Pilonidal Cyst: Symptoms & Treatment

pilonidal cyst or sacrococcygeal fistula is a chronic inflammation near the tailbone (coccyx) area. This cystic formation is usually due to the penetration of hair into the skin, where the hair penetrates the skin and becomes embedded, but it can also be caused by a cyst that was developed during foetal life.

Today science has advanced and we can find the revolutionary painless method that offers an immediate solution to the problem without trauma in Greece as well. Endoscopic treatment does not create any traumas to the patient, does not leave scars and does not require dressing change.

A new innovative method has now been added to the treatment options with great success rates, and we are the first to apply it in Greece. This is the Endoscopic pilonidal sinus treatment (EPSiT). After the examination, the specialized surgeon determines if the method can be applied to the patient, similarly to all surgery methods and techniques.

Anastasios G. Xiarchos

Contents

pilonidal cyst or sacrococcygeal fistula is a chronic inflammation near the tailbone (coccyx) area. This cystic formation is usually due to the penetration of hair into the skin, where the hair penetrates the skin and becomes embedded, but it can also be caused by a cyst that was developed during foetal life.

 

During the Second World War pilonidal cyst became also known as “Jeep disease”, since many American soldiers suffered from it.

The soldiers were sitting in military jeeps for prolonged periods of time driving on bumpy, destroyed by the war roads. As a result, they had to undergo surgical treatment for pilonidal cysts in US military hospitals.

Today science has advanced and we can find the revolutionary painless method that offers an immediate solution to the problem without trauma in Greece as well. Endoscopic treatment does not create any traumas to the patient, does not leave scars and does not require dressing change.

It is an effective, permanent treatment performed with a micro-camera, which enables doctors to accurately trace the problem and then provide suitable solutions.

The treatment is permanent, bloodless, painless, since there is no trauma, and allows patients to return to their daily life the next day.

The procedure lasts 20-30 minutes depending on the case. Hospitalization is not required, and patients can go home after approximately 2 hours. Patients can eat, walk, exercise and swim from the next day following the procedure.

Endoscopic treatment of pilonidal cysts with laser or RF offers important advantages over traditional methods, since it is bloodless, painless and doesn’t require hospitalization, while at the same time provides a permanent solution to the problem.

The disease is more common in men than in women, and it usually affects people from adolescence up to 40 years of age. Furthermore, it is more often observed in hairy or obese persons. Nevertheless, slim persons can also be affected.

Until recent years, pilonidal cyst treatment was painful and very hard on patients. However, today, the new treatment method for pilonidal cysts provides perfect results, and it is bloodless, painless and enables patients to return immediately to daily life.

5+1 Pilonidal Cyst Symptoms

Symptoms vary and can extend from a small swelling near the tailbone to the formation of a big and painful inflammatory mass, namely an abscess. Pus or fluid secretions from an opening in the skin (fistula) is often observed in the area. When the area gets inflamed, it becomes red, swollen and hard, and it may exude pus, which has usually a foul odour.

 

In some cases, inflammation causes fever, debilitation of the body and nausea.

A pilonidal cyst with no complications causes minimum discomfort. It is often discovered by sero-hematic fluid staining on the underwear.

The acute form of the disease involves severe pain, abscess formation and sometimes fever. In this case, immediate surgery is required. Constant or intermittent fluid secretion is observed in the chronic form.

5+1 Pilonidal Cyst Symptoms

• A small swelling near the tailbone appears
• A big and painful inflammatory mass – abscess is formed
• Pus or fluid exude from the abscess
• Discomfort is felt only at the lower back
• When the abscess is inflamed, it becomes red, swollen and hard. It may exude malodorous pus
• Fever, debilitation of the body and nausea due to the inflammation are noticed.

Pilonidal Cyst: Treatment depending on the case

 

The indicated treatment depends on the condition of the disease.

An acute abscess is usually checked via incision and drainage, so that pus is released, inflammation is reduced and the patient is relieved from pain.

chronic pilonidal cyst, however, is effectively cured only with surgery. The surgery aims at completely removing the cyst, together with the accompanying tracts and fistulae, in order to ensure a very low possibility of recurrence.

There are several surgical procedures: “open,” “closed,” and “semi-closed”. The suitable procedure is selected following a discussion with the attending surgeon.

Let’s note, however, that modern surgery procedures very often use specialized forms of energy instead of scalpel, such as Laser or R-F (radiofrequency). These allow less bleeding and a quicker healing, but mostly they involve significantly less postoperative pain. Modern techniques practically eliminate the possibility of recrudescence.

Endoscopic treatment of pilonidal cyst instead of scalpel

 

A new innovative method has now been added to the treatment options with great success rates, and we are the first to apply it in Greece. This is the Endoscopic pilonidal sinus treatment (EPSiT). After the examination, the specialized surgeon determines if the method can be applied to the patient, similarly to all surgery methods and techniques.

The method does not require any imaging examination (MRI or ultrasound), no hospitalization is necessary, it guarantees the patient’s immediate return to work, provides a permanent solution to the problem and finally, no pain medication or dressing changes are required after the surgery.

The endoscopic pilonidal sinus treatment includes 2 phases: a diagnostic and an operative one. The two phases take place simultaneously and last a few minutes. It is not necessary to detect the fistula type beforehand, and this saves time and money.

During the diagnostic phase, the exact pathway of the fistula and the pilonidal cyst is localized, namely the damage is traced. A special fistuloscope (an equivalent of a laparoscope) is inserted in the fistula, with irrigation with a specialized solution running in parallel. Thus we trace the cyst and its branches (fistulae) via 3D visualization in a HD screen. Tissue blockages or hair in the tract are easily removed with a special 2 mm forceps.

Then the operative phase follows, whose purpose is to destroy the fistula tract, its branches and the cyst from the inside. The tract is meticulously cleaned and the rotten epithelium is eliminated and removed via suction. At the same time, meticulous haemostasis is performed using radiofrequencies (RF). The residual tract remains open to enable drainage of the produced secretions.

Pilonidal Cyst: Endoscopic Treatment advantages

The Endoscopic pilonidal sinus treatment (EPSiT) offers important advantages over traditional methods.

The operation is completely painless and is performed with local anaesthesia. The endoscopic method can be characterized as revolutionary, since it offers many advantages to patients and insurance institutions, if we also take into consideration the financial crisis we are experiencing nowadays.

The results are aesthetically perfect and there is minimum possibility of recurrence. The method does not require an incision, there are no sutures and thus the patient does not experience inconvenience. Furthermore, post-operative pain medication is not necessary and the solution to the problem is permanent. The most important treatment advantage though is that patients do not feel any pain.

Ενδοσκοπική εικόνα της βλάβης

Endoscopic image of the damage, which allows us to perform a full visualization of the problem and enables us to offer a permanent solution to the problem of the pilonidal cyst.

The method offers many advantages to the specialized surgeons as well, since the direct, enlarged vision via a 3D screen allows them to perfectly see not only the opening, but also all possible fistulae with their branches and the abscess cavity.

After that, the epithelium is destroyed and the lesion is thoroughly cleaned. These procedures are performed with absolute accuracy using laser or RF.

The perfect precision of the screen enables the full removal of hair and follicles within the fistula.

There is a perfect aesthetic result, while the life quality of the patients is incomparably better in relation to other techniques.

No painful dressing changes are required and patients can immediately return to all their daily and sports activities.

EPSiT method in the USA, Germany and now Greece

This particular pilonidal cyst treatment method can be applied to 80% of patient cases.

Thanks to the endoscopic pilonidal sinus treatment, we have a perfect aesthetic result without using a scalpel.

The first endoscopic pilonidal sinus treatment in Greece was performed on a 32-year old patient, who was suffering from the disease for 6 years and had had a recrudescence, and who had already had one other procedure in the past.

The treatment lasted only 20 minutes and was a great success. The patient returned home a few hours later, since the operation was painless, bloodless and was performed with local anaesthesia.

The method was first presented in Italy 10 years ago, in 2005, and was later further developed in Germany and the USA.

Today, it is also available in Greece and it provides an immediate solution for a complex problem.

Pilonidal Cyst Treatment for Athletes

This specific method is also indicated for athletes, who wish to minimize their absence from the sports arena and training.

The pilonidal cyst is no longer considered troublesome or painful, and painful dressing changes are not required anymore. Endoscopic treatment is now effectively performed without suffering.

10+1 advantages of the endoscopic pilonidal sinus treatment method

The EPSiT method:

• Is bloodless
• Is painless
• Can also be performed with local anaesthesia
• Does not require imaging examination (MRI or ultrasound)
• Does not require hospitalization
• Allows the patient to immediately return to work
• Provides a permanent solution to the problem
• Does not require post-operative pain medication treatment
• Has significantly reduced possibility of a recurrence, since we have traced the damage and removed all the affected tissue
• Enables patients to leave the clinic after one hour and return to their daily activities
• Allows the removal of any gauze pads the next day and the patient is allowed to shower just after that.

ABOUT

Anastasios G. Xiarchos

General Surgeon

  • Director of General and Laparoscopic Surgery Clinic of the Medical Center of Athens
  • President of the Scientific Association of Anorectal Surgery

Contact Info

Office:
Patriarchou Ioakeim 25, Kolonaki, 10675

Office Tel:
0030 210 7296584

Secretarey Tel: 0030 6938 340 082

24hr Emergency Phone Number: 0030 6983 340 082

info@axiarchos.gr

4 SHORT ANSWERS ABOUT DR. ANASTASIOS XIARCHOS

Learn More About the Doctor

Who is Dr. Anastasios Xiarchos?

Anastasios G. Xiarchos is a General Surgeon, the Director of General and Laparoscopic Surgery Clinic of the Medical Center of Athens – Peristeri Clinic and the President of the Scientific Association of Anorectal Surgery.

Learn more about Dr. Anastasios Xiarchos on the page with his
curriculum vitae.

What are the days and hours that I contact him?

To book an appointment call 0030 210 7296584 or his secretary directly at 0030 69 38340082.

Once you’ve booked your appointment you can visit the Doctor at his office in Kolonaki (Patriarchiou Ioakeim 25) or at the Medical Center of Athens.

In case of a medical emergency, please call the following number: • Office Tel.: 0030 210 7296584
• Secretary Tel.: 0030 69 38340082

24hr Emergency Phone Number:
0030 6938 340 082

Which funds and insurances are supported?

Affordable Packages & Contracts with:

• All funds

• All private insurance companies

Where does Dr. Anastasios Xiarchos operate?

Athens Medical Group