There are basically two strategies available for the treatment of the pilonidal sinus, each of which has its specific advantages and disadvantages and differs in the course of treatment.
The easiest way to do this is to book an appointment directly in our online calendar:
Please note that examination or treatment for other diagnoses (hemorrhoids, anal fistulas, etc.) is not possible on these dates due to lack of space and/or personnel.
An appointment requested via our booking system will only be confirmed by the physician if either the patient has already been examined in our practice or image documentation has been submitted in advance and the online questionnaire ("Access to Ondasys") has been completed.
Decision for surgery and informed consent / consent for surgery
Preparation for the anesthesia interview:
Organize an adult to pick you up: After surgery under anesthesia, an adult must be available to pick you up. You are not allowed to go home alone, even by cab or public transport.
Here's what you should have prepared for the day of surgery:
Operations with anesthesia take place in the Iatros Clinic, not in the practice. You will find the clinic at Nymphenburger Str. 1, 80335 Munich, on the second floor of the high-rise building opposite the Löwenbräukeller on Stiglmaierplatz. Please expect intense city traffic, especially during rush hour, and unexpected routing due to numerous construction sites. Therefore, plan enough time, this will help avoid stress. There is (somewhat narrow) parking for patients with entrance from Seidlstraße. Otherwise, the subway and streetcar go to Stiglmaierplatz.
For the procedure under general anesthesia, you must be fasting for 6 hours. This means no food intake, no smoking, no chewing gum, no coffee - in short, anything that could stimulate the stomach acid.
If possible, we ask you to shave the buttocks generously. This makes it easier for us to work and for you to change the dressing if it does not stick to your hair.
And: shower out the region of the butt crease as much as possible, this reduces the density of bacteria on the skin.
The principle of reconstruction in the area of the gluteal fold is the displacement of the suture to the side, i.e. asymmetric wound closure. The preferred technique is the operation according to Karydakis. Tissue ("flap") is mobilized from the side and the wound is covered with it. The wound is stably sutured in 3 layers. The sutures are dissolvable and are knotted countersunk so that no sutures are visible on the surface.
After the procedure, the local anesthetic administered in addition to the anesthetic usually continues to work for several hours. You can and may therefore assume a normal sitting position in a car or train without pain. A slight pressure on the wound is even desired and reduces the already low risk of post-operative bleeding.
They should be accompanied by their collector for 24 hours after the procedure and are also not allowed to drive or operate machinery during this time. Patients with a very long journey usually go to a hotel over the weekend and come to the practice on Monday for a final check-up before going home.
If the process is normal, a stable scar can be expected after about three weeks. The swelling conditions will also have improved by this time, at least to the extent that there is no longer any significant restriction.
Sports and professional activities can be resumed.
Permanent hair removal by laser epilation is not recommended by all experts in Karydakis surgery. The importance is certainly lower than for a scar in the midline.
Especially after several recurrences, we believe it can still be a worthwhile investment to permanently remove the hair in the gluteal fold and around the scar.