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Pilonidal Sinus Surgery - Risks, Benefits, & Treatments

You must get pilonidal sinus surgery immediately as it is a painful anorectal condition that needs surgical intervention. We ensure an efficient patient journey with qualified surgeons, medical care coordinators, paperwork and insurance assistance, and post-surgery care.

You must get pilonidal sinus surgery immediately as it is a painful anorectal ... Read More

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  • What is Pilonidal Sinus?

    Pilonidal sinus is a medical condition that occurs due to the formation of a cyst or abscess in the cleft of the buttocks. The condition is more common in men than women and usually affects people who sit for longer periods. 

    There are two types of pilonidal sinus – acute pilonidal sinus and chronic pilonidal sinus.

    Acute pilonidal sinus is a one-time problem, and it doesn’t recur once treated. The most common symptom is pain and tenderness in the area around the natal cleft. The affected area may also be red and swollen. Acute pilonidal sinus is usually caused by an infection, which can be bacterial or fungal in nature.

    Chronic pilonidal sinus is a long-term condition that becomes severe over a period of time. The symptoms of chronic pilonidal sinus are similar to those of acute pilonidal sinus, but they may be more severe. In chronic cases, the affected area may develop a small pit or sinus that drains pus. The condition may also cause recurrent infections, which can lead to the formation of abscesses.

    Pilonidal sinus can be treated with medications and home remedies in initial stage. Surgical treatment for severe cases of pilonidal sinus is necessary to remove the sinus tract and prevent the recurrence of the condition. 

    • Disease name

    Pilonidal Sinus

    • Surgery name

    Endoscopic

    • Duration

    15 to 20 Minutes

    • Treated by

    General Surgeon

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    How is Pilonidal Sinus Diagnosed?

    Pilonidal sinus can be diagnosed by an experienced proctologist. During the consultation, the doctor may ask you about your medical condition, medical history etc. The most commonly performed tests for the diagnosis of pilonidal sinus include:

    Physical Examination

    To diagnose pilonidal sinus, your doctor will first physically examine the affected area. They will look for signs of inflammation, such as redness, swelling, or tenderness. They may also look for signs of infection, such as the presence of pus or drainage. 

    Imaging Tests

    Your doctor may recommend imaging tests, such as an ultrasound or MRI, to get a better understanding of the severity of the condition or the chances of any other complications. 

    Biopsy

    If your doctor suspects that you have pilonidal sinus, they may also perform a biopsy. During a biopsy, your doctor will take a small sample of tissue from the affected area and send it to a lab for analysis. This can help confirm the diagnosis and find out other possible conditions.

    Are you going through any of these symptoms?

    What is the Surgical Treatment For Pilonidal Sinus?

    Surgery is often recommended for pilonidal sinus because it is a condition that tends to recur. The main goal of surgery is to remove the affected tissue and prevent the formation of new pilonidal sinuses.

    Several surgical techniques can be used to treat pilonidal sinus, including;

    Lancing

    During lancing, your doctor will make a small incision in the affected area to drain the abscess and relieve pain and discomfort. This can be done in a doctor’s clinic or outpatient setting and is typically followed by wound care and antibiotics. Lancing is often effective in treating pilonidal sinus and may be recommended when other treatments have failed.

    Open surgery for pilonidal sinus

    There are two common types of open surgery- incision-drainage and pilonidal cystectomy.

    • Incision and drainage- Incision and drainage treatment is a common approach for managing pilonidal sinus. The procedure involves making a small cut in the affected area to drain the pus-filled abscess. This helps to relieve pain and prevent the infection from spreading. After drainage, the wound is packed with gauze or left open to heal from the inside out. Antibiotics may also be prescribed to prevent further infection.
    • Open pilonidal cystectomy- Open pilonidal cystectomy is a surgical treatment for pilonidal sinus. The traditional procedure for Pilonidal cystectomy involves making an incision over the cyst, excising the cyst and surrounding tissue, and draining any abscesses.

    Based on the size of the cyst removed, the doctor may or may not pack the area with surgical gauze. In cases where the infection is severe, the doctor places a tube to drain the fluid from the cyst. The tube is only removed when the entire fluid has been collected from the cyst to reduce the chances of recurrence.

    Laser pilonidal sinus treatment

    Laser pilonidal sinus treatment is a minimally invasive technique that has been proven effective in treating pilonidal sinus. The procedure involves the use of laser energy to destroy the sinus tracts with a few incisions.

    This results in faster healing time and reduced risk of complications. Patients can expect to return to normal activities within a few days. Laser treatment is a viable option for those seeking a less invasive approach to pilonidal sinus treatment.

    After surgery, patients typically need to keep the area clean and dry to prevent pilonidal sinus infection and promote healing. Pain medication may also be prescribed to manage discomfort. With proper care, most patients can expect to make a full recovery within a few weeks.

    What are the Benefits of Pilonidal Sinus Laser Surgery?

    Pilonidal sinus laser surgery offers various benefits, including;

    1. Minimally invasive: Laser pilonidal sinus surgery is a minimally invasive procedure that involves less pain and bleeding.
    2. Outpatient procedure: The procedure is done on an outpatient basis, which means no overnight hospital stay is required.
    3. Fast recovery: Laser surgery has a shorter recovery time compared to traditional surgery.
    4. Lesser risks of infection: The risk of pilonidal sinus infection is lower with laser surgery due to lesser incisions made during the procedure.
    5. Lesser chances of recurrence: Laser surgery reduces the chances of recurrence compared to traditional surgery.
    6. No or less scarring: The procedure involves less scarring due to the smaller incisions made during surgery.
    7. High success rate: Laser surgery has a higher success rate for treating pilonidal sinus disease.
    8. Precise: Laser surgery is a more precise method of treating pilonidal sinus disease.
    9. Cost-effective: Laser surgery is a more cost-effective option as it requires fewer hospital resources and is less likely to require additional procedures.

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    How to Prepare Before Pilonidal Sinus Surgery?

    Preparing for Pilonidal Sinus Surgery is an important step toward a successful surgery. There are a few things a patient can do to prepare for the pilonidal sinus surgery. Some standard guidelines to prepare are as follows: 

    1. Get informed about the procedure: Consult with your surgeon and ask any questions you have about the surgery. 
    2. Do fasting for 8 hours before the surgery: Do not eat anything at midnight before the surgery to avoid complications during the procedure.
    3. Arrange someone to drop you home: After the surgery, you will be under the influence of anesthesia, so arrange for someone beforehand to drive you back home after the surgery. 
    4. Arrange recovery stuff: Before undergoing the procedure, prepare your home and make arrangements for any recovery period. Ensure that you have any necessary medical supplies, such as wound dressings, before the surgery.
    5. Quit smoking and alcohol: Quit smoking and avoid alcohol at least 2-3 weeks before the surgery to reduce the risk of complications during and after surgery.

    By following these suggestions, you can ensure that you are well-prepared for your pilonidal sinus surgery and set yourself up for a smooth and successful recovery.

    How to Recover After Pilonidal Sinus Surgery?

    Self-care at home is essential after undergoing pilonidal sinus laser surgery to make the procedure successful. Here are some recovery tips after pilonidal sinus surgery. 

    1. Follow your doctor’s instructions: Your doctor will give you specific instructions on how to care for your wound and manage pain. It is essential to follow these instructions closely to avoid complications.
    2. Keep the wound clean and dry: You will need to clean the wound regularly to prevent pilonidal sinus infection. Your doctor will give you instructions on how to do this and what products to use.
    3. Change dressings regularly: You must change your wound dressings regularly to keep the area clean and dry.
    4. Avoid physical activity: You should avoid physical activity for a few weeks after surgery to allow your body to heal.
    5. Take pain medication as prescribed: Your doctor will prescribe pain medication to manage any discomfort you may experience. It is essential to take this medication as prescribed.
    6. Watch for signs of infection: Keep an eye on signs of infection, such as redness, swelling, warmth, or drainage from the wound. Contact your doctor immediately, if you experience any of these symptoms.
    7. Eat a balanced diet: Eating a healthy diet will help your body heal faster and promote overall wellness.
    8. Get plenty of rest: Your body needs rest to heal, so make sure to get plenty of rest and avoid overexertion.
    9. Attend follow-up appointments: Your doctor will schedule follow-up appointments to monitor your progress and ensure that you are healing correctly. Attend these appointments as scheduled.
    10. Be patient: Recovery after pilonidal sinus surgery takes time, so be patient and allow your body to heal at its own pace.

    What Lifestyle Changes Need to Make After Pilonidal Sinus Surgery?

    After undergoing pilonidal sinus surgery, it is important to make some lifestyle changes to make the treatment successful. Here are some common lifestyle changes you should follow after pilonidal sinus surgery;

    1. Keep the surgical area clean and dry: After surgery, it is important to keep the surgical area clean and dry to avoid infection. Take regular showers and gently clean the area with soap and water. Avoid using any harsh chemical-based soaps or scrubs in the area.
    2. Follow your doctor’s instructions: Your doctor will provide you with specific instructions on how to care for the surgical area, including how to change dressings and how often to clean the area. It is important to follow these instructions carefully to avoid complications.
    3. Avoid sitting for long periods: Sitting for extended periods can put pressure on the surgical area and slow down the healing process. If possible, avoid sitting for long periods and take short breaks to stand up and move around.
    4. Maintain a healthy diet: A healthy diet can help speed up the healing process after surgery. Make sure to eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein.
    5. Avoid strenuous activities: Strenuous activities can put pressure on the surgical area and slow down the healing process. Avoid activities such as heavy lifting, running, or jumping until your doctor gives you the okay to resume them.
    6. Quit smoking: Smoking can slow down the healing process and increase the risk of complications. If you smoke, it is important to quit before and after surgery.

    By following these lifestyle changes, you can ensure a speedy recovery after pilonidal sinus treatment through surgery. Always remember to follow your doctor’s instructions and to contact them if you experience any complications or concerns.

    What are the Risks and Complications Associated with the Pilonidal Sinus Laser Surgery?

    While pilonidal sinus laser surgery is generally safe, there are some risks and complications associated with the procedure. The most common risks and complications associated with pilonidal sinus surgery are:

    1. Infection: Any surgical procedure carries a risk of infection. Infections can occur at the surgery site and can be serious if left untreated.
    2. Bleeding: Pilonidal sinus surgery can cause bleeding at the surgical site. In some cases, this bleeding can be severe and require additional treatment.
    3. Pain: Pain is a common complication of pilonidal sinus surgery. The pain can be mild or severe and may last for several weeks after the surgery.
    4. Scarring: Pilonidal sinus surgery can leave scars at the site of the surgery. These scars can be unsightly and may cause discomfort. 
    5. Numbness: Numbness is another common complication of pilonidal sinus surgery. This numbness may be temporary or permanent and can affect the surrounding skin and tissue.
    6. Allergic reactions: Some people may be allergic to the anesthesia or other medications used during the surgery. This can cause serious complications and requires immediate medical attention.
    7. Blood clots: Pilonidal sinus surgery can increase the risk of blood clots in the legs or lungs. This can be a serious complication and requires immediate medical attention.
    8. Anesthesia complications: Anesthesia is used during pilonidal sinus surgery to numb the area and prevent pain. However, anesthesia can cause complications, including allergic reactions and respiratory problems.

    Overall, pilonidal sinus surgery is generally safe, but there are some risks and complications associated with the procedure. Patients should be aware of these risks before undergoing surgery and should discuss any concerns with their doctor.

    What is the Cost of Pilonidal Sinus Laser Surgery?

    The cost of pilonidal sinus laser surgery ranges between INR 40,000 to INR 55,000 and open surgery for pilonidal sinus surgery cost between INR 35,000 to INR 80,000. The final cost of pilonidal sinus surgery may be different for individuals depending on various factors such as hospitalization charges, surgeon fee, cost of diagnostic tests, the severity of the condition, type of procedure used, cost of anesthesia, anesthesiologist fee, follow-up charges etc.

    Is Pilonidal Sinus Surgery Cost Covered Under Health Insurance?

    Usually, major health insurance companies cover pilonidal sinus surgery cost in India, but it is better to ask your insurance provider about your policy coverage. If you have insurance and choose Pristyn Care for pilonidal sinus surgery, then our dedicated insurance team can help you in claiming your insurance on your behalf and let you free to be prepared for the procedure.

    What are the Home Remedies for Pilonidal Sinus?

    Patients seeking pilonidal sinus treatment without surgery can rely on home remedies to relieve the symptoms. Here’s a list of home remedies that you can follow at the initial stages of pilonidal sinus. 

    • Warm compress: Applying a warm compress to the affected area can help to reduce pain and inflammation. To do this, soak a clean cloth in warm water, wring out the excess water, and place it on the affected area for 10-15 minutes. Repeat this several times a day.
    • Tea tree oil: Tea tree oil has antibacterial properties that can help to fight infection. Mix a few drops of tea tree oil with a carrier oil like coconut oil, and apply it to the affected area. Leave it on for 10-15 minutes before washing it off with water. Repeat this twice a day.
    • Aloe vera: Aloe vera has anti-inflammatory properties and can help to reduce pain and swelling. Cut a fresh aloe vera leaf and extract the gel. Apply the gel to the affected area and leave it on for 30 minutes before washing it off with water. Repeat this twice a day.
    • Epsom salt bath: Taking a warm bath with Epsom salt can help to reduce pain and inflammation. Add 1-2 cups of Epsom salt to warm water and soak the affected area for 15-20 minutes. Repeat this once a day.
    • Castor oil: Castor oil has anti-inflammatory properties and can help to reduce pain and swelling. Apply a small amount of castor oil to the affected area and massage it gently for a few minutes. Leave it on for a few hours before washing it off with water. Repeat this once a day.
    • Garlic: Garlic has antibacterial properties and can help to fight infection. Crush a few garlic cloves and apply the paste to the affected area. Leave it on for 15-20 minutes before washing it off with water. Repeat this twice a day.
    • Turmeric: Turmeric has anti-inflammatory properties and can help to reduce pain and swelling. Mix 1-2 teaspoons of turmeric powder with water to make a paste. Apply the paste to the affected area and leave it on for 15-20 minutes before washing it off with water. Repeat this twice a day.

    These home remedies can help to alleviate the symptoms of pilonidal sinus. However, it is important to consult a doctor if the symptoms persist or worsen.

    Ointments Creams for Pilonidal Sinus

    Metronidazole Ointment

    Metronidazole ointment is a medication used to treat pilonidal sinus. It contains ingredients such as methylparaben, propylene glycol, and propylparaben and sodium hydroxide that fight bacteria.

    The ointment is applied topically to the affected area and is known for its anti-inflammatory properties. It is often prescribed alongside oral antibiotics for maximum effectiveness.

    Clindamycin Ointment

    Clindamycin ointment is a medication commonly used to treat bacterial infections. Its active ingredient is clindamycin, which belongs to the class of antibiotics known as lincosamides.

    This ointment is effective in relieving pilonidal sinus. It is important to follow the instructions provided by your doctor or pharmacist when using this medication to ensure the best possible outcome.

    Medications for Pilonidal Sinus Treatment

    Metronidazole

    Metronidazole is a medicine that has been used as an antibiotic for decades. It effectively stops the growth of bacteria and protozoa in the cyst.

    Metronidazole is available in capsule, tablet as well as topical form. The dosage of Metronidazole depends upon the severity of the pilonidal cyst or sinus.

    If you are taking the medicine orally, you should take it with food or with a full glass of water or milk to avoid stomach upset. Metronidazole is effective against various infections and thus will bring significant relief from the condition of pilonidal sinus.

    Erythromycin 

    It is the most common antiobiotic that doctors prescribe for treating pilonidal sinus. It is also popular for treating various infections.

    It slows down the growth of bacteria. Erythromycin can also kill sensitive bacteria by reducing the production of proteins that the bacteria need to survive. Erythromycin is available in oral, topical as well as intravenous forms.

    The dosage will depend upon your condition and your response to the medicine. Erythromycin works best when it is taken empty stomach. Try to take the medicine before meals. In case of nausea, you can take it with food or milk.

    Clindamycin

    Clindamycin is another effective antibiotic to cure the problem of pilonidal sinus. It stops the growth of harmful microbes and prevents them from multiplying. It is effective against a number of infections that are bacterial in nature.

    Clindamycin is available as oral solutions and capsules as well as topical foams, gels, and ointments. To get the best results for pilonidal sinus, you should take the capsule at evenly spaced intervals of time.

    Take the capsule with a full glass of water and do not lie down for at least 10 minutes after taking the medicine.

    Cefixime

    Cefixime is yet another broad-spectrum antibiotic that is popular in use for curing pilonidal sinus. It prevents the harmful bacteria in the cyst from forming cell walls.

    These cell walls are necessary to keep the bacteria alive and thrive. Hence, cefixime destroys the infection-causing bacteria in the pilonidal cyst. Cefixime is available in the form of capsules, tablets and chewable tablets. For best results, take the medicine with or without food as your doctor recommends. 

    Antibiotics

    One common non-surgical treatment option is the use of antibiotics. Antibiotics can be prescribed to help fight infection and reduce inflammation. They can be taken orally or applied topically, depending on the severity of the condition. 

    Along with these antibiotics, your doctor may also prescribe certain anti-inflammatory drugs that will help relieve the pain and subsiding the swelling of the cyst. These include medicines like acetaminophen and ibuprofen.

    Note: You should not take the above-mentioned medicines without proper consultation with a doctor. Self-medication can have side effects. Also, if you get relief before the completion of the course of the medicine, do not discontinue its use without discussing with your doctor.

    What are the Signs of a Healing Pilonidal Sinus?

    • Decrease in Pain: One of the most significant signs of a healing pilonidal sinus is decreased pain. If the pain is becoming less intense or if the pain is becoming less frequent, it is a good sign that the sinus is healing.
    • Reduction in Swelling: Another sign of a healing pilonidal sinus is reduced swelling. If the swelling around the sinus is going down, it is an indication that the body is healing the wound.
    • Reduced Discharge: The amount of discharge from the sinus is another sign of healing. If the amount of discharge is decreasing, it is a sign that the wound is healing.
    • Formation of Granulation Tissue: The formation of granulation tissue is a sign that the body is healing the wound. Granulation tissue is a pinkish-red tissue that forms at the base of the wound.
    • Reduced Redness: If the skin around the sinus is becoming less red, it is a sign that the wound is healing.
    • Decrease in Temperature: If the temperature around the sinus is decreasing, it is a sign that the wound is healing. 

    What Happens if Pilonidal Sinus is Left Untreated?

    If pilonidal sinus is left untreated, it can lead to a number of complications. Here are the main points to consider:

    • Infection: The sinus is essentially an infected pocket of skin, hair, and debris. If left untreated, the infection can spread to other parts of the body and cause serious health problems.
    • Abscess: In some cases, the infection can lead to the formation of an abscess. This is a painful, swollen lump that contains pus. It can be difficult to treat and may require surgery.
    • Fistula: A fistula is an abnormal connection between two parts of the body. In the case of pilonidal sinus, it can form between the sinus and the skin surrounding the buttocks. This can lead to further infection and discomfort.
    • Chronic pain: Even if the infection doesn’t spread or lead to an abscess or fistula, pilonidal sinus can cause chronic pain and discomfort. This can make it difficult to sit or engage in physical activity.
    • Recurrence: If pilonidal sinus is not treated properly, it is likely to recur. This means that the infection, abscess, or fistula can return even after treatment.

    Overall, it is important to seek medical attention if you suspect you have pilonidal sinus. Early treatment can help prevent complications and improve your overall health and quality of life.

    What Foods Should You Eat If You Have An Pilonidal Sinus?

    If you have a pilonidal sinus, it is essential to follow a healthy diet to promote healing and prevent complications. Here are some foods you should include in your diet:

    • Foods high in fiber, such as whole grains, fruits, and vegetables can help prevent constipation and reduce strain on the pilonidal sinus.
    • Lean proteins like chicken, fish, and tofu can aid in healing and recovery.
    • Foods rich in omega-3 fatty acids, like salmon and nuts, can reduce inflammation and promote healing.
    • Foods high in vitamin C, such as citrus fruits and leafy greens, can boost the immune system and aid in healing.
    • Probiotic-rich foods like yogurt and kefir can help maintain a healthy gut and prevent infection.
    • Garlic and onions have antimicrobial properties that can help fight infection.
    • Turmeric, a spice with anti-inflammatory properties, can be beneficial when added to dishes.
    • Ginger, another anti-inflammatory spice, can be consumed in tea form or added to meals.
    • Bone broth, made from simmering animal bones and connective tissues, can provide essential amino acids and promote healing.
    • Zinc-rich foods like oysters, beef, and pumpkin seeds can aid in wound healing.
    • Foods high in iron, like spinach and red meat, can also help with wound healing.
    • Avoid processed and sugary foods, which can weaken the immune system and exacerbate inflammation.
    • Limit alcohol consumption, as it can interfere with the healing process.
    • Drink plenty of water to stay hydrated and flush out toxins.
    • Avoid foods that you are allergic or sensitive to, as they can worsen symptoms and delay healing.

    What Foods Should You Avoid If You Have An Pilonidal Sinus?

    Here’s a list of foods that you should avoid if you have a pilonidal sinus. 

    1. Fried or fat-rich foods: Fried and fatty foods should be avoided as they can cause inflammation and worsen the condition of pilonidal sinus.
    2. Processed foods: Processed foods that are high in sodium and preservatives should be avoided as they can lead to inflammation and aggravate the condition.
    3. Red meat: Red meat and other high-protein foods should be consumed in moderation as they can increase the risk of developing pilonidal sinus.
    4. High-sugar foods: Sugary foods and drinks should be avoided as they can cause inflammation and lead to other health issues.
    5. High-fat dairy products: High-fat dairy products should be avoided as they can contribute to inflammation and worsen the condition of pilonidal sinus.
    6. Spicy foods: Spicy foods should be avoided as they irritate the digestive system and cause inflammation.
    7. Citrus Fruits: Citrus fruits and juices should be consumed in moderation as they can irritate the digestive system and worsen the condition of pilonidal sinus.
    8. Alcohol and smoking: Alcohol and smoking should be avoided as it can weaken the immune system and worsen the condition of pilonidal sinus.
    9. Caffeine: Caffeine should be consumed in moderation as it can increase inflammation and worsen the condition of pilonidal sinus.
    10. Fried foods: Fried and processed snacks should be avoided as they can increase inflammation and worsen the condition of pilonidal sinus.
    11. Carbonated beverages: Carbonated drinks should be avoided as they can cause inflammation and lead to other health issues.

    Frequently Asked Questions

    Can pilonidal sinus go away on its own?

    Sometimes pilonidal sinus goes away on its own, but there are high recurrence rates. 

    Can pilonidal sinus be treated without surgery?

    Most people need surgery to treat a pilonidal sinus completely. However, you can use medications and home remedies to manage symptoms.

    When should I go to the doctor for pilonidal sinus surgery?

    You must seek immediate medical attention if you experience increased pain while sitting and notice a small dimple or large swollen sinus-like formation at the tailbone or between the buttocks. The sinus may also be oozing fluid with a foul smell.

    Which treatment for pilonidal sinus is best?

    Laser surgery is the best method for treating and excising a pilonidal sinus.

    How to sleep after pilonidal sinus laser surgery?

    Sleeping on your front or side is the best way to sleep after the surgery, as this reduces the strain on your surgery wound. However, do not curl into a fetal position when sleeping on your side, as this would stretch your lower back. 

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    Content Reviewed By
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    Dr. Falguni Rakesh Verma
    27 Years Experience Overall
    Last Updated : March 30, 2024

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