Dec 07 2007 10:40 am
Surgery – Pilonidal Abscess Removal
For the past few months I have been battling a Pilonidal Abscess on my lower back near my tailbone. I did my research before going to the doctor and self-diagnosed myself with one, but knowing that I’m not a doctor myself I kept my mouth shut and let the smart ones tell me what they thought it was.
The first doctor I visited was a dermatologist and was familiar with cyst removal, as Jamie had gone to him to have a small cyst removed from under her scalp. They were hopeful that all I had was small cyst and that a simple in-office procedure with local anesthetic would do the trick. The procedure went relatively well with the only problems being insufficient anesthetic due to inflammation. Feeling them cut me and the cauterization in areas was quite unpleasant. But, I got through it and was back at work the following day.
Two days later the cyst had returned, and this time with a vengeance. I felt pressure like I hadn’t felt before and later that night, it burst through the skin. What a mess. So, I went back to the dermatologist and he speculated that I had a Pilonidal. He referred me to a general surgeon to discuss my options.
The surgeon took a look at it and agreed with the dermatologist’s assessment. He was pretty upset that I had been on antibiotics for so long (3 cycles) and strongly suggested that I finish my current cycle and not refill as the bottle indicated. I took his advice because of articles in the news about bad staph infections going around. He scheduled my surgery for yesterday, Dec. 6, 2007.
I arrived at the hospital at 8:30am as instructed, and was taken to a prep room relatively quickly. I believe I spent close to two hours in there before being taken to a surgical holding area. My stay in holding was the most lengthy. My surgeon was late, which seems to be a pattern with him, and I don’t think I actually got in to the operating room until about 2:00pm. The time spent in the holding area was long, but surprisingly I wasn’t upset like I normally would be. Patience is not one of my virtues. I was all hopped up on drugs too, so it’s mostly a blur now. But I do remember being quite lucid during my time there.
The surgery, I have to say, was great. If you’re ever told you’ll be receiving something called “twilight anesthesia”, rejoice. It’s pretty much just like general anesthesia, except you’re not as deeply sedated. No breathing tubes required or anything like that, but you’re totally under. When I woke up, I was fully aware. None of the “sleep the day away” leftovers like with general anesthesia.
The doctor said my abscess was “large and complex”. I asked to see it but it had already been disposed of. They did hold up fingers though and showed me an approximate size. It appeared to be like six or seven inches long. Yikes. Kind of explains the odd feeling that I’m experiencing of having something missing back there.
I came home with a drain attached to me, and a bandage the size of a diaper. Taking that out was a treat, and I’d have probably cried like a baby if it wasn’t for Jamie. Jamie, incidentally, has been amazing for me over these past few months. Changing bandages, taking care of me when I’m down, and pulling that tube out of my back this morning. I am so grateful and consider myself incredibly lucky to be marrying this fine lady.
So, here’s to hoping I’m finally done with this business. This abscess has sucked and I’ll be very glad to never deal with it again. To those dealing with one, I offer my sympathies.
Damn right I’m a fine lady!!
I can’t wait for this to be all over for you. I know you have been suffering for these last few months.
I’m sorry you’re in pain now buddy, but I’m sure it’ll all be worth it when it heals
i had pilonidal surgery about 2 weeks ago. How long am I going to drain? The drain was taken out a week ago. I am also still in a little pain. Is this normal?
Quita…
How was your wound closed after removal? Mine was completely enclosed with a drain coming out above the incision and I removed it the same day as the surgery. Drainage for me lasted a few days (maybe a week) after taking the drain out. If it continues, I’d recommend asking your surgeon.
Pain or discomfort for several weeks is normal from what I understand. I experienced pain for probably 1 to 2 weeks, and then it eased to only hurting when I sat on it improperly. I highly recommend buying a coccyx cussion. It has spared me considerable discomfort over the past several weeks.
Here’s a good site for what to expect when recovering from and living with a pilonidal abscess: http://www.pilonidal.org/
Also, I think I was cut twice. I have a closed stitch wound right at the top of my tailbone but I also have sort of an open wound on my left cheek which is where he literally snatched the drain out. Does this sound familiar?
It sounds very familiar. My drain was in higher than yours, above my right cheek. But it was completely separate from the surgical incision itself. Mine came out same day though, and was done at home.
hi I have search around, and this is the only one that attract my attention. I just had surgery due to an abscess removal also. I was just wondering if anyone had one on their anal going straight to the rectum. because i just got over one surgery and i was told that i need another one . this one is going inside my rectum and i am pretty scared about this second sugery. I had to be in the showers everytime i use the potty the protect myself from having an infection. and believe me it has not been easy. has anyone had something like this and can you share it with me. thank you and god bless everyone.
[...] March. I had what I consider to be a serious health scare at that time (completely unrelated to my Pilonidal procedure) and decided a lifestyle change was needed immediately. My weight had reached a point that was [...]
has your’s ever returned ? im about to go under the fourth time now
Sorry for the slow response Rachel.
Fortunately, mine has not returned at this point. It’s almost a year since the surgery though. How long are you going between procedures? My surgeon told me that they can reoccur, but he took a lot of surrounding tissue out from the area around the abscess. Which, he said, should help minimize the chance of any recurrence.
I have done as much as I can do, I think, to help keep my chances of staying free of one as high as possible. I keep the area very clean, I’ve lost a great deal of weight, and improved my diet and exercise tremendously. Being overweight is a huge factor with these things I’ve been told.
Have you sought out a different surgeon to perform the procedure in case some of the abscess is being left behind when you go in? If any is left behind, it will come right back.
- UPDATE -
I have to say, my surgeon wasn’t messing around when he said that the abscess was pretty big and he took out a lot of surrounding tissue. I hit my tailbone on everything now. LOL Just laying on the bench at the gym I can feel myself teetering on it. Craziness!
Scary, and sometimes painful… But nonetheless, funny.
Im in the waiting room right now and I was wondering, when they don’t close it up is the big dent in your backside,?
Haha im that scared I am going to burst out laughing in this quiet waiting room full of old people hahahahaa.
My surgical site was closed and not left open for the healing process. Although I have heard of some surgeons leaving it open and packing the wound for a period of time.
And yes, I’m missing quite a bit of tissue now since mine was rather big. lol But there isn’t a “dent.” haha
Good luck Sarah! You’ll be fine.
The term “simple procedure” merely sound like a joke to me, coz I had mine removed without local anesthetic, painful as heck. 5 min job but a tremendous torture that was. Open wound healing procedure is as painful too, since the wound tend to close on you pretty quick, so it has to be re-opened to fit in a special type of dressing which is sharper to keep the wound from closing. Just weeks and weeks of continuous pain. Hope this comes to an end soon.
I have been living with this pilonidal abscess for approximately 32 years. I think I was around 17-18 when I first noticed it and I am now 49. I haven’t had surgery yet but I am going to make an appointment soon to have it looked at. I have been reading everybodies comments and stories on this sight and many others. Can I say SCARY!!! OMG!! It will probably be way embarrassing but I definately have to take care of it like right now! It is so painful and uncomfortable especially when it flares up. I just hope it hasn’t tunnelled so deep from letting it go so long. Thank you for this website and for sharing everyone. I will write back after I have surgery and tell you all about it.
Good luck Cheryl! You’ll feel completely different once it’s done after having it for so long. I can’t imagine living with it as long as you have. You’re definitely a trooper!
Definitely post again after you’re done and let us know how you’re feeling.
Hi guys,
Great discussion! I have had mine for about 5 years now, not infected since but kept ignoring it all this time until a few days ago I realized that I actually was bleeding from my abcses so my wife convinced me to show it to my fam doctor. Went to my doc and that’s when I realized what it actually is. My doc said that it’s nothing serious but he smirked and said “IT’S A PAIN IN THE ASS” lol. Saw a surgeon the other day, he told me my options and that surgery should be the last resort. He suggested shaving the area every two weeks, washing it everyday, keep it clean and told me that if is infected, DON’T go to the doctor and get anti-biotics, instead dip into the hot tub to get rid of the bacteria. CHERYL: I think you have had yours for too long, my fam doc told me that depending how long you have it, it can canal thru your spine, not trying to scare you but you should definitely get it checked and get rid of it. As far as I’m concerned, I’m going for the surgery, I can deal with as long as it takes to heal, but I WANT THIS THING OUT OF ME. My only concern is and hope someone can help, HOW IS IT WHEN YOU USE THE WASHROOM, TAKE BATH ETC??? specially when that wound is left wide open??
Appreciate your inputs….
Cheers
To all of you that are going through this or have gone through the pain…I feel you all…About 2 yrs ago I was diagnosed with a Pilonidal cysts. I was hospitalized for a week. At home I had to pack the wound for about 3 weeks (not a pleasant feeling) was very painful. . I still got flare ups after this, but did sit baths etc..(2 yrs later)This year I had a flare up that ended up in the E.R (On Thanksgiving day) was cut to drain the cyst, put on antibiotics again….I saw a surgeon yesterday and was told that the best thing to do is get the surgery. She did say that there are chances of wound care (if stitches open)..I’m nervous but I do not want to live with this pain and so much on antibiotics can make you in the long run have low immunities which can lead to other illness. Can any one give me advice on the surgery? Did anyone have the surgery and cysts came back? Thank you for your time..
Hi everyone, found u guys while Googlin on the crackberry. N e wayz, I am writing this on the floor face down. I am 26 years old,and going through my 2nd abcess cyst on the tailbone!!!! In 2 years!!! What’s creepy is,5 years ago when I was working ,I smelled something bad but didn’t know if it was me. I was so baked I didn’t realize what it was!!! As the time passed I put 2 n 2 together, the weird brown stain in my boxers,and all day driving/pain in my tailbone. Then,after 3 years of noticing a very slight discharge once an a while,I had a serious Bruce Lee Death punch hanging off the top of my crack.I had to wait 3 days to see a prick of a quack-whom u can tell their is a shortage of good doctors because this guy was a dick-he gave me 2 shots (said it would be cold)it was but him scoopin my BLF and stabbing like a pirate and yelled F;##!!! He gives me some Percocet,antibio, and says come back for surgery. I heal up and didn’t go back to pay 1600$ on a 30 minet procedure,so like a true hard head I go on,and because now I’m unemployed hoping my family can help. WELL,a year and 2 months later, which is now, I AM Back at the doctors getting ANOTHER Abcess sliced!!! WTF so the same prick doctor,who now has 30 people in a 20 man waiting room,decides to slice me again. Thanks to Dads insurance, but I could have used a scalpel too.?.? So really,I just paid him for darvocet and anti this time. Dr. says the same thing, “surgery is the way to make it stop” and I am worried!!!!But if its worth not having this pain,I mean Fuc### PAINNNN, I was on the floor,couldn’t walk,even stand straight, eat,piss,anything for 5 days until the prick cuts it??? This shit has to be prevented,so anybody who reads this Help,and if you are suffering, pray to Jesus Christ and the Lord God
I love that I came across this site, however, I still have a question. About 2 1/2 years ago I got my first cyst and boy did it hurt! I got it lanced open and had to pack it, I was not only lucky enough to have my mom do it but also my boss’ wife is a nurse and he offered up her.. what a nice guy huh? The packing i think is the worse part i find it more painful that the rest of everything. I was clear for the 2 1/2 years with a little soreness here and there but nothing major until i started to get another bump. I had it lanced open and this time my mother says theres no option but surgery which i’m excited and scared for at same time. Excited because I want to be rid of this problem but scared because ive never had any time of surgery or anything before. My question is how long is the usual hospital stay? how is the pain after surgery? I realize my situation is a little different because I also had a cyst in my belly button that were going to have removed but I was just curious how long i’ll be in the hospital. Thank you for all your help!
For bee dee and Abby, and anyone else wondering if there are options besides surgery on a pilonidal abscess…
Unfortunately, if you indeed have a pilonidal, the only option is surgery to completely remove it. The abscess is a sac, and draining it only provides temporary relief until it fills back up again. The lump at the surface of the skin is only the tip of the iceberg so to speak. I imagine it like a volcano… The big lump of lava is underground while the mound at the top is just the exit point. To remove the pilonidal completely, the entire sac and a small portion of tissue surrounding it must be removed.
Fortunately though a good surgeon can take care of the problem relatively easily. My surgery took a few hours and I was in and out in the same day. I had to make the same choice… Keep getting it drained, or get it cut out. I went with surgery and my surgeon said it was one of the bigger and more invasive ones he has come across. So don’t worry… You’ll be fine.
Hello everybody,
i stumbled across this website and read all the comments. so i have a question I am 17 years old and just went to the hospital today to (im not even sure) drain i suppose my annoying pilonidal abscess. all the doctor did was squeeze out all the puss from the abscess. i still feel a little soreness but its hell of a lot better than barely walking and sitting, i couldnt even sleep.. i started to notice it hurting when i sat down a week or 2 ago… now heres my question im assuming that what i went threw today was a simple drainage. and that it might come back again. but if you go through surgery it will be completely removed and i will never EVER get it again? iver read that its the only way to get rid of it so im hoping that it would never come back. but some people here said they had it done 2 or 3 times. and for anyone who went through the surgery, how was it? and how long did it take?was it painful? please let me know as soon as you can.
Wow. I never thought I’d find so many people who have to make (or have already made) the same decision I’m faced with today… I have been living with this embarrassing condition for about 5 years, and i would not even wish it on my worst enemy. thanx for all the information on the subject, I’m now going to phone my GP and schedule an appointment with a surgeon and take the leap…
Ok so I have had my cyst for 11 years. I just had a flare up and went to the dotor and got the thing lanched and now he wanst me to go to the surgeon. I have a couple questions for those who have had surgery…was it outpaient or did you have to stay? If you had to stay how long? How long are you off work? I am so scared it is not even funny. Just sitting her thinking about it I want to cry. Sorry
awesome thread i must say! I do however wish i was still ignorant of pilonidal cysts, but oh well…last week I fractured my tailbone(lower saccron) and three days later had an emergency draining of a pilonidal cyst 3″ long and 2.5″ deep running down my crack…am now on my third round of packing, with my fourth round tomorrow and a consult with the colorectal surgeon…for those of you who are past the surgeon, are there any qualifications or specific questions to ask them to make a better decision? i figure I can only live off perky’s and vicodin for soo long…lol…well any help you guys could give would be awesome!!!!
Hi Steve (and others),
I recently whacked my tailbone and somehow triggered an inflamed pilonidal <cyst/abscess/whatnot). Apparently it isn't infected (although on antiB's in case), but it's persisted for about a month. It only hurts when I sit down quickly or when I bend over, but I'm worried about its growth. All that said…
Are there any surgeons recommended in the Bay Area (pref Oak/Berkeley/SF) who really know their stuff in this regard. I've seen too many scary things on the web and on lit reviews (i.e. Nature Clinical articles on how no one really knows the best way to treat this, even now), so I'd really like to find a doctor who specializes in this.
To everyone who still has this/has had the surgery/lancing, etc.–good luck!
I too wish I didn’t know anything about this subject! lol
Last year I had an open wound op (pretty small but apparently lots in there!) and went through the packing thing. I hear it does work for some people but didn’t for me. It seemed to heal up for about a month but then opened up again.
Jeremy, I can only say go with the packing and hope that it works for you. Best things to do are to make sure you shower after every time you go to the toilet (don’t get lazy when you think it’s just about healed) and be sure that you keep the open wound covered while you’re up and around your normal business but also give it some air for a while each day (make sure not to expose it closely to fabrics etc).
I’d also give a warning about particular wound dressings – for ages i was using a dressing called allevyn gentle borders but these created quite a warm environment and I had 3 infections while using these (despite the wound constantly being covered). i then switched to using a simple melolin dressing with a small wound dressing underneath – i’ve had no infections since.
Despite this, my problem never cleared up and i suspect the original drainage was simply not deep enough. I got referred to a very experienced colorectal surgeon and without a hesitation when he seen it, he said i should go for the flap technique and have more invasive surgery and close it up properly.
So i’ll be in for that in just under 2 weeks. When i told my grandfather (he suffered with 5 operations for it), he told me to go for it and that this surgeon knew what he was talking about. My grandfather had 5 smaller open wound surgeries before he was offered what i was offered and it worked for him, so i’m hoping it will work for me too!
I have the surgery next Monday and tge surgeon told me that it will have to be packed and heal from the inside out but packing hurts. Did anyone else have to go through this because he refuses to just remove the cyst drain the fluid and them stitch me up. how long are u on bed rest? Can u walk well or move properly? I’m extremely nervous and scared and the only reason I’m having the surgery is because I have been suffering with this n my mom is tired of paying hospital n doctor bills for drainage!!!!!! Can anyone please give me good advice that will help make me realize exactly what’s going to be taking place after all this is over?
Hi Sierra,
Yes I had the packing first time round. Sure, the packing itself isn’t pleasant but don’t worry too much, it is usually done very quickly. The nurse I had always told me to take my high-strength pain killers about 40mins to an hour before her visit and this really reduced the pain! I also used to just grit my teeth while they were doing it and it does get less painful every day so i really wouldn’t worry about it.
I think the method you are having is the best first choice for surgery, if it heals up ok as it does for many people, you’ll probably not even have a scar.
The only other advice i would give is to not go back to work too soon, make sure it’s fully healed, i was stupid and went back too soon. I went back about 2 1/2 weeks but really should have taken off until it was healed properly – maybe 3 1/2 weeks or so?
Hope that helps, good luck with the op! I’m in on the same day having a closed op x
Oh and Sierra, don’t worry too much after the op, you’ll be able to walk slowly at first round the house etc, will probably take a week until you can walk decent distances, so take it easy x
Great find and thanks to everyone for the great insight and information. I had my procedure done today and the surgeon used the lateral incision (Bascom Technique) which was approx. 3 inches. He scrubed the sac and left open to heal from the inside out. He also picked the pits. I feel fine today and really having no pain. Has anyone had this procedure done on them and what can I expect regarding healing time? Also, how many times a day do you change the packing and is it painful? When might I expect to resume my running? Thanks
My best friend has been dealing with this for 5 years. The first time he went in to the ER at Harborview in Seattle…they gave him a lotion and sent him home.
I finally forced him to go to the ER at Swedish (again in Seattle) … like last June. We then got referral to colo-rectal specialist (and I felt bad but couldn’t help it -I cracked up when I saw the office sign).
This specialist sliced him open in front of me, without warning and liquid poured and poured out. We were told to just let it drain, and this is the solution. A year later, my friend still has an open hole that never heals…it will scab up for a few days and then fluid builds up and has to be released.
Is this normal for a doctor to cut you open and leave you with an open wound, and say live with it?
We are going to the same speciality clinic tomorrow, but different doctor…this time a doctor from the pilonidal.org hall of fame.
Hopnig this finally gets resolved, but worried that we’ll be told again – to just live with it and it will continuously drain.
The poor guy wears a band aid every day…when it gets to the point of you might as well buy stock in band aids…ya kinda have a problem.
I just had mine drained for the second time this week and i have packing in the opening, the doctor told me to take a bath with epson salts and pull it out myself, so my husband wanted to do it and i told him it would be ok, I am really scared that is going to hurt would you guys know if it hurts that bad? or is there something that i could do to to relief the pain??
Wow i thought I was the only one going through this horrible issue. I have a cyst right below my tailbone. I went to emergency and they so called numbed me and sliced me open with a scapel and i felt every last bit of it. i was literally crying. They packed it with some special packing and sent me on my way with some antibiotics. that was the 4th of july weekend. now after getting it packed 3 times which keeps coming out, i have to go in again and see why it has a small odor, i just finished all my antibiotics, im so scared of what the dr. might say, and it hurts to get it packed. to make matters worse i just had surgery on both my feet and am trying to let them heal and now this…