What is the coccyx cyst?

A coccyx cyst or Coccygeal cyst is a fistula (tunnel under the skin) where we have our so-called “tail”. Its treatment used to require excision (cutting) of the damaged tissue. But things have changed since 2012, when Dr. Alkiviadis Pappas first developed the SiLaT technique, which has now become widely accepted and tends to completely replace the old methods.

Coccyx cyst is a fairly common condition. It occurs with a frequency of about 26 cases per 100,000 of the population, mainly in young men, in a ratio of 3 or 4:1 (men: women). A coccyx cyst is a fistula in the subcutaneous in the coccygeal region.

The majority of experts conclude that it is an acquired disease, although a minority believe it is a congenital condition.

Patey & Scarff, shortly after the end of World War II, hypothesized that the condition is the result of hair infiltration into the subcutaneous tissue, with a subsequent granulomatous reaction. Uncertainty as to its etiology and complexity is also found in its treatment. The best strategy in the management of the condition remains unclear. A wide variety of approaches are used in the management of the disease ranging from conservative treatment to extensive surgical resection. Several techniques have been described for the treatment of coccygeal cyst, but the optimal treatment is still under debate.

In recent years simple techniques such as simple scraping of the cavity, or use of fibrous adhesive, as well as chemical treatments of the wound, have gained greater acceptance in the treatment of coccygeal cyst. Our main goal should be to approach the ideal treatment, which should be simple, with minimal tissue loss and a low recurrence rate.

In addition, shorter hospital stays and minimal time for functional recovery and return to active life, with low cost and high aesthetic appeal.

The use of laser and optical fiber with cyclic energy diffusion has encouraging results in the treatment of perianal fistulas – sinus laser therapy (SiLaT) technique. The first results show that their use in the treatment of coccygeal cysts serves the basic parameters of ideal treatment.