Epithelial coccygeal passage (ECC) is a congenital disease in which a person forms a subcutaneous canal in the intercostal region leading to the cyst cavity in the fatty tissue of the coccyx. This formation looks like a small hole in the skin, it is located strictly along the midline between the buttocks in the projection of the coccyx, the lower part of the sacrum. The epithelial passage has other names – fistula or pilonidal cyst. According to the experience of doctors, this disease is more common in men than in women. EMC offers highly effective ECH treatment. The technologies used in the clinic ensure rapid recovery after removal of coccygeal passages.
Epithelial coccygeal passage is a congenital disease that develops due to mutations and breakdowns in the genome. There are no other proven causes of ECC. According to one hypothesis, the cyst may be an acquired disease that is associated with the reverse direction of hair growth. They, in turn, deepen and grow into the subcutaneous fat layer. For this reason, fistulas form.
The epithelial coccygeal passage can proceed for a long time without any special signs. Chronic inflammation is manifested by the following symptoms: blood or pus flows from the fistulas, there is a slight pain, swelling, and sometimes redness appears. There may also be traces of secretions from the interstitial fold on underwear during ECG. With acute inflammation and infection, patients develop symptoms such as fever, a person cannot sit, and it is impossible to touch the epithelial coccygeal passage due to severe pain. These symptoms may indicate the presence of abscesses.
Types of coccygeal cyst are classified according to the presence of symptoms. If there are no symptoms, the cyst is characterized only by visual signs. In this case, it is the presence of a primary opening of the pilonidal coccygeal cyst. The second type is associated with an acute abscess of the epithelial coccygeal passage. Usually, the patient develops inflammation against the background of sports, weakened immunity, and insufficient hygiene of the intercostal fold. An infection enters the ECX and provokes the proliferation of microbes, which leads to suppuration. As a result, symptoms such as mucus discharge and ECG abscess appear. In this case, the inflammation may subside and temporarily give no symptoms, and then recur and lead to the appearance of repeated abscesses and the formation of multiple fistulas. In this case, ECG requires emergency surgery.
A preventive examination by a doctor allows you to determine the presence of a primary ECG hole. Sometimes, in patients with coccygeal passage, they can be very small and dotted. The most accurate method of examination for ECG is magnetic resonance imaging (MRI) with intravenous contrast, which allows you to distinguish healthy tissues from cystic ones and notice inflammation. Ultrasound examination (ultrasound) may also be used if ECC is suspected.
Doctors recommend removing the coccygeal passage. The earlier the surgical procedure is performed, the easier the operation is and the greater the chances of full recovery after ECG removal, as well as the lower the likelihood of repeated inflammation. Coccygeal cyst is treated much more effectively in a "calm" period without inflammation, before the appearance of abscesses. If the patient comes with an acute phase of the inflammatory process of ECG, and he has suppuration, then a two-stage operation is required. It consists of drainage of an acute purulent process and subsequent removal of the entire cyst with secondary formations.
Coccygeal cyst drainage can be outpatient and performed under local anesthesia. The first task of a doctor is to eliminate inflammation. The surgeon opens the abscess, drains it, and cleanses the wound. Hospitalization for ECG is not required in this case. Dividing the treatment into stages allows you to wait for the period when the wound clears and the patient does not have suppuration: in the "calm" period, surgery is performed.
If the epithelial coccygeal cyst is in a chronic form, without inflammation, suppuration and abscesses, then in this case the surgical treatment is one-stage: the cyst is removed, then, as part of a single surgical intervention, the doctor can perform plastic surgery. An MRI scan is required before and after surgical ECG treatment. There are standard treatments for epithelial coccygeal passage (ECC) and more modern Karidakis surgery. During the surgical procedure, ECG excision is performed. All methods of treating coccygeal cysts have their pros and cons, but none of them guarantees the absolute absence of repeated inflammation and relapses after treatment.
Karidakis surgery for epithelial coccygeal passage.
This is a radical method of surgical treatment: it involves an operation to remove the ECG with near-median access. The method was patented in 1976 by army surgeon G.E.Karydakis. During this method of cyst treatment, the surgeon makes an incision to remove the cyst not along the midline, but next to the intercostal fold. After such treatment, rehabilitation is faster, and the likelihood of recurrence of coccygeal passages is significantly reduced. Karidakis surgery has the only drawback – the asymmetry of the buttocks after removal of the coccygeal passages. In EMC, surgeons, performing such treatment, minimize this defect, find a way to make the suture less noticeable after surgical treatment of the coccygeal cyst. So, after cyst removal, the incision is sewn up with a complex layered multi-storey seam, which is then removed. This gives a very good result. In addition, modern electrosurgical equipment is used at the EMC, which makes it possible to operate on patients more efficiently and without severe blood loss and to remove coccygeal passages. All this has a positive effect on the outcome of surgical treatment, reduces the duration of rehabilitation and the likelihood of recurrence of inflammation.
At EMC, surgeons have extensive experience in performing nerve-sparing extirpations and have all modern technologies for dissecting (dissecting) the necessary tissues without damage. The surgeon has a Harmonic ultrasonic scalpel in his arsenal, which allows him to isolate tissue structures very subtly and accurately and not harm them. As a result of this approach, the patient will be able to avoid complications in the early postoperative period (urinary disorders, erectile dysfunction, pelvic organ dysfunction).
As with any surgical treatment, infectious complications are possible after removal of the epithelial coccygeal passage. EMC surgeons performed a huge number of operations to remove epithelial coccygeal passages. In addition to the enormous experience, the success of operations is ensured by modern electrosurgical equipment, which is available in the arsenal of EMC surgeons.
In addition, in addition to coccygeal passages, patients may have concomitant diseases that will make themselves felt after the operation. It is very important that a multidisciplinary team of doctors of different categories is responsible for the patient's treatment at all stages. For this reason, internists, cardiologists, and anesthesiologists examine the patient at the EMC before surgical treatment. A comprehensive examination and the adoption of a collective decision by doctors on surgical intervention make it possible to avoid complications after removal of the coccygeal passages in the future.
Since epithelial coccygeal passage is a congenital disease, there are no methods of prevention. But there are tips that will help prevent inflammation and abscesses in the interstitial area and near the anus.
It is necessary to observe hygiene rules from birth, if the baby has signs of the disease, contact a pediatric surgeon or a coloproctologist. Before this daily treatment, the child should be treated with Ecchromistin. These simple rules make it possible to avoid the proliferation of microbes and the subsequent occurrence of inflammation.
These preventive methods are referred to as conservative ECC treatment, but it is ineffective: according to doctors, the coccygeal cyst requires removal, and one should not wait for the development of a more acute course of the disease and the occurrence of inflammation.
