Hello doctor,I am a 26-year-old male. I have a sitting job (mostly eight to 10 hours a day with no exercise). I was diagnosed with pilonidal sinus a few months ago and was suggested a surgery. As it comes with a long recovery time, I never opted for it. One of the doctors suggested that I just live with it as it causes no harm if there is not much discomfort and pain. It is situated at the back (tailbone) photos attached. It normally pains (drain with pus/ blood) once a month and causes discomfort. So, I just apply betadine ointment till it is cured. It again comes back after few weeks or a month's time. So, I need your help and got few questions: What can be the possible cause of it?Is surgery the only option to cure this or can I try something that can help me to escape from surgery? Someone suggested me to use salicylic acid pads to wipe the area twice a day. Will this work? Can you please suggest me anything else that can help me to get rid of it?One doctor suggested that he will be keeping the wound open after surgery and other doctor suggested to use stitches once the surgery is done. Which method is more beneficial in case of a surgery? Also is there any chance of recurrence even after surgery?I want to get a scan done of the area just to know if it is not critical as it has been more than one or two years I am having this problem. What scan is the best for this? MRI or CT scan? I will share the scan results with you in the next query.Please share your consultation on the same. What do you suggest, please? Any medications, etc.? Can it worsen and damage other parts if delayed? Just worried as it has been long. Thanks and regards.
Hello. I have gone through the clinical images (attachment removed to protect patient identity). The reason why this occurs is elusive, although many hypothetical explanations are given. Surgery is the best and only curative option. The wound can be closed without any problems after surgery. Keeping the wound open is an outdated technique of operation. Generally, no scan is advised. You can get an MRI if you want to get it done but it will not be of great help. Do not worry. It is not a life-threatening condition. It will not spread to other parts of the body. It is an easily treatable condition. You should go and get it operated. I would advise you to reduce weight, and check blood sugars, and BP. For more information consult a general surgeon online -->