- Pilonidal sinuses are rare, affecting about 26 in 100,000 people each year.
- They affect at least twice as many men as women. The average age for a pilonidal sinus is 21 in men and 19 in women.
- They are less common in children and people over the age of 45.
Pilonidal Sinus Treatment
A Pilonidal sinus also called Pilonidal cyst, Pilonidal abcess or Sacrococcygeal fistula is a cyst (small sac) or tunnel in the skin. It develops over the tailbone at the top of the cleft of the buttocks. The cyst usually contains hair and skin debris. More than one cyst may develop and these are linked by tunnels under the skin.
Causes Of Pilonidal Sinus
- More common in males
- Sedentary lifestyle
- People who sit for long hours at a stretch eg. Drivers
- Thick body hair especially those that are coarse and curly
- Previous injury in the area
- Family history of Pilonidal Sinus
- Having a deep cleft between buttocks
- History of previous Pilonidal Cyst
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
If your case is diagnosed early on, you aren’t experiencing severe pain, and there’s no sign of inflammation, it’s likely that your doctor will prescribe a broad-spectrum antibiotic, which is an antibiotic that treats a wide range of bacteria. It’s important to realize that this won’t heal the sinus tract, but it will give you relief from the infection and discomfort. Your doctor will recommend that you get a follow-up exam, regularly remove hair or shave the site, and pay particular attention to hygiene.
Before this procedure, your doctor will give you a local anesthetic. They will then use a scalpel to open the abscess. They will clean away any hair, blood, and pus from inside the abscess. Your doctor will pack the wound with sterile dressing and allow it to heal from the inside out. The wound usually heals within four weeks, and many patients don’t require any further treatment.
For this type of treatment, your doctor will first give you a local anesthetic. They will then inject phenol, a chemical compound used as an antiseptic, into the cyst. This procedure may need to be repeated several times. Eventually, this treatment will cause the lesion to harden and close. This treatment has a very high recurrence rate. Therefore, it’s very uncommon in the United States. Doctors turn to surgery as the treatment of choice in some cases.
What Complications Are Associated With Pilonidal Sinus Disease?
There are a number of complications that may arise from PNS. These include wound infection and a recurrence of the PNS even after surgery.
If you have a recurring PNS or if you have more than one sinus tract, your doctor will recommend a surgical procedure. You will first be given a local anesthetic. Then, the surgeon will open the lesions, removing all of the pus and debris. Once this process is complete, the surgeon will stitch the wounds closed. After surgery, your doctor will explain how to change the dressings and will recommend shaving the site to prevent hair from growing into the wound.
Wide excision and healing by secondary intention.
This operation involves cutting out (excision of) the sinus but also cutting out a wide margin of skin which surrounds the sinus. The wound is not closed but just left open to heal by natural healing processes (healing by 'secondary intention'). This usually requires several weeks of regular dressing changes until it heals fully. The advantage of this method is that all inflamed tissue is removed and the chance of the condition coming back (a recurrence) is low.
Excision and primary closure.
This means taking out the section of skin which contains the sinus. This is done by cutting out an oval-shaped (ellipse) flap of skin either side of the sinus, which takes out the sinus. The two sides of the ellipse are then stitched together. The advantage for this is, if successful, the wound heals quite quickly. The risk of a recurrence or of developing a wound infection after the operation is higher than with the above procedure. This risk may be reduced by using a wound technique in which the line of stitches is moved away from between the buttocks.
A plastic surgery technique.
In some cases, where the sinus recurs or is extensive, plastic surgery may be advised to remove the sinus and refashion the nearby skin.There are variations on the above procedures, depending on your circumstances, the size and extent of the sinus, and whether it is a first or recurrent problem.
Pilonidal Cyst Treatment Using Laser( EPSiT)
It is literally a non-invasive, completely painless and very therapeutic effect of laser that contributes noticeably to the spectacular healing of Pilonidal Cyst disease. As is known, therapeutic laser differ from the surgical laser, which means that, with a therapeutic laser only have the possibility of treating a pathological tissue while a surgical laser is used to remove the tissue from the rest of the organism.On this rests the brand new revolutionary endoscopic treatment that uses the therapeutic laser FiLac.
Although the Pilonidal cyst is not a life threatening disease, it is one of the most difficult to be completely cure because the modern classical medicine finds it difficult to give a definitive treatment. Here is why:
- The antibiotics and anti-inflammatory formulations do not particularly affect the coccyx cyst.
- Draining the fluid from the cyst does not mean immunity from infection in the ulcer.
- The ulcer that is created does not heal easily because of the location and texture.
- Fistulas created in the region are also very difficult in healing.
- A surgical resection of this kind has risks of failure or relapse.
- Patients who have surgery unless they have symptoms postoperative pain, slow healing and prolonged edema also require much recovery time with the patient lying prone (face down) position.
Pilonidal Cyst Treatment Using Endoscope and Laser ( EPSiT and SiLaT )
Anon-invasive, completely painless and very therapeutic effect of laser that contributes noticeably to the spectacular healing of Pilonidal Sinus disease.
- Finally the tedious and time consuming process of healing of Pilonidal cyst can be done using a new surgical method, the endoscopic sublimation of the cyst using laser.
- Till now the cyst was removed at whole using either a scalpel or by RF or laser. But there was a sizable scar left that needed several days to months to heal, after almost daily surgical debridements.
- The new innovative endoscopic method with laser puts an end to this difficult process.
- Through a hole in the skin that is usually present in each coccyx cyst after an inflammation,(Fistula Bladder) a tiny endoscope enters (about 3 millimeters). The endoscope is able to see inside sinus tract.
Inside, the tractis thoroughly cleaned and the necrotic material and hair is removed. When the tract is cleaned from any material and all inflammatory tissues, an optical fiber (Laser) is inserted and the tract is ablated.This leads to healing..
Optical Fiber Laser in Pilonidal Cyst
Photo-coagulation following inside the cyst results in sublimation of the capsule inside the coccyx cyst. The aseptically inflammation promoted by photo-coagulation with LASER result to a perfect healing of Pilonidal Cyst in about a week. The procedure last about 15 minutes to half an hour and is performed under local anesthesia. The patient, after just an hour, is ready to return to everyday life, at work, he can sit and there is no need to change patches.
The pain is almost nonexistent.
Precautions After a Laser Treatment for Coccyx Cyst:- The patient is completely relieved and does not have any pain after the laser treatment.
Not required by the patient painful continuous changes with some patches because the wound dries and heals safely. The would will start healing immediately after treatment. The placement of a simple single gauze is sufficient in order for the ulcer to be oxygenated.
How Long does the Healing Last?
The total time of the treatment in order to heal the tissue depends upon the extent of disease, severity of symptoms, and the presence of contamination. Surely, it requires a period of several days.
What is the Risk of Recurrence?
- In the treatment of complete healing and restoration of Pilonidal Cyst there is no serious risk of recurrence. Recurrences are rare.
- This is because the treatment and healing of a coccyx cyst with Laser FiLac completely eliminates the inflammatory component which is responsible for the gradual erosion of the region.
- According to the above treatment with Laser FiLac is clearly better compared with some medications, classical or other surgical procedures.
Advantages of Non-invasive Laser Therapy for Pilonidal Cyst
- Minimal Pain
- Least risk of Complications
- Least Tissue Trauma
- Absolutely blood less
- Short Hospital Stay