the advice of a specialist. After all, the earlier such a formation is detected and removed, the less the risk of negative consequences and serious complications, and a much shorter postoperative recovery period is also required.