Pilonidal Cystectomy A pilonidal cystectomy is a surgical procedure done by a surgeon to remove a cyst from the end of the tailbone near the buttocks. A pilonidal cyst forms when hair becomes embedded in the skin, causing the cyst to form. These cysts may have branching extensions (sinuses) extending into surrounding tissue. Pilonidal cysts tend to become painful and infected, oozing pus, bleeding, and smelling bad. Prior to the surgery, the patient is given a local anesthetic to numb the operative region. The cyst including the hair is cut out and the surgeon opens any of the branching sinuses to promote drainage. The wound is left open with dressings to allow it to heal slowly and completely. The procedure is done in an outpatient surgery center. Careful wound care and dressing change instructions are given. It takes approximately 5-6 weeks for the wound to heal. Patients should consult their physician for a complete explanation of the procedure and its associated risks and complications.