Coccygeal fistula: sinusectomy

Removing coccygeal fistulas effectively and gently

If the coccygeal fistula is treated with pit-picking or by sclerosing the fistula ducts with the FilaC laser, this produces quite good results, but neither option is the best solution. For this reason, Dr. Hofer has further developed the laser method and created a procedure that can cure coccygeal fistula by 90 percent.

Treatment of the coccyx fistula without surgery: peeling of the fistula ducts

Dr. Hofer's proctology practice in Munich has many years of experience in the treatment of coccygeal fistula by means of debridement. As with pit-picking, this creates a minimally small wound through which the fistula ducts are completely removed. This procedure offers the great advantage that almost all coccygeal fistulas can be cured with it.
Advantages and disadvantages of the treatment

Advantages when stripping the fistulas:

• The success rate rises to over 90 percent
• The impairment caused by the hardened fistula capsule is largely eliminated.
• Very good functional and cosmetic result, similar to classic pit picking
• The operation can be performed on an outpatient basis and under local anesthesia.

Disadvantages of peeling the fistulas:

• Longer operation time (average 30-60 minutes)
• Somewhat higher risk of secondary bleeding
• Compared to classical pit-picking, a slightly longer time until complete healing is achieved (6-8 weeks)

Fistulectomy represents an optimal compromise because it combines the thoroughness of removal as in flap surgery with the minimal interference in the course of healing as in pit-picking. This method is feasible in about 80 percent of patients who have not undergone preoperative surgery and in about half of patients who have undergone preoperative surgery.

1. Cleaning of the fistula tract with pit-picking
2. Economical removal of the coccyx fistula with a fistulectomy
3. Removal of the coccyx fistula with flap surgery (after Karydakis)

The procedure requires appropriate experience on the part of the practitioner and particularly fine instruments. We have the necessary experience to carry out the procedure as precisely and gently as possible. Make an appointment and get advice on fistulectomy at the Proctological Practice Munich.