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Is there a chance of recurrence with pilonidal cyst?

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Hi, I had a pilonidal cyst surgically drained almost three weeks ago and last week the doctor said it has healed and is good. However, they asked me if I would like to have the surgery with stitches so it does not come back. However, this was my first time getting one. I got a wax today and do not sit as much to prevent it from coming back. So I wanted to know if I should get the surgery or not because the doctor said there could be a chance it will not come back. Thank you.


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Category: Family Physician-GP
Dr. John Monheit is online now

Expert:  Dr. John Monheit replied 4 Days.

Hello, pilonidal cyst is of infective origin and occurs in sacral region between the buttocks, umbilicus, axilla.it is epithelium lined tract, situated short distance behind the anus, containing hairs and unhealthy diseased granulation tissue .It is due to the penetration of hairs through the skin into subcutaneous tissue. It forms granuloma or unhealthy tissue in the deeper plane. Type of hair, force of hair insertion into the subcutaneous tissue, vulnerability of the skin are the three factors that cause pilonidal cyst. This is common in hairdressers, jeep drivers. It is commonly seen in 20-30 years. It is common in males and mostly affects hairy men. It is seen in interbuttock sacral region. Such patients usually present with serosanguinous or purulent discharge, throbbing or persistent type of pain, tender swelling at the site. Tufts of hairs may be seen in the opening of the sinus. It causes recurrent infection, abscess formation that bursts open forming recurrent sinus with pain, discharge and discomfort .In the acute phase, drainage of the abscess and antibiotics are the initial treatment. However the definite treatment consists of excision and primary closure under general or local anesthesia. Here all the sinus tracks, unhealthy granulation tissues with hairs are removed completely. Methylene blue is injected to demonstrate the multiple tracks properly. In regard to your question, I would suggest you to get the surgery done as pilonidal cyst has a high recurrence rate. Thank you.


Dr. John Monheit
Category: Family Physician-GP
Experience: 
Residecny: North Colorado Family Medicine
Medical School: The Chicago Medical Center
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