Pilonidal Sinus Treatment in Hyderabad

What is pilonidal sinus?

The pilonidal sinus, also referred to as sacrococcygeal fistula, is a small tunnel or hole in the skin or a sac formed over the tailbone at the upper part of the buttocks’ cleft.

An infected pilonidal sinus is called a pilonidal cyst or abscess and usually has dirt, debris, and hair. Multiple cysts or abscesses can develop and these are connected by under skin tunnels. Best Doctors For Pilonidal Sinus Treatment in Hyderabad at Sree Nandaka Advanced Surgery Clinic can help treat this condition using the most advanced technology and deliver them with best surgical outcomes.

Causes of Pilonidal Sinus

Pilonidal sinus or cyst is likely to develop in:

  • Males
  • Obese people
  • Individuals who earlier had an injury in the area
  • Those who have thick, coarse, and curly body hair
  • Those who have deep cleft between the buttocks
  • People who have pilonidal sinuses running in their family
  • Individuals who have records of pilonidal cyst
  • People with sedentary lifestyles or those having long-sitting jobs.

There is no definite reason behind the occurrence of an infected pilonidal sinus. However, it is believed to be caused by a combination of factors like hormonal changes, hair growth, and friction from tight underwear or prolonged sitting.

Symptoms of Pilonidal Sinus

Pilonidal sinus usually isn’t much noticeable unless it gets infected. At first, the pilonidal sinus appears as a small, dimple-like depression on the skin surface. However, when it gets infected, it quickly turns into a cyst (a fluid-filled sac) or an abscess (an inflamed tissue where pus collects).

The signs or symptoms of pilonidal sinus (usually an infected one) include:

  • A painful lump under the skin in the tailbone area
  • More than one sinus tract or holes in the skin
  • Frequent pain, swelling, or red, sore skin in the tailbone area
  • A pus-like yellow discharge or bloody discharge from the tailbone area which may have a bad odour
  • Hair coming out of the lesion
  • Feeling discomfort while riding a bicycle or doing sit-ups
  • Low-grade fever (less common).

Treatment of Pilonidal Sinus

A dormant pilonidal sinus needs no treatment. To abate the chances of it getting infected or requiring surgical intervention, certain precautions are advised to be taken by an anorectal specialist. For infected pilonidal sinus, surgical management becomes a necessity.

Surgical management can be done by two approaches: Open or Closed. All these procedures are available at Sree Nandaka Advanced Surgery Clinic, in Hyderabad.

Open surgery

  • Conventional Wide Excision- This surgery involves making a local, wide-bore cutting of the skin having the sinus tract. The excision creates a cavity that is allowed to heal and naturally fill from the bottom upwards. The surgery is safe with a 10-15% recurrence rate but the wound created is large, needs repeated dressing changes, and heals in up to 3 months.
  • Advanced Laser Pilonidal Plasty- Pilonidal Sinus Laser Treatment in Hyderabad involves making a small skin incision in the tailbone area to drain out pus and then using laser fiber to seal the entire sinus tract. The procedure is safe and painless and has a short recovery period (usually 6-8 weeks) and negligible recurrence rate.

Close Surgery

  • Excision with Primary Closure- This surgery involves surgical excision of the pilonidal sinus and abscess and wound closure with sutures. The sutures are placed preferably away from the midline where there is minimal tension and better healing chances. The procedure allows quick healing, in around 4-6 weeks but it has a high infection rate (almost 20-25%).
  • Flap Closure- It involves either of the three surgical approaches associated with lengthy recovery.
  1. Z-Plasty - Following the pilonidal sinus and abscess removal, the surgeon makes loose the triangular flaps on either side of the midline to fill the cavity with a flap pointing towards the head and foot. When closing, the surgeon converts N shaped incision to Z shaped closure by crossing the flaps and making it horizontally cross over the midline.
    This procedure has many drawbacks including very high recurrence rates, high post-operative pain and discomfort, and flap necrosis.
  2. Cleft lift/Cleft Closure/ Modified Karyadakis- This procedure involves the removal of all diseased areas and ensuring healthy wounds. The removal creates a football-shaped ellipse or cavity that one-sidedly parallelly lies to the midline. Next, the surgeon slightly frees up the skin edges, and wound closure is done with multilayered stitches. In cleft lift, the actual shape of the cleft is made more shallow for better healing. This makes the gathering of loose hair less likely and less probability of anaerobic bacteria growth in the cleft.​
  3. Limberg Flap/Gluteal flap- This surgery is preferred in cases where the pilonidal disease is affecting both sides of the buttocks and is extensive. It involves the removal of an oblong-shaped plug having the skin, fat, and abscess, thereby creating a cavity. The cavity is filled with a thick fat and skin flap which is shifted from the buttocks on either side and below the cavity. The flap is kept free to swing at the centre while its edges are stitched.

For more details on Pilonidal Sinus Surgery Cost in Hyderabad, India, consult the expert surgeon at Sree Nandaka Advanced Surgery Clinic.

Dos and Don’ts Following Pilonidal Sinus Treatment

  • Do keep the treated area clean and dry
  • Do wear comfortable, loose-fitting underwear
  • Do have dietary fibres in meals to keep your stool soft and avoid straining during defecation
  • Do not indulge in any vigorous physical activities including heavy weight lifting for the first week or so
  • Do not go bike, horse, or cycle riding for a few months
  • Do not go swimming unless your treated area fully heals.

Frequently Asked Questions Around Pilonidal Sinus Treatment in Hyderabad

How is pilonidal sinus diagnosed?

To confirm the diagnosis of a pilonidal sinus, the patient's symptoms are noted followed by a thorough examination of the patient’s anal area.

Is pilonidal sinus life-threatening?

No, pilonidal sinus isn’t a serious or fatal problem. It may get infected and, in that case, surgery is required.

Can the pilonidal sinus heal on its own?

If the pilonidal sinus isn’t infected, then surgery isn’t needed and the pilonidal sinus can be healed naturally by following certain precautions at home. These precautions include avoiding prolonged sitting, practising good washroom hygiene, and getting rid of the area around the anus.

What is the best treatment for pilonidal sinus?

The best treatment is Laser Pilonidal Plasty (LPP) as it allows quick recovery with minimal pain and recurrence rate.

Can females get pilonidal sinus?

Pilonidal sinus is the result of thick body hair, especially curly and coarse hair. As most males have thick, coarse, and curly hair growth, the condition is prevalent in males but females too can suffer from this issue.

What are the complications of pilonidal sinus infection?

An infected pilonidal sinus can lead to wound infection and recurrence of pus discharge (infection) even after its operation.

When can I get back to my usual routine activities following pilonidal sinus surgery?

On the day of your surgery, you can get back on your feet and start walking at normal speed. Probably, you need to take a few days leave from your job. Your leave period will depend on the nature of your job and how you feel. Following laser surgery, you can get back to work in around 3 days whereas after flap surgery where you get stitches, you would need to stay home for about 2 weeks. For the first few weeks, you should avoid strenuous workouts and if having stitches, you would need to stay away from activities that could disrupt your stitches.

Is pilonidal sinus curable?

Yes, surgery can help cure pilonidal sinus. But, if the pilonidal sinus gets infected, it is not curable through advanced laser procedures.

How can I avoid pilonidal sinus recurrence?

Pilonidal sinus is majorly caused by extra thick hair in the anal area, which breaks and gets embedded in the skin. Its recurrence is preventable by the removal of the hair or by reducing hair growth and thickness with lasers.

How can I avoid  pilonidal sinus getting infected?

Pilonidal sinus infection can be prevented by daily washing the anal area with gentle soap and warm water; ensuring all soap is removed after washing; keeping the anal site fully dry; and avoiding prolonged sitting.

Schedule an Appointment

Feeling as if there is a small tunnel in your anal area? You might be having a pilonidal sinus or cyst. Our team of Top Pilonidal Sinus Surgeons in Hyderabad can help diagnose your condition and provide you with an appropriate treatment plan, all at reasonable prices. All you need to do is step forward and book your appointment with our experts today.

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Hyderabad, Telangana 500014, India.


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Sree Nandaka Advanced Surgery (Laser and Laparoscopic Centre) has been founded by Dr. Praveen Koduru, a distinguished laparoscopic and hernia surgeon with a remarkable record of over 30,000 surgeries.

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