PILONIDAL SINUS CENTER MUNICH
Your specialists in Pilonidal surgery
Your specialists in Pilonidal surgery
Here we have the questions that patients with coccyx fistula repeatedly ask about diagnosis, treatment without surgery, the various surgical procedures for the pilonidal sinus and postoperative treatment and duration of healing. Clicking on the question opens the window with the answer.
Question: My doctor diagnosed a pilonidal sinus (pilonidals sinus). How do I find out whether a treatment with pit picking and / or laser is possible?
Answer: Provided that the diagnosis is correct, treatment of the pilonidal sinus is always possible with our minimally invasive methods.
Question: I have been pit-picked before, without (lasting) success. Do we need a major surgery now?
Answer: No, we don't really see any reason for radical surgery today. We supplement conventional pit-picking by peeling out the fistula capsule ("fistulectomy"), or more rarely by laser treatment ("FilaC"), and are successful in over 90% of cases, even if pit-picking operations have already taken place in the past.
Question: I have already had one or more "major" operations and the fistula has not healed or come back. Is there a way to still treat minimally invasive now?
Answer: Yes! A recurrence of a pilonidal sinus (recurrence of a pilonidal sinus) is almost always caused by re-ingrown hair roots or penetration of hair into the still sensitive scar. In the former case pit-picking, in the latter laser hair removal and triggering of penetrated hair leads to permanent healing.
Question: Is the operation paid for by my statutory health insurance?
Answer: The operation itself is a service of the statutory health insurance, we are approved by all statutory health insurers for treatment. A number of health insurance companies have even concluded special supply contracts with us for the treatment of coccyx fistulas. In addition, many patients choose a treatment for permanent hair removal as a preventive measure, which is not paid for by most insurance companies and costs 70 € per treatment.
Question: What is the fee if I come to you as a private patient or self-payer for examination, laser treatment and surgery of the pilonidal sinus?
Answer: Depending on the complexity of the fistula and the necessary consumables (especially fiber optic probes for lasers), they invest between 600 and 1500 € in treatment with local anesthesia. If an operation with general anesthesia is preferred, you must also take into account the fees of the clinic and the anesthesiologist (600 € for outpatient surgery).
Can the operation be performed on an outpatient basis, or do I have to go to the clinic for it?
Answer: More than 95 % of our operations are performed without any problems and pain, under local anaesthesia, and the patient can return home after a short period of supervision. In case of a very long journey it is advisable to stay overnight in a hotel in Munich after the operation. If preferred, surgery can be carried out under general anaesthesia in the Iatros Clinic. An overnight stay in the Iatros Clinic is also possible at an extra charge. In the clinic, however, the laser is not available for hair removal. We do not consider fully inpatient operations to be necessary for the pilonidal sinus and therefore do not offer them.
Question: I have an acutely inflamed pilonidal sinus with severe pain. My doctor explained to me that in this case a minimally invasive operation is not possible. What do you say to that?
Answer: In this situation we first perform a pre-treatment with puncture of the abscess and/or antibiotics, almost always allowing the inflammation to get under control and planning a minimally invasive surgery about 2 weeks later.
Question: What is the quickest way to get to an appointment?
Answer: Send a brief description of your complaints, together with a photo documentation of the region concerned and a telephone number where you can reach them, to firstname.lastname@example.org.
Question: I have a long journey, can I schedule an examination and an operation on the same day?
Answer: Yes, this is possible, if it is your express wish, you can waive your right to a period of reflection and to obtain a second opinion and the procedure can follow directly after the examination. Please let us know this wish when making an appointment, so that we can plan enough time! This option is used by the majority of patients. If you are not yet sure about your decision, you can of course schedule a second appointment for treatment.
Question: How long are patients on sick leave after surgery for a coccyx fistula?
The duration of the inability to work depends very much on the type of operation performed. After conventional radical surgery, one often has such a large wound that sitting and walking are very difficult. Frequent dressing changes and wound treatments are usually also necessary. In these cases an incapacity to work can result for at least 4 weeks, but also up to months. This is the great advantage of the minimally invasive surgical technique based on pit-picking. Hardly any of our patients are on sick leave for more than 2 weeks. Any kind of physical activity is allowed from the 3rd day after the operation.