All you need to know about a Pilonidal Sinus


Pilonidal Sinus – the Latin term (Latin pilus ‚hair‘ und nidus ‚nest‘) is the most appropriate description of the disease. We are talking about inflammation of soft tissue in the area of the fold between the buttocks over the tailbone caused by ingrowing or intruding hair. It has nothing to do with the tailbone itself (“tailgut cyst”) or an embryonal malformation (“dermoid cyst”, “sacral dermoid”).

Patients with Pilonidal Sinus treated since founding of the practice 2013 (15.02.2019)

Development of a Pilonidal Sinus as a foreign body granuloma

A Pilonidal Sinus develops with the initiation of puberty when hair growth increases in number and thickness. A hair shaft may break by shear forces caused by sitting, the fragments get pushed back into the hair follicle. The follicle fills with keratin particles and gets distended so that the opening becomes visible as a tiny hole or black dot, called a “pit”. The body lacks enzymes to degrade hair particles and encloses them in a sheath of scar tissue, the fistula capsule. Bacteria can invade the cavity and cause inflammation. As long as the cavity can drain through the pit, a chronic inflammatory process leads to the development of a tubular duct, called fistula (Latin fistula  ‚whistle, pipe‘). If fluid collects within the cavity, an encapsulated collection of pus can originate, the pilonidal abscess.

Allgemeine Chirurgen
in München auf jameda
in München auf jameda

Signs and symtoms of a Pilonidal Sinus

Schema einer Steißbeinfistel von der Seite gesehen

Chronic form: Pilonidal Fistula

  • Discharge of fluid, blood or pus
  • Pain and tenderness
  • Visible opening in the midline: Primary fistula opening ("pit")
  • Lateral visible opening: Secondary fistula opening ("pimple")

Acute form: Pilonidal abscess

  • Pain
  • Reddening
  • Visible "bulge"
  • Fever, general feeling of illness



Employed Surgeons:

Klaus Baertl M.D., Board Certified Visceral Surgeon
Susanne Schuster M.D., Board Certified Surgeon
competent center for proctology (BCD)
Brienner Straße 13
80333 Munich, Germany
Sprechzeiten: Monday to Friday 8 – 13 and 14 – 18 o’clock
Phone 0049 89 – 292679
Fax 089 – 29160900 2019