Pilonidal sinus disease refers to a subcutaneous infection occurring in the gluteal
sulcus of the sacrococcygeal region. Although the cause is not clear, it is thought to be
related to obesity, hairy body, and deep gluteal sulcus. The incidence of this acquired
disease is about 26/100,000 subjects worldwide. The incidence rate among males is 4 times
higher than that among females. Pilonidal sinus disease was first de scribed by Herbert
Mayo in 1833 as a congenital condition, but is now accepted to be an acquired disease,
given its absence in childhood .
Although its cause re mains unknown, the increased hormone levels associated with
puberty, the growth of thick hair, long periods of sitting, and friction imparted by
tight-fitting clothing may be in play. Other risk factors are hirsutism, obesity, and a
family history of the disease. As the cause of the dis ease, hairs falling from head,
neck, and back are placed in the intergluteal area and hairs that penetrate the skin
initiate foreign body reactions. In the affected area, the hairs are moist, sweaty, and
unhygienic, readily trig gering development of the subcutaneous skin cysts and sinuses
characteristic of the disease, which (in the gluteal region) present as asymptomatic
pits, painful abscesses, or sinuses associated with purulent serous discharge.
The acute phase is characterized by sacral abscess, and during the chronic phase cyst
formation or persistent sinus discharge may be observed. At present, no consensus exists
regarding the best treatment choice, but conservative treatment can only control the
symptoms, and most patients have to undergo operation. Traditional surgery has good
success rates; it requires removal of all diseased skin and subcutaneous tissue,
including wide excision and healing by secondary intention or reconstructive ("flap")
techniques, which results in a long recovery time and a large wound. In recent years,
minimally invasive surgical methods for the treatment of SPD (such as endoscopic
pilonidal sinus ablation, laser ablation, phenolization, or fibrin glue injection) have
improved, reducing wound scarring and pain and shortening the time it takes for patients
to return to their normal lives. Surgical success is evaluated by recovery time, the time
to return to daily activities, and the complication and recurrence rates.
Patients presenting with pilonidal sinus disease at the Department of General Surgery,
Mersin University (Türkiye) were evaluated for participation in this study. Patients aged
≥18 years with symptoms related to pilonidal sinus disease were included in this study. A
power analysis was performed using the G*Power (v3.1.7) program to determine the sample
size.
Exclusion criteria include the absence of symptoms associated with pilonidal sinus
disease, suspicion of an extensive subcutaneous sinus tract network, and the presence of
a pilonidal abscess and previous surgery for pilonidal sinus disease, recurrent and
complicated pilonidal sinüs disease.
At least 64 patients who meet the inclusion and exclusion criteria will be included in
this study. Appropriate surgical procedures will be applied to patients with pilonidal
sinus disease who apply to Mersin University Hospital General Surgery Department. The
method to be applied will be decided by discussing with the patient.
Data for this study will be collected between November 2024 and November 2025. During
this period, data from patients who underwent surgery for pilonidal sinus disease at
Mersin University Hospital General Surgery Clinic will be collected. Data will be
collected from patients who apply for follow-up on the 1st day, 7th day, 6th month and
12th month after laser ablation or phenol treatment. Demographic characteristics,
symptoms, clinical examination findings, surgical findings, postoperative VAS pain
scores, wound complications, recurrence rates and return to daily life times will be
examined. This data will be obtained through the retrospective review of medical records
and confirmed by face-to-face interviews with patients who have attended the outpatient
clinic, and then recorded in the data collection form.
Data collection will continue until at least 32 patients are reached in the phenolization
and laser ablation groups. Once the target sample size is reached, new data collection
from patients will be terminated and statistical analyses will be performed to compare
prevalence between groups.
