Outpatient treatment of pilonidal sinus by phenol sclerotherapy

ABSTRACT

The study included 28 patients with chronic post anal pilonidal sinus; 22 were males and 6 were females. The average age was 24.7 years. They were treated by full strength phenol sclerotherapy. Injection was performed in the outpatient clinic without general anesthesia. Local infiltration anesthesia was sometimes administrated. In 7 patients [25%], a sinus opening had to be sharply widened for adequate removal of hair from inside the sinus. Hair was found in a total of 10 patients [35.7%]. The 28 patients received 65 injection sessions. The procedure failed in 2 patients and recurrence occurred in another 2 patients, 2 and 4 months after apparent cure. One of the recurrent cases could be successfully treated by reinjection, resulting in 89.3% final cure rate. The follow up period after cure ranged between one to 4 years. The average was 17.5 months. The complications of the technique were all minor. Pain during the procedure was mainly due to the trials for removing hair from the pits. It was usually tolerable. Small superficial chemical burn of the skin around the sinus occurred in all patients, but it healed readily without complication. Minimal sloughing of a sinus opening developed once. It can be concluded that phenol sclerotherapy of chronic post anal sinus is a very satisfactory line of treatment. It is very simple. It can be done as outpatient procedure without general anesthesia. It does not necessitate any sick-leave or limitation of activity. It gives an excellent cure rate for such a disease notorious for recurrence, with negligible complications. It can be repeated without any inconvenience. It has a marvelous cost- effectiveness ratio