Tailbone Removal (Coccygectomy): Drains, Antibiotics

Surgical removal of the tailbone (coccyx) is medically known as coccygectomy.

In the United States the coccygectomy surgery would often be considered an outpatient surgery, meaning that you have the surgery in the morning and go home by that evening. But that may vary depending on how someone is doing in the recovery area after the surgery, etc.

Different surgeons use different approaches for handling the fluid drainage from the surgical site. Some surgeons will send the patient home with a drain in place. The drain lets fluid flow out from the surgical site so that it does not form a big collection at the site. 

The rate of infection at the surgical site is unfortunately much much higher than it is for most other elective surgical procedures. So many surgeons doing tailbone removal surgery (coccygectomy) give the patient antibiotics even before there is any infection, to prevent an infection from taking hold. There is high variability on the details of how many doses to give and which antibiotics to use. 

Regarding complications and side-effects from coccygectomy (surgical removal of the tailbone), please click on the links below:

Patrick Foye, M.D.

Founder and Director at The Tailbone Pain Center
Patrick Foye, M.D.
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5 comments to Tailbone Removal (Coccygectomy): Drains, Antibiotics

  • Tridib Mukherjee

    Sir,
    I had a coccyx injury two months ago. I consulted the doctor a week after the injury had taken place. The doctor asked me to undergo an X-ray, from which the doctor confirmed that I had my tailbone dislocated. The doctor gave my a medicine-course of one month and said that if the situation did not improve within that time period, I would have to undergo surgery. Otherwise, it would take a year and half for complete recovery. Fortunately, I found a lot of relief after taking the complete course of medicine and that pain disappeared almost entirely. The doctor then said that I would not be required to undergo surgery. Last week, the pain started again and it is still there. Will I be required to undergo surgery? Or should I wait for a year and half, as the doctor had said earlier? Also, can coccyx dislocation be cured without surgery? After all, the dislocation has not been a major one.

  • First of all, I am very sorry to hear about your tailbone injury, and the pain and suffering that it has caused you for these past two months.

    You mentioned that you received excellent relief, to the point where your tailbone pain almost entirely disappeared, after a month or so of medications by mouth. That is terrific.

    While of course I cannot give medical advice to people who I have not evaluated in person within my medical practice, I can say that in general patients who get their pain to essentially disappear by taking medications by mouth overall have a very good chance of getting complete recovery without the need for surgery.

    Regarding the fact that the tailbone pain has come back, I wonder if that is because you have stopped using a cushion, or you have been sitting for longer periods, says the lack of pain allows you to do so. Or maybe the pain has been coming back from stopping the pain medications by mouth?

    Meanwhile, regarding your doctor’s recommendation to have surgery if tailbone pain persists for more than a month or two, that would seem, in general, very very soon to be considering such surgery.

    Coccygectomy (surgical removal of the tailbone) is a significant surgery that is typically only considered in cases where patients have failed to give adequate relief despite an adequate trial of nonsurgical treatments (typically including not only oral medications, but also cushions, a variety of local tailbone injections that are usually helpful, etc.).

    Also, it sounds like your surgeon has implied that recovery time is quicker from a coccygectomy that it is from a tailbone injury itself. However, please realize that most patients who undergo coccygectomy report that recovery can take several months to more than a year.

    I wish you well and all the best for smooth recovery.

  • After he got the tailbone out, he irrigated it with antibiotic fluid, then put me on a strong IV dose of antibiotics for several days. He put a drain in so that blood wouldn’t pool in the wound, because that was another thing that invites infection and abscess.

    • Thanks for sharing your experience. When your surgeon used the antibiotics within the local fluid irrigation, and by IV, and used the drain, did you end up getting any infection at the coccygectomy site?

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