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Pilonidal Sinus — Detailed Guide

Modern treatment options for chronic sinus disease in the sacrococcygeal region caused by hair and debris accumulation.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Pilonidal Sinus — Detailed Guide?

Pilonidal sinus is a sinus or cyst disease that develops most commonly in the sacrococcygeal region (above the coccyx in the natal cleft) when broken hairs penetrate the skin, creating a foreign-body reaction and chronic granulation tissue. It is most often seen in men aged 15-35.

The disease presents in three clinical forms: asymptomatic, acute abscess and chronic draining sinus. In the acute phase patients present with a painful fluctuant mass; the chronic form features intermittent discharge and recurrent infections.

Treatment selection depends on the phase of the disease, number of sinuses and surgeon's experience. Minimally invasive techniques (sinusectomy/pit-picking, Karydakis flap, Limberg flap) offer lower recurrence rates than open excision with primary closure.

Symptoms

Painful swelling and redness in or just lateral to the natal cleft (acute abscess)
Chronic seroserous or purulent discharge
Pain worsened by sitting and prolonged driving
Tender, painful nodule on palpation in the natal area
Recurrent episodes of infection
Multiple sinus openings (rare)

Risk Factors

Male sex and age 15-35
Obesity and sedentary lifestyle
Frequent sitting (drivers, office workers)
Heavy and coarse body hair
Poor perineal hygiene
Previous pilonidal abscess or surgery

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Acute abscess in the natal area with redness, swelling and fever
  • Chronic draining sinus impairing quality of life
  • Recurrent infectious episodes
  • Recurrence after spontaneous abscess drainage
  • Increasing or widening sinus openings

Treatment Methods

01
Acute abscess: incision and drainage under local anesthesia; antibiotics alone are inadequate
02
Pit-picking (sinusectomy): minimally invasive excision of sinus openings; primary closure
03
Karydakis flap: eccentric excision and asymmetric primary closure; low recurrence, fast healing
04
Limberg (rhomboid) flap: skin-subcutaneous rotation flap for large lesions or recurrence
05
Open excision and secondary healing: in recurrent and complicated cases; long healing period
06
Postoperative shaving, weight control and avoidance of prolonged sitting

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.