A pilonidal sinus is a small cyst that forms in the cleft at the top of the buttocks. It mostly affects men and young adults. If it becomes infected the resulting abscess can produce pus and blood, smell unpleasant, and be extremely painful. Treatment depends on how much infection is present and how early it is picked up.
Caught early
If there is little pain or swelling, a broad spectrum antibiotic may be enough. If it settles, a second examination is arranged and regular hair removal at the cleft is advised to keep the area clean.
Incision and drainage
Where the infection is painful, the abscess is opened under local anaesthetic and the hair, pus and blood inside are cleaned out. The wound is packed with sterile dressing and left open so it heals from the inside out.
Excisional surgery
If the problem keeps returning, or there is more than one sinus tract, surgery is usually advised. Under anaesthetic the lesions are opened and all pus and debris removed, then the wound is closed with stitches. You will be shown how to change the dressings and advised to keep the area shaved so hair does not grow into the healing wound.
Professor El-Khoury will talk through the operation with you in the rooms, covering why it is being recommended, what it involves, the risks and the benefits. He also provides Royal Australasian College of Surgeons information sheets on the procedure so you can read them at home and bring questions back.
This page is general information, not medical advice. What applies to you depends on your history, your examination and your results. Bring your questions to the consultation.