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Pilonidal Sinus

It is not a rare condition and is quite common amongst young adults.

 It can cause an abscess or continued discharge, so the best and most dependable solution is surgery.

 

What is pilonidal sinus?

Natal cleft is the area between buttocks.

A pilonidal sinus is when hairs grow in natal cleft, or loose hairs fall and amass in the area.

These hairs can carry bacteria which, in turn, can cause the area to become inflamed or infected.

Sometimes, an abscess will form, or pus will drain through the sinus (tunnel) out on to the skin.

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What are the causes of Pilonidal sinus?

  • Family history of Pilonidal sinus

  • More common in males

  • Sedentary lifestyle

  • People who sit for long hours at a stretch  e.g. Drivers, IT professionals

  • Thick body hair especially those that are coarse and curly

  • Obesity

  • Previous injury in the area

  • Having a deep cleft between buttocks

  • History of previous Pilonidal cyst

 

What are the symptoms of Pilonidal sinus

  • Recurring episodes of pain or swelling in the area of the tailbone.
     

  • Yellowish pus-like or bloody discharge from the tailbone area which may be foul smelling
     

  • Painful lump under the skin in that area
     

  • Certain activities like riding a bicycle, doing sit-ups may be very uncomfortable.
     

  • Fever

How is Pilonidal Sinus diagnosed?

A history of symptoms followed by a visual examination of the tailbone area is enough to diagnose a Pilonidal sinus.

 

What are the alternatives to surgery?

Taking care of the natal cleft on a daily basis and ensuring it is clean can prevent an infection occurring.

Infrequent discharge from the site can be treated with antibiotics.

A procedure to drain an abscess is also a possibility.

 

What are the advantages of having a surgery?

Surgery is the most reliable way of removing the pilonidal sinus and the infected pockets

 

What is Laser Pilonidoplasty ?

In Laser Pilonidoplasty  a small cut is made on the skin and all the pus is drained out.

The entire sinus tract is then sealed with the laser fiber.

This is a minimally invasive procedure.

 

Advantages of Laser Pilonidoplasty

Patient is discharged within 24 hours and can return to routine work by the 5th day.

Wound healing occurs in about 6-8 weeks and thus recovery is much faster as compared to conventional surgery

Recurrence rate is negligible.

 

Excision with Primary Closure

In this procedure, the abscess and sinus are surgically removed and the wound is closed with stitches.

The stitch line is preferably off  the midline, where the tension is less and chances of healing are better.
The advantage of this technique is that the healing is faster .

The main drawback is that the infection rate is almost 20-25%.

In case of such an infection a revision procedure is done and the wound is left for open healing

 

What will happen during the operation?

Performed under general anaesthetic, the procedure usually takes around half an hour to one hour to complete, during which time the surgeon will take out the sinus and the infected tissue.

 

Risks and complications

Any risks or complications will be discussed in advance of your treatment with your expert consultant.

 

Recovery

Typically, you should be able to return home within 24 hours of the operation and go back to work after 5-7 days.

Regular exercise can aid the healing process and help you resume daily activities as soon as possible. However, prior to embarking on your exercise regime you must seek advice from your doctor.

Please be aware that the pilonidal sinus can return in the future.

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