My Pilonidal journey from surgery to healing 2024


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I've been following this forum and wanted to share my story. I’m a female, 31 with no history of the disease. I’m not hairy at all so I wonder how I was so unfortunate to get this disease. In December 2023, I started experiencing pain in my lower tailbone, which eventually led to the development of an abscess in the top of my midline causing pus leakage. Initially, I had a dull ache for about two weeks until the cyst suddenly popped, resulting in constant drainage for three weeks. I did my research and investigated the area. The two small pinholes I saw and a few google searches suggested it was a Pilonidal cyst. To manage it, I simply tucked gauze in the midline and took ibuprofen for pain until I sought medical help in January 2024 from a colorectal surgeon in Houston.

I sought two opinions and each colorectal surgeon confirmed it was indeed a Pilonidal cyst and needed to be removed. Eventually, I consulted and chose Dr. Stananna at southwest surgical Houston, who advised having surgery at the end of January. She put me on antibiotics first. Despite a week of antibiotics, the drainage persisted. Fortunately, the cyst wasn't too deep or complicated from examination, requiring only excision with primary closure. Surgery went well, I had stitches from the top of my midline down towards my butthole, but it wasn’t too close to it. I was sent home in stitches and bandage to cover it. The first few days post-surgery recovery went well. I was instructed not to shower 24 hours after surgery and not to sit. Barely had drainage with minimal pain that was managed with tramadol and ibuprofen 500mg. For the two weeks post surgery, I kept the area clean by bathing twice a day with cetaphil showergel and using a gauze to clean the stitches and let water run through my midline. I pat it dry with a paper towel and tuck a guaze between my butt cheeks. I tried not to sit on my buttocks and laid down most times on my stomach. I didn’t drive until after two weeks and was very careful not to rip my stitches. I sat lumpsided, did not lift heavy, squat, apply pressure to my butt as much as I could. I work from home so that helped!

However, during the stitches removal two weeks post-op, the incision reopened at the top part. It wasn’t a large opening, it was the size of an orange seed. I continued post up visits every 2-3 weeks. Dr. recommended letting the hole heal by secondary intention without using hydrogel or serums. She said this might impede healing or cause infection. Despite this, the wound didn't close, leading to frustration, discomfort and ongoing drainage. I had light brown discharge and sometimes small amount of blood. Sometimes it had a smell.

I continued regular appointments with the surgeon, where silver nitrate was applied. Unfortunately, this seemed to worsen the healing process, causing more discharge and pain. By the first week of March, the hole still hadn't closed completely, and I also noticed a sharp bump near the hole. I noticed it was blue and suspected it was a suture. It also caused me discomfort when sitting. This prompted me to seek a second opinion from Dr. Umoh at Houston Pilonidal Clinic, as my initial surgeon claimed she couldn’t see any sutures left in the wound and dismissed my concerns as hard scar tissue. Dr. Umoh indeed identified a suture that had been left in the wound, preventing it from closing properly. I was right after all!! After its removal, a week and half later, the wound finally closed completely by mid-March 2024. Today, end of March, I am fully healed and the area is covered with skin. Looking back, I believe that addressing the suture issue earlier could have significantly shortened the healing time.

Throughout this journey, I learned valuable lessons. It's essential to advocate for oneself as doctors too make mistakes and can be negligent. Please seek an experienced colorectal specialist who has expertise in this specific condition. Ask questions about there history of surgeries and experience with the disease and go to your appointment with a list of questions to ask.

Additionally, maintaining a healthy lifestyle, including proper wound care and mental health support, is crucial for a smoother recovery. This disease is draining and recovery takes a toll on your mental health during recovery, especially if things don’t go as planned. Lean on your support system.

Regarding wound care, I bathe religiously twice a day using cetaphil and a gauze to clean the area. Now the choice between a moist or dry environment for wound healing is subjective and should be tailored to individual circumstances. I got contradicting opinions on here so do your own research and listen to your body. For example I bought Multidex gel as highly recommended on this forum when my hole was not closing cause I thought the hole was too dry and impeding healing. But I ended up not needing or using the it as I found out the suture left inside the incision was the issue all along. Keeping the area dry (pat it dry after showering and tuck a guaze in between the cheeks) worked for me. I got no infection throughout my healing and the drainage lessened over time. I believe this is cause I let my body do its job and kept the area super clean. For supplements I took vitamin c 2000 and zinc 50mg daily. I let my body heal by itself and didn’t use gels or ointments (do your research as some ointments impede healing too).

This forum was helpful in the healing process, so please use the information on here cautiously as everybody’s surgery, wound, healing time and body varies. Make sure you seek your surgeons opinion first before using anything. Do your due diligence and if you have any feeling of not being heard or something is wrong, SEEK ANOTHER OPINION IMMEDIATELY!

While my initial surgeon's approach and surgery went well, her bedside manner and attention were disappointing. Dr. Umoh's expertise and attentive care were instrumental in resolving the issue. I would recommend him if you are in Texas and he also performs cleft lifts. I may have needed another surgery to close my wound or even a cleft lift but thank God my wound healed. I look forward to a normal life now as this has been traumatic.

I share this experience to contribute to the forum and help others navigate similar challenges in their Pilonidal journey.

Good luck!