Treatment during pregnancy

In order to prevent the bacteria from spreading during pregnancy and to prevent blood poisoning (sepsis), a splitting of the abscess should be done during pregnancy. This can also be done under local anesthesia without putting the woman under general anesthesia. In most cases, the splitting of the abscess allows to avoid antibiotic therapy.

If splitting is not possible under local anesthesia, a nonfruit-damaging antibiotic should be administered. One can speak of a healing of a coccyx abscess if the abscess has been removed and there is no recurrence (i.e. a recurrence of the abscess). Depending on the surgical method used, the recurrence rate varies relatively widely from study to study, as does the duration of wound healing.

The most common surgical technique used in Germany to treat a coccyx abscess is the classic excision with secondary wound healing. Although wound healing can take weeks to months with this method, the recurrence rate is between 2% and 6%, depending on the study, and is therefore relatively good. In high-risk patients, however, the recurrence rate can be as high as 35%.

Especially people who have already had surgery to remove a coccyx abscess or coccyx fistula are at risk for recurrence. The reason why the surgical method with primary wound healing is not preferred to the method with secondary wound healing despite faster wound healing is the higher probability of recurrence after such an operation. Here the recurrence rate is 2-13%.

The postoperative care of the wound is especially important for its correct healing. Individual care by relatives or nursing staff is necessary and helpful in most cases due to the localization of the wound. At the same time, adequate pain therapy is necessary for a certain period of time after the operation.

Depending on the surgical procedure the wound has to be treated differently. In the case of an open wound after an operation with secondary wound healing, the wound should be regularly showered out and under medical observation. After complete healing of the wound, it is important to keep the probability of recurrence low.

Previously, it was thought that shaving the hair in this area could prevent the occurrence of recurrence to some extent, but it has been found that such shaving can actually cause the appearance of a new abscess or fistula. The removal of hair by laser therapy cannot be recommended at the moment due to lack of data. Overall, when treating a coccyx abscess, there is a good chance that the condition can be cured by surgery. It should be noted, however, that wound healing after surgery can sometimes take up to 3.5 months, with an average incapacity to work of about one month after surgery with secondary wound healing.