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[Retrospective study 10 years after plastic surgery for sacrococcygeal pilonidal sinus].

The authors give a brief summary on the etiology and pathomechanism of the sacrococcygeal pilonidal sinus. They have distinguished the congenital, cystic deformation (dermoid cyst) from the pilonidal sinus which is considered to be an adventitious illness. During ten years (1976-1985) 208 patients were operated on with the method the authors applied. Only one early recurrence was registered and 7.2% of the patients recovered from secondary healing. Delayed recurrences were analysed according to questionnaires. From 151 of the questionnaires only three male patients complaints referred to delayed recurrence.

Dermoid Cyst↗

Anterior perineal sinus.

Each year we treat several patients with an anterior perineal sinus tract. They do not conform to commonly encountered perineal problems such as pilonidal disease, epidermal cysts, hidradenitis, fistulous abscess, or inflammatory bowel disease. In an effort to improve understanding of the problem and its clinical significance, we reviewed our practice records for the period from 1968 through 1988. Fifty-six patients underwent surgery for an anterior perineal sinus tract. In 31 patients, the clinical and pathologic condition defied classical diagnostic categorization. We have termed these lesions "anterior perineal sinuses." Their clinical characteristics, treatment, and pathologic assessment from the body of this report. Male predominance (87 percent) and midlife presentation (average age, 44 years) characterized this group. Local symptoms were present from several weeks to several years prior to treatment. Local anesthesia (74 percent) and limited surgery (100 percent) resulted in complete healing in all patients (average, 7 weeks). A 15 percent recurrence rate was noted. The pathologic evaluation demonstrated acute and chronic dermal and subcutaneous inflammation. The etiology of this process remains uncertain. Its predominance along the median raphe suggests a congenital midline inclusion disorder.

Adult↗

Pilonidal sinus of the penis. A report of two cases, one of them associated with actinomycosis.

Pilonidal sinus is a long-standing chronic inflammatory condition which occurs most commonly in the sacrococcygeal area and it is rare in the penis. Two cases of penile pilonidal sinus in patients aged 25 and 28 years are reported and the literature is reviewed. The lesion is acquired and has to be distinguished from balanoposthitis, epidermal cyst and carcinoma. For pilonidal sinus to occur at this site, it is hypothesized that the coronal sulcus acts as a cleft where hair may accumulate and be driven into the shaft and prepuce by the natural movement between these two surfaces. One of our cases was associated with actinomycosis. Actinomycosis associated with pilonidal sinus of the penis is extremely rare and there are only two previous reports. It is suggested that pilonidal sinus may have been predisposed to the infection with the actinomyces organisms. Information stating that penile pilonidal sinus and actinomycosis may occur simultaneously is necessary to accomplish an early diagnosis.

Actinomyces↗

[The use of a laser in the surgical treatment of an epithelial coccygeal cyst].

In acute inflammation of pilonidal sinus (PS), use of a laser scalpel permitted to reduce considerably the incidence of postoperative suppuration. Pain syndrome became less pronounced, or was absent, wound swelling disappeared at the early period. No differences in results of surgical treatment of uncomplicated PS at the stage of chronic inflammation in use of CO2-laser and conventional methods of treatment were noted. An original technique of operation for PS complicated by multiple fistulas, purulent leaks, pyodermia has been suggested. For plastic closure of a wound, the effect of laser photohydraulic preparation was used. Operated on was 31 patient, no disease recurrence was noted. Rough cicatricial deformity of the sacro-coccygeal region was absent.

Acute Disease↗