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Pilonidal cyst

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Pilonidal cyst

Posted by
Phil [918.1351] on November 04, 2004 at 09:48:00:

Hi, I've had a pilonidal definitely for 12 years - since I was 18. But I can remember some discomfort since I was about 6!

Anyway, after the usual immense pain, flare ups, leakage etc etc for 11 years, I had it cut out and sewn closed in May '03. It flared again in October '03. It is now pretty much constantly leaking.

Anyway - the tracks go down the left side of my ass cleft and the usual eruption is about 1" from my anus. However, 6 weeks ago I developed a large abcess in my groin - again left hand side, pretty much in the crease between leg and scrotum. It was cut, drained, and packed - it looks to have healed nicely - scar is approx 2.5" long.
I've now got another abcess, much smaller, that has grown next to the groin scar, nearer my cojones. Can these all be interlinked? Can the pilonidal track this far and in this direction?? I'm getting pretty sick of all this.
The only person that hasn't been in my pants for the last 6 weeks is my wife.
Yep - throw any modesty out of the door - we don't need that here.
BTW I'm in the UK.
Cheers
Phil



Re: Pilonidal cyst (Hemicorporectomy?)

Posted by Walt Stoll [9.8] on November 05, 2004 at 06:49:14:

In Reply to: Pilonidal cyst posted by Phil [918.1351] on November 04, 2004 at 09:48:00:

Hi, Phil.

Unfortunately they probably are all linked. This puts you in the class of the worst of this problem. Study the archives and then go to the medical school library and have the librarian find you the book that would fully explain this condition (with pictures).

Let us know what you learn. In my opinion the only cure for you is a below navel amputation. However there are still many things you can do to help keep it under control short of that hemicorporectomy.

Walt



Re: Pilonidal cyst (Hemicorporectomy?)

Posted by Phil [918.1351] on November 10, 2004 at 08:53:14:

In Reply to: Re: Pilonidal cyst (Hemicorporectomy?) posted by Walt Stoll [9.8] on November 05, 2004 at 06:49:14:

Right then, following some more research, i'm going to print the cleft lift bumf and take it to my surgeon. For once the free NHS is a blessing - but it'll probably take 6 months to get to see her.
I still have a question though Walt: If the cleft lift is as successful as claimed, do they need to clean out all my fistulas (fistulii?) and if so, how are they going to manage it if they are up to 8 or 9" inches long and not very large in dia? If they can't clean properly will the whole thing happen again, or will I just be left with the possibility of localised infections? Or will my body sort it out over time?

Cheers

Phil



Re: Pilonidal cyst (Hemicorporectomy?)

Posted by Walt Stoll [9.8] on November 11, 2004 at 10:50:37:

In Reply to: Re: Pilonidal cyst (Hemicorporectomy?) posted by Phil [918.1351] on November 10, 2004 at 08:53:14:

Thanks, Phil.

The reason I suggested the "hemicorporectomy" :o) was that these nidi are microscopic and so cannot easily be seen at surgery.

ALL predictions of prognosis I have yet seen from surgeons have been wildly optimistic and unrealistic--PRIOR TO THE SURGERY..

When one has such a widely disseminated case as yours, I have yet seen surgery be the solution.

Wish I could help more.

Walt



Re: Pilonidal cyst (Hemicorporectomy?)

Posted by Phil [918.1351] on November 12, 2004 at 03:22:50:

In Reply to: Re: Pilonidal cyst (Hemicorporectomy?) posted by Walt Stoll [9.8] on November 11, 2004 at 10:50:37:

My understanding - and correct me if I am wrong - is that the "nidi" are concentrated and attached in the region of the coccyx - and the fistula grow away from this. Is it that the nidi can spread around the tunnel system? If so, then i'm knackered. If pus only is left in the labyrinth after surgery, will this be sorted by my body, or will it have to eventually erupt?

I'm of the opinion that this "cleft lift" does little more than add padding between skin and spine and thus protects the area from impact/irritation. Butt (pun intended) hey! If it works, i'll go for it.

Another thing is that my sinus have always been pretty teeny - 4mm across at the most - so nothing like some of the photos i've seen. I did manage to fire goo out of it a couple of times from a standard height bed and hit the ceiling!!!!

I'll be in touch with my surgeon today. Let's see what happens!

Phil



Re: Pilonidal cyst (Hemicorporectomy?) (REVIEW: Archive in pilonidal.)

Posted by Walt Stoll [9.8] on November 13, 2004 at 07:11:36:

In Reply to: Re: Pilonidal cyst (Hemicorporectomy?) posted by Phil [918.1351] on November 12, 2004 at 03:22:50:

No. Phil, that is not what is going on.

Pilonidal cysts and sinuses are caused by remnants of epithelial cells that have been buried by the normal infolding process of the spinal canal closure during fetal development. When this is done perfectly, no cells are left to be buried and we are normal. When imperfectly done cells are left and can be anywhere from right at the tip of the coxxyx to almost anywhere in the lower body--the distance from the coxxyx is determined by what stage the imperfection began. Once they are there they will usually continue to flare up so long as they have not been removed.

Rememnber that these nidi are frequently microscopic and so can only be removed at surgery by luck. That is why "wide" resections" are done: the closer to the tip of the coxxyx, the more likely it is for them to be there.

Hope this helps. This has been described in the archives many times but it never hurts to repeat it. Maybe this time it is concentrated enough and simple enough for people to get it more easily.

Walt



Re: Pilonidal cyst (Hemicorporectomy?) (REVIEW: Archive in pilonidal.)

Posted by Phil [918.1351] on November 17, 2004 at 07:39:25:

In Reply to: Re: Pilonidal cyst (Hemicorporectomy?) (REVIEW: Archive in pilonidal.) posted by Walt Stoll [9.8] on November 13, 2004 at 07:11:36:

Y'know, i'd come to my own conclusion that the cause was something like that - but didn't know about the irregular cells. I just thought it was a hair folicle that had been folded under during skin development.
I know where the root of my infections are at the moment - I can feel it. The thing i'm worried about is the source of the infection moving down the fistula. It's bad enough where it is - but it could be worse. If we manage to get the current root(s) out, am I likely to get areas in the fistula flaring up, or will they heal of their own volition?



Re: Pilonidal cyst (Hemicorporectomy?) (REVIEW: Archive in pilonidal.)

Posted by Walt Stoll [9.8] on November 17, 2004 at 15:16:44:

In Reply to: Re: Pilonidal cyst (Hemicorporectomy?) (REVIEW: Archive in pilonidal.) posted by Phil [918.1351] on November 17, 2004 at 07:39:25:

Phil,

If they are lucky enough to get all the nidi, this will heal up and there will be no recurrence.

Walt

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