Specialist practice Munich

Pilonidal Sinus - Pilonidal sinus?

Finally be free from pain, bleeding and unpleasant odors again

Do I really have a Pilonidal sinus?

Ignore? Operate? And if so, how?

I've already had surgery. The fistula's back. What to do?

Pilonidal sinus - What is it?

Schematic drawing Pilonidal Sinus, also called pilonidal sinus or pilonidal sinus
1 secondary opening, 2 primary opening ("pit"), 3 hair tufts in primary opening, 4 anal fistula, 5 anal canal, 5 rectum, 7 coccyx (os sacrum), 8 subcutaneous tissue

Mayo The term fistula (lat. fistula tube, pipe) denotes a tubular duct as a result of chronic inflammation. The term sinus pilonidalis ( pilonidal sinus, pilonidal cyst, coccygeal cyst, sacral dermoid, dermoid cyst) originates from Hodge 1880 (lat. pilus = hair and nidus = nest).

These fistulas are only found in the gluteal fold. They can be chronic (= Pilonidal Sinus) or acute (= coccyx abscess). Ingrown or spiked hair leads to a state of irritation as a foreign body. A protective wall of scar tissue forms, the fistula capsule (foreign body granuloma).

A stable layer of collagenous connective tissue, the fascia, protects the gluteus and coccyx.

The rectum and sphincter are never involved.

The pilonidal sinus is a simple disease.

Read also the interview with Dr Hofer

Which doctor is the best to go to?

Why does one need a specialist for a simple illness?

The Pilonidal Sinus is a skin disease. Consequently, the dermatologist would be responsible. However, the first point of contact is usually the family doctor. He refers the patient to the surgeon.

In Germany, approximately 50,000 patients undergo sinus pilonidal surgery each year. In other words, each surgeon treats an average of only 1.4 patients with a Pilonidal Sinus per year. With this number of cases, it is difficult to gain experience.

Look for a doctor who really has a lot of experience with his method and focuses on the treatment of coccygeal fistula. Do not choose the nearest hospital, not the fastest appointment, not the doctor with the best reputation in general, but the best doctor for your problem.

Pilonidal Sinus - OP: What is the problem?

The supposedly small intervention can have unexpectedly large consequences.

  • Long healing period with sick leave
  • Extensive and painful wound treatment,
  • frequent wound healing disorders
  • high relapse rate of up to 57 %(Deutsches Ärzteblatt 2019)
  • scarring 
  • Repeated hospital stays
  • Loss of income and career interruption 
  • Restrictions in sports fitness, weight gain
  • Restrictions of body feeling and sexuality
Statue newly exposed
The healing of a coccyx fistula gives you back physical well-being!

Good decisions are based on experience.

We are the experts


Operations for pilonidal sinus (as of 29.03.2023)


Treatment cases for pilonidal sinus (as of 14.04.2022)

Laser Treatments

Experience in laser therapy and laser surgery since 2012

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Full authorisation for outpatient surgery and integrated care

Pit Picking Operation - The gentle alternative

According to the current state of science, a cure for Pilonidal Sinus is only possible through surgery. The factors that determine the success or failure of an operation were described as early as 1965 by the English surgeon Peter Lord.

  • The cause of Pilonidal Sinus is hair that has grown into the subcutaneous tissue.
  • All ingrown hairs must be completely removed.
  • All ports of entry (porus, pits) for hair must be identified and eliminated.
    These goals can usually be achieved by a relatively simple and minor surgery.

All fistulas will heal if they are not kept open. A pilonidal sinus is a foreign body - fistula, with hair being the foreign body. If the hair is removed, the fistula will heal

Surgical techniques