What is pilonidal sinus surgery?
A pilonidal sinus is a small hole or tract in the skin which usually contains hair and skin debris. It is usually located near the tail bone at the top of the buttocks. Pilonidal sinus conditions are most common in young adults aged between 15 and 40.
Pilonidal sinus symptoms can develop quickly or gradually over time. If symptoms develop quickly, the area will be painful and an abscess will develop over a number of days. If the sinus develops slowly, pus may be gradually released which will temporarily relieve the pressure. Pilonidal sinus symptoms never completely clear up without surgical intervention. This intervention is called pilonidal surgery.
Why do I need pilonidal sinus surgery?
If your pilonidal sinus is diagnosed early, and you are not experiencing severe pain, your doctor may be able to treat the condition with a broad-spectrum antibiotic. While this won’t heal the sinus tract it will treat the infection.
In some instances, your doctor will have to lance the abscess. This is normally done under a general anaesthetic as local anaesthetic does not work well in an infected area. Your doctor will then open the abscess with a scalpel and clean away any hair, blood, and pus. Your wound will then be packed with a sterile dressing and allowed to heal. Recovery from this procedure usually takes around four weeks.
If pilonidal surgery is required, you will be given an anaesthetic and your surgeon will cut out the entire sinus as well as an area around it. The wound will either be stitched, or left open to heal.


Risks and potential complications from pilonidal sinus surgery
Pilonidal sinus surgery is a safe procedure, however, the following complications can arise:
- Adverse reactions to the anaesthetic
- Bleeding and infection of the wound
- Scarring
- Slow healing
- Recurrence
What is the cost of pilonidal sinus surgery?
Pilonidal sinus surgery is performed in both public and private hospitals. A portion of the cost for your pilonidal sinus surgery may be covered by your private health insurance and you should discuss this with your provider.
Please contact the Sydney GI Surgery team to discuss your needs and for an accurate assessment of the cost involved.
Recovery from pilonidal sinus surgery
Immediately after your surgery you will be taken to a recovery room where your vital signs will be monitored. You may feel uncomfortable after your surgery and you will be given pain medications.
In most cases, your wound will have been stitched. These stitches will need to be removed by your doctor approximately 14 days after your surgery. If your wound has been left open your dressings will need to be changed daily for the first week then every second or third day after that until healed,
Most people need to take some time off work after this surgery. Your surgeon will talk to you about your situation and what you should expect. It’s also important that you keep your wound clean, dry, and not sit directly on it. Loose fitting cotton underwear is a good option for the first few weeks after surgery. A donut pillow may help as well.