▁terminal ▁my el oc yst oce le ▁are ▁especially ▁difficult ▁to ▁distinguish ; ▁ ▁for ▁more ▁accurate ▁diagn osis , ▁M RI ▁has ▁been ▁recommended . ▁ ▁Tre at ment ▁The ▁preferred ▁first ▁treatment ▁for ▁S CT ▁is ▁complete ▁surg ical ▁removal ▁( i . e ., ▁complete ▁res ection ). ▁The ▁preferred ▁approach ▁to ▁a ▁small ▁S CT ▁is ▁through ▁the ▁per ine um ; ▁a ▁large ▁S CT ▁may ▁require ▁an ▁additional ▁approach ▁through ▁the ▁ab d omen . ▁ ▁R ese ction ▁should ▁include ▁the ▁c oc cy x ▁and ▁may ▁also ▁include ▁port ions ▁of ▁the ▁sac rum . ▁The ▁surg ery ▁should ▁include ▁re attach ment ▁of ▁the ▁small ▁mus cles ▁and ▁lig aments ▁formerly ▁attached ▁to ▁the ▁c oc cy x , ▁in ▁effect ▁re construct ing ▁the ▁posterior ▁per ine um . ▁ ▁If ▁not , ▁there ▁is ▁an ▁increased ▁risk ▁of ▁per ine al ▁h ern ia ▁later ▁in ▁life . ▁ ▁S CT s ▁are ▁class ified ▁morph olog ically ▁according ▁to ▁their ▁relative ▁extent ▁outside ▁and ▁inside ▁the ▁body : ▁Alt man ▁type ▁I ▁— ▁entirely ▁outside , ▁sometimes ▁attached ▁to ▁the ▁body ▁only ▁by ▁a ▁narrow ▁st alk ▁Alt man ▁type ▁II ▁— ▁mostly ▁outside ▁Alt man ▁type ▁III ▁— ▁mostly ▁inside ▁Alt man ▁type ▁IV ▁— ▁entirely ▁inside ; ▁ ▁this ▁is ▁also ▁known ▁as ▁a ▁pres ac ral ▁ter at oma ▁or ▁retr ore ct al ▁ter at oma ▁ ▁The ▁Alt man ▁type ▁is ▁significant ▁in ▁the ▁context s