COMMON IN YOUNG ADULTS
Pilonidal Sinus
A small tunnel or cyst that develops in the cleft of the buttocks, usually containing trapped hair and debris — leading to recurrent pain, swelling, and discharge from the affected area.
ABOUT THIS CONDITION
What is Pilonidal Sinus
A pilonidal sinus is a small tunnel or cavity that forms in the natal cleft (the groove between the buttocks), usually containing hair, dead skin, and other debris. It commonly affects young adults, particularly males, and those with deep clefts, excessive hair growth, or sedentary lifestyles. The condition may present as a painless dimple, a tender lump, or an acutely inflamed abscess with discharge of pus and blood. If untreated, pilonidal sinus tends to recur, with repeated cycles of pain, swelling and infection. Treatment depends on whether the condition is acute or chronic, and ranges from simple drainage to advanced flap surgeries. Dr. Tejasree Vengala offers comprehensive pilonidal sinus treatment — from minimally invasive EPSiT to flap reconstruction techniques at Lux Hospitals, Hyderabad.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Ingrown hair and debris trapped in the natal cleft
- Prolonged sitting or sedentary work and travel
- Friction and pressure on the buttock cleft area
- Excess body hair, particularly stiff or coarse hair
- Deep natal cleft anatomy increasing risk of trapping
- Obesity, poor hygiene, or excessive sweating in the area
CLINICAL DETAILS
KeyFacts
Acute pilonidal abscess — needs urgent drainage. Chronic sinus — definitive surgery.
Pit picking, EPSiT, Bascom Cleft Lift, Karydakis Flap, Limberg Flap, excision techniques.
EPSiT and pit picking offer faster recovery with very small wounds.
Minimally invasive options — 1–2 weeks. Flap procedures — 4–6 weeks.
Flap procedures (Karydakis, Limberg, Bascom) offer the lowest long-term recurrence.
Available at Lux Hospitals, Hitech City, Hyderabad.
HOW WE TREAT IT
Treatment Approach
EPSiT (Endoscopic Pilonidal Sinus Treatment)
Dr. Tejasree Vengala offers EPSiT — a minimally invasive endoscopic technique for pilonidal sinus that visualises and removes the entire tract through a tiny opening. There are no large wounds, no flaps, and no prolonged dressings — patients return to daily activities within a few days with excellent cosmetic results.
- 1
Consultation & Assessment
Dr. Tejasree examines the affected area, identifies the openings, and assesses whether the disease is acute, chronic or recurrent.
- 2
Treatment Planning
Based on the severity and recurrence risk, the most suitable procedure is chosen — from pit picking and EPSiT to flap-based reconstruction.
- 3
Procedure
The selected surgery is performed under spinal or short general anaesthesia, usually completed within 30–60 minutes.
- 4
Recovery & Follow-up
Patients are typically discharged the same or next day. Wound care, hair removal, and lifestyle advice help prevent recurrence.
AVAILABLE TREATMENTS
Treatment Options
Incision and Drainage (Acute Abscess)
Emergency procedure to drain pus and relieve pain in an acutely inflamed pilonidal abscess — followed later by definitive surgery.
Bascom Cleft Lift
Advanced flap technique that flattens the natal cleft and significantly reduces the chance of recurrence.
Karydakis Flap
An off-midline closure that moves the wound away from the cleft — offering very low recurrence rates.
Limberg Flap (Rhomboid Flap)
A rhomboid-shaped flap rotated to cover the defect after sinus excision — a strong, long-term solution.
Excision with Open Healing
Complete excision of the sinus tract, with the wound left open to heal slowly — used in heavily infected disease.
Excision with Primary Closure
The sinus is excised and the wound stitched closed — quicker recovery but with a higher recurrence risk if midline.
Pit Picking
Minimally invasive removal of only the small pit openings — quick procedure with very fast recovery.
EPSiT
Endoscopic Pilonidal Sinus Treatment uses a small endoscope to clean the tract under direct vision — with excellent cosmetic results.
COMMON QUESTIONS
Frequently Asked Questions
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