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Pilonidal Sinus

A Pilonidal Sinus is a small hole or tunnel in the skin at the top of the buttocks near the tailbone, where they divide (the cleft). The sinus tract goes in a vertical direction between your buttocks. A pilonidal cyst usually contains hair, dirt, and debris. It can cause severe pain and can often become infected and filled with pus. A Pilonidal Sinus can go unnoticed unless it becomes infected.

Pilonidal sinuses are more common in men because they tend to be hairier. Commonly found in teenagers and young adults.

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Causes

Although the root cause of Pilonidal Sinus is not clear, there are various factors that contribute to it. But most pilonidal cysts appear to be caused by loose hairs that penetrate the skin. Some factors include:
loose hairs that penetrate the skin
friction and pressure
obesity
hereditary inheritance
Symptoms
Holes in the skin
A tender lump under the skin,
usually near the tailbone
More sinus tracts over
a period of time
Low grade fever
Swelling of cyst
Pain while sitting or standing
Reddened and sore skin around the cyst
Pus or blood oozing out from the cyst
Foul odour in the sac
Nausea
Extreme tiredness
Hair protruding from the area

Risks If Condition Persists

Abscess formation
Abscess formation- If not treated, this infection can lead to a cyst, and possibly into an abscess (pockets of infection) or a sinus (a cavity underneath the skin).
Recurrence
The cysts may return because the area gets infected again or hair grows near the incision scar.
Systemic infection
If the abscess is ignored or spreads then the infection can spread throughout the body
Skin Cancer
If not treated properly, you may be at slightly increased risk of developing a type of skin cancer called squamous cell carcinoma.

About Treatment at Pelvinic

At Pelvinic, we perform a specialised Surgery for treating Pilonidal Sinus. Here are some advantages of our Surgery over the Traditional Surgical Procedure.
logo Less Pain
Our Surgery is Painless, compared to Open surgery procedure which is painful.
logo No tissue damage
Our Surgery cause minimal cuts and wounds compared to Open surgery causes which causes cuts and wounds
logo No Diet Restrictions
Our Surgery doesn't cause cuts and wounds compared to Open surgery causes which causes cuts and wounds
logo Fast Recovery
Can resume work immediatly
logo Minimally Invasive
Our Surgery is minimally invasive compared to open surgery for which its large
logo No Incontinence
Anal sphincter is well preserved so no chances of incontinence/ fecal leak

Patient Testimonials

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A patient of Dr Sandip Banerjee got operated for her health related problem. Her family's previous experiences with healthcare service was like a nightmare and hence inspite of surgical diagnosed case she was not
Mrs. Harpreet
Ghazibad
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45 year lady referred by physician was diagnosed to have one sided renal mass and was operated for radical surgery and the affected kidney removal by Dr Sandip Banerjee. She responded well discharged after 1 day
Mis. Anita
Lucknow
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Patient from Nepal came for gall bladder stone with underlying chronic liver disease and hence was made unfit for surgery. He was first managed to limit risks and then undergo ne Gall Bladder removal
Patient from Nepal
Nepal
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An Afghanistan National Patient smiling after undergoing laparoscopic surgery for gall bladder stone and inguinal hernia. Abdullah’s wife &
Mr. Abdullah
Afghanistan

Treatment Procedure for Pilonidal Sinus

Every year more than 1 million cases of Pilonidal sinus surfaces and patients suffer with the problem of recurrence due to either faulty diagnosis or improper surgery. Pilonidal sinus requires a medical diagnosis clinical examination and rarely needs any specific laboratory or imaging tests. Our expert will diagnose a pilonidal cyst by first doing a physical examination. A pilonidal infection should be visible by the naked eye.

The doctor may see what looks like a pimple or oozing cyst. If infection is severe, blood tests may be performed for diagnosis. Doctor also ask you several questions, including:

• Whether the cyst or pimple has changed in appearance
• Whether it is draining fluid
• Whether you have any other symptoms
Rarely, a CT scan or MRI may be ordered to look for sinus cavities under the surface of the skin
A broad spectrum antibiotic that treats a wide range of bacteria may be used to treat Pilonidal Sinus, if diagnosed early.

It is useful if there is only mild pain and no inflammation or reddening.
Surgery is needed to drain and remove a pilonidal cyst that does not heal. Our doctor may recommend below procedure if you have pilonidal disease that is causing pain or infection. A pilonidal cyst that is not causing symptoms does not need treatment.

Pilonidal Sinus treatment has been revolutionised over the years by arrival of new age ambulatory surgery or Day Care surgery is a clinical admission for a surgical procedure, with discharge of the patient on the same working day. We have a trained anesthesiologist, OT assistant, and nursing assistant do the advanced procedures like Laser and Flap surgeries.

Dr Sandip Banerjee in many of the lectures that he has given and in his practice believes that there is no need in aggressively removing entire affected tissue up to tail bone bed. In this way the surgical principle of lowering the depth of natal cleft to prevent recurrence is not met. So the best way to remove as much affected tissue with Flap cover (W flap, Z plasty) in non-infected cases which not only reduces down post-operative morbidity but also completely cures the problem with relapses.

Laser Pilonidotomy is a new technique where ablation of the sinus tract is done by using radial laser fiber, one or two or maximum three 1 cm incisions are made to prevent collection of fluid and help efficient drainage, thus allowing faster wound healing with secondary intention with minimal recurrence rate.

Our patients and our surgeon will decide on the best anesthesia to use during the surgery. Choices include:

• general anesthesia, which puts patients into a deep sleep throughout the surgery
• Saddle block is a low dose of spinal anesthesia which involves medication that numbs your body from the waist down being delivered by a shot into your back
• local anesthesia, which numbs only your anus and rectum
• Patient can expect rectal and anal pain after having Pilonidal Sinus surgery. So doctor will prescribe a painkiller to ease the discomfort.
• Patient can help in his/her own recovery by:
• Avoid baths until the wound is completely healed. ... Avoid sitting for a long time or sitting on hard surfaces until your incision has healed.
• Eat a light diet with extra fluids as tolerated. Eat a well-balanced diet with extra fibre (like vegetables, bran, whole grain, breads to prevent Constipation.
• Avoid any activities that involve heavy lifting or pulling. Although individual recovery times vary, many people can expect to make a full recovery within about 7 to 10 days.

Why Pelvinic

Pelvinic - The Pelvic Floor Clinic, is a proctology specialty center. We offer treatment and cure for diseases in the pelvic area under one roof. Treatment is done by our experienced doctors using latest technologies at a very affordable cost.
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We have taken all safety measures to combat Covid-19.
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We strive to provide a home-like environment and the best treatments for our patients for quick recovery.
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PELVINIC’s success is recognized by many awards from the various organizations national & international.
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We use the latest technology and medical equipment in patient care that helps the doctors diagnose diseases and treat patients effectively and efficiently.
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Highly skilled surgeons. Our doctors have a vast experience of over 50000 surgeries.
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50% more cost effective than corporate hospitals.
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Frequently Asked Questions

Only a doctor can tell you for sure since Pilonidals take different courses in different people. Some people may just experience a bit of a pain when sitting, others may only have some drainage and no pain, still others will be making a trip to the ER or surgeon because they are in excruciating pain. The usual signs of an acute infection are swelling and pain in the tailbone region. Most people end up at this site by Googling "tailbone pain". The most singular common symptom is discomfort in the area around the tailbone.

Even the doctors don’t agree on this issue but we can give you the primary prevailing opinion: Without getting too technical, the primary theory on Pilonidal Disease involves "follicular occlusion" which is the blocking and inflammation of pores in the midline of the buttocks. This tends to occur in the tailbone area because of the friction and pressure on the area that stretches the pores when the person is sitting. We caution people to make sure your doctor has the latest info on Pilonidal Disease. There are an appalling number of "old school" doctors out there who still think that Pilonidal is completely congenital and there is no way to get rid of it. You can usually spot these doctors by their use of the phrase "the cure is worse than the disease.

Somewhat. There are plenty of instances where multiple family members have Pilonidal Disease. Doctors speculate that this is due to the inherited shape of the buttocks and natal cleft, type of hair and predisposition to blocked follicles/pores.

Causes can include: * Muscle damage. Injury to the rings of muscle at the end of the rectum (anal sphincter) may make it difficult to hold stool back properly. This kind of damage can occur during childbirth, especially if you have an episiotomy or forceps are used during delivery.

* Nerve damage. Injury to the nerves that sense stool in the rectum or those that control the anal sphincter can lead to fecal incontinence. The nerve damage can be caused by childbirth, constant straining during bowel movements, spinal cord injury or stroke. Some diseases, such as diabetes and multiple sclerosis, also can affect these nerves and cause damage that leads to fecal incontinence.

* Constipation. Chronic constipation may cause a dry, hard mass of stool (impacted stool) to form in the rectum and become too large to pass. The muscles of the rectum and intestines stretch and eventually weaken, allowing watery stool from farther up the digestive tract to move around the impacted stool and leak out. Chronic constipation may also cause nerve damage that leads to fecal incontinence.

* Diarrhea. Solid stool is easier to retain in the rectum than is loose stool, so the loose stools of diarrhea can cause or worsen fecal incontinence.

* Hemorrhoids. When the veins in your rectum swell, causing hemorrhoids, this keeps your anus from closing completely, which can allow stool to leak out.

* Loss of storage capacity in the rectum. Normally, the rectum stretches to accommodate stool. If your rectum is scarred or your rectal walls have stiffened from surgery, radiation treatment or inflammatory bowel disease, the rectum can’t stretch as much as it needs to, and excess stool can leak out.

* Surgery. Surgery to treat enlarged veins in the rectum or anus (hemorrhoids), as well as more-complex operations involving the rectum and anus, can cause muscle and nerve damage that leads to fecal incontinence.

* Rectal prolapse. Fecal incontinence can be a result of this condition, in which the rectum drops down into the anus.

* Rectocele. In women, fecal incontinence can occur if the rectum protrudes through the vagina.

4) What are the Risk factors? A number of factors may increase your risk of developing fecal incontinence, including:

* Age. Although fecal incontinence can occur at any age, it’s more common in adults over 65.

* Being female. Fecal incontinence can be a complication of childbirth. Recent research has also found that women who take menopausal hormone replacement therapy are more likely to have fecal incontinence.

* Nerve damage. People who have long-standing diabetes or multiple sclerosis — conditions that can damage nerves that help control defecation — may be at risk of fecal incontinence.

* Dementia. Fecal incontinence is often present in late-stage Alzheimer’s disease and dementia.

* Physical disability. Being physically disabled may make it difficult to reach a toilet in time. An injury that caused a physical disability also may cause rectal nerve damage, leading to fecal incontinence.

5) Complications Complications of fecal incontinence may include:

* Emotional distress. The loss of dignity associated with losing control over one’s bodily functions can lead to embarrassment, shame, frustration and depression. It’s common for people with fecal incontinence to try to hide the problem or to avoid social engagements.

* Skin irritation. The skin around the anus is delicate and sensitive. Repeated contact with stool can lead to pain and itching, and potentially to sores (ulcers) that require medical treatment.

* Reduce constipation. Increase your exercise, eat more high-fiber foods and drink plenty of fluids.
* Control diarrhea. Treating or eliminating the cause of the diarrhea, such as an intestinal infection, may help you avoid fecal incontinence.
* Avoid straining. Straining during bowel movements can eventually weaken anal sphincter muscles or damage nerves, possibly leading to fecal incontinence.

Bowel movements should be soft and formed. They should pass easily like toothpaste flowing out of a tube. 


 

The standard time frame for normal bowel movement (BM) frequency ranges from as many as three bowel movements per day to as few as three bowel movements per week. This is a wide range. Our program usually gives patients suffering from constipation a rescue drug to use if no bowel movement has occurred in 3 days’ time. The colon draws water from stool, the longer stool sits in the colon, the harder the stool becomes. What is more important is whether you are comfortable with your bowel movement frequency or whether there has been a significant change from your typical bowel movement frequency.
Body position can help you to move your bowels. While sitting on the toilet, placing your feet on a small step stool can position the rectum at an angle which makes it easier to pass stool. Bowels like a routine, so eating the same amounts around the same time of day helps to regulate the bowels. Bowels also like regular exercise to keep them moving. Eat a fiber rich diet (refer to our high fiber diet teaching sheet on the web site). Plenty of decaffeinated fluid (if you are not on fluid restrictions) also helps to keep bowel movements soft.
Most Americans eat only 12 grams of fiber a day. The recommended amount is between 25-35 grams of fiber a day. To find out how much fiber you are eating, read the nutrition label of your foods and add the grams of fiber together. When you add fiber to your diet, you will initially be gassy. This gas will decrease over time. For this reason we recommend adding only 5-6 grams of fiber to your diet every two weeks.
No there is no difference whether you eat fiber or take a supplement. Some patients feel that the supplement makes them have less gas.
There are different types of constipation. Not all types of constipation are best treated with additional dietary fiber. For instance, our program has found that people with dysynergic defecation or slow transit constipation may experience worsening symptoms with increased dietary fiber.
Activia can improve mild constipation. Studies have shown an initial improvement in 2 weeks. Most patients eat 2 Activia a day to receive the best benefit.