Pilonidal cyst (pilonidal sinus)

A pilonidal cyst (or pilonidal sinus) is a cavity under the skin of the cleft between the buttocks, at the top of the groove, often containing hairs. It mainly affects young adults, more often men, and is encouraged by abundant body hair and prolonged sitting. It shows as small openings in the cleft, a discharge, or a painful, swollen abscess. In the case of an abscess, a quick procedure to open and drain it relieves the pain; definitive treatment is carried out later, once things have calmed down. It consists of removing the cyst and its tracts completely. The wound may be left open to heal gradually with nursing care, or closed, possibly shifting the scar away from the cleft with a small skin flap to reduce the risk of recurrence. Less extensive techniques, which remove only the openings and clean the cavity, are also possible for limited forms. Surgery is offered for cysts that become infected, discharge or hurt. A cyst that has never caused symptoms can simply be monitored. The technique is chosen in consultation, according to the extent, any recurrences and the person's constraints. At Clinique Pasteur Tunis, the operation is usually done as day surgery or with one night in hospital. Precise instructions are given on dressings, hygiene and hair removal in the area, which play an important role in preventing recurrence.