Pilonidal sinus surgery (PNS)

Pilonidal sinus surgery (PNS)

A pilonidal sinus (PNS) is a small abnormal pocket or hole in the skin. It may be filled with fluid, pus, or hair and skin debris, initiating the development of a cyst or abscess. It’s mostly located in the cleft at the top of the buttocks. It can cause intolerable pain and may often become infected. If it becomes infected, it may emit pus and blood with a foul odour. Infected hair follicles usually produce these cysts to progress. The cyst can be removed through a small incision or removed surgically.

The significant causes of pilonidal sinus are unknown, but it appears to be caused by broken or loose hair penetration into the skin. The combination of changing hormones, wearing tight clothes, long periods of sitting, bicycling, and similar factors can result in the development of sinus. Hairs are considered a foreigner substance, and the body launches an immune response against it and creates a cyst around the hair.


The symptoms of pilonidal sinus are quite the same in people, at first small dimple like appearance can be seen on the surface of the skin. However, when it gets infected, it becomes a cyst or abscess filled with fluid or inflamed tissue. Some common symptoms include 

  • Discomfort and pain while sitting and standing
  • Itching, redness, and sore skin around the affected area
  • Hair protruding from the abrasion  
  • Discharge of blood or pus from the opening of the skin
  • Infection and smell from pus
  • Swelling of the cyst

Treatment Options


Treatment of pilonidal sinus depends on the severity, symptoms, and size of the sinus. Some of the treatments followed include; 

Non-surgical treatment

If the case is diagnosed early on, and pain is not that severe, non-surgical treatments may help. Some non-surgical treatments include

  • Antibiotics – Antibiotics treat a wide range of bacteria and help to give relief from infection and discomfort. Painkillers like paracetamol and anti-inflammatory are also provided to reduce pain and swelling.
  • Phenol injection – In this treatment, local anaesthesia is given, and then phenol injections are inserted. This procedure is repeated several times.

Surgical treatment

When non-surgical treatments fail to treat the cause, surgical treatments are applied. The surgical procedures accustomed to treat pilonidal cysts include

  • Incision and drainage – This surgery is performed for large or repeatedly infected snus. The sinus is cut, and all the pus and debris are removed. After completion of the process, the wound is closed by stitching. 
  • Endoscopic ablation – In this process, an endoscope is used to have a clear view of the infected area. Then hair and infected tissues are removed, and sinus is cleaned with a solution. Sinus is sealed using heat
  • Plastic surgery – Plastic surgery is considered an option if the area being treated is large. In this case, sinus is removed, and the affected skin is reconstructed. 

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