Pilonidal Cystectomy

A pilonidal cyst (or pilonidal sinus) is a pocket in the skin that usually contains hair and skin debris and that is almost always located near the tailbone at the top cleft of the buttocks. While there seems to be a number of theories regarding the cause of a pilonidal cyst, it is thought that it forms when loose hairs penetrate the skin and friction (skin rubbing against skin, tight clothing, sitting for long periods), forces the hair down into the skin. The body then responds to the hair as a foreign substance and creates a cyst around it. If the cyst becomes infected, it can be extremely painful and may need to be surgically removed (pilonidal cystectomy).

Purpose/Benefits of the Pilonidal cystectomy

An infected pilonidal cyst or abscess requires surgical drainage. Pilonidal cystectomy is the surgical removal of a pilonidal cyst or tracts extending from a sinus.

Depending on the type of anesthesia used, you may need someone to drive you home and help you with tasks around the house as you recover. If general anesthesia will be used, you will likely undergo a health screening as well as blood tests, a chest x-ray, and maybe an electrocardiogram (EKG). Please be sure to let the doctor know about all medication that you are taking as some may need to be stopped before the procedure. Please also inform the doctor of any allergies you have to medication and/or medical equipment. You may need to avoid food and water for six to eight hours before the procedure, or as recommended by the doctor.

A pilonidal cyst may be removed using local or general anesthesia. The exact procedure will depend on whether or not the cyst is infected. In the case of an infection, antibiotics may be prescribed to treat the infection before surgery. Or the doctor will cut into the cyst and remove the contents, including draining the pus. In other cases, the entire cyst may be removed. The skin may then be closed with stitches or left open, and a bandage will be placed over the surgical site.

You will likely stay in hospital for one to two days. Healing will depend on the exact type of procedure performed and if the wound was left open or closed. It can take up to six months for an open wound to fill with scar tissue. Stitches, if placed, are usually removed after two to three weeks and the wound can take one to two months to heal. It will be recommended that you keep the area free of hair by shaving or removing it another way.


There is a risk of bleeding and infection from the procedure. Complications from anesthesia are also possible.

  • If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure.
  • Travelers to Thailand should plan to stay in the country for at least two to three weeks or for the entire duration of treatment.
  • If you plan to return home after the procedure, please speak to your doctor before making travel arrangements.
  • During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).

The success of the procedure depends on a number of factors. Please discuss the likelihood of success with your doctor before the procedure.

What if this procedure is not performed?

Pain from the pilonidal cyst can be severe enough to prevent you from carrying out normal activities. If infection is present, it will persist without treatment.

Often removing the cyst is the only treatment option left if the pain of the cyst is severe enough to interfere with daily life.

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