Service
Pilonidal sinus surgery
A pilonidal sinus is a tract in the skin above the tailbone into which hairs have grown. The operation removes the whole tract with the affected tissue, because the condition comes back for as long as the tract exists.
What concerns does it address?
Who is it for?
Pilonidal sinus surgery is done for a person who has a tract or cavity in the skin above the tailbone, with one or more openings on the skin.
People most often come for the operation after the sinus has become inflamed at least once, or when it constantly discharges.
How is it done?
Common to all techniques: the whole tract with the affected tissue is removed, not just the inflamed part. Partial removal leaves part of the tract, and the condition comes back for as long as the tract exists.
The tract and the affected tissue are cut out in full. How the wound is closed depends on the size of the sinus: a smaller one is stitched, shifted away from the middle of the cleft, because a stitch in the cleft itself heals poorly; a larger one is left open to heal from the inside, with dressing changes, or is covered with skin from the side, which flattens the cleft and reduces friction. The area is shaved before the procedure.
When is the procedure not suitable?
An acutely inflamed sinus with pus is opened first; removal of the tract is planned once the inflammation has settled. A procedure with a flap is not planned for smokers until they stop smoking, because a flap heals poorly. For a few weeks after the operation it is best to avoid sitting for long periods — if your job does not allow that, the schedule is discussed beforehand.
General reasons for postponing a procedure (pregnancy, breastfeeding, inflammation, a clotting disorder, smoking): When is a procedure postponed?
Anaesthesia
Before a procedure under general or regional anaesthesia, you are seen by the anaesthetist, who works full time at the clinic; the same doctor is also present during the procedure. The anaesthetic assessment and the anaesthesia for larger operations are included in the price of the procedure. What happens before, during and after anaesthesia is described on the Anaesthesia page.
Recovery
Recovery after pilonidal sinus surgery differs from most procedures in that the wound is in a place that bears weight when you sit.
In the first days you sit as little as possible, then with a cushion; you sleep on your side or stomach. An open wound is dressed until it has healed; a stitched one heals faster. The area is kept clean and dry, and the hairs around the cleft are removed regularly (shaving or permanent hair removal), because ingrown hairs form a tract again.
Procedures are grouped into four recovery profiles: A, outpatient (home straight away, no restrictions apart from dressing changes), B, minor procedure (home the same day or after one night, marks are visible for about a week), C, major procedure (one to two nights in the clinic, sick leave and planning in weeks) and D, functional procedure (sick leave and return to work). This procedure belongs to profile B. How long recovery takes and what it depends on is described on the Recovery after surgery page.
What can the procedure not do?
The operation removes the existing tract. It does not change what caused the tract to form — the shape of the cleft, the growth and direction of hairs, sweating and friction. That is why in some people the condition can appear again.
Risks
Expected — pain when sitting, swelling, discharge from the wound in the first days, a scar that is red for months. Occasional — slow wound healing, wound infection, separation of the wound edges.
Expected, and rare but serious → Risks and complications: what is the course of healing, and what is a complication?
Price
| Service | Price |
|---|---|
| Incision of a pilonidal sinus | €300–400 |
| Excision of a pilonidal sinus under local anaesthesia | €800–1,000 |
| Excision of a pilonidal sinus under general anaesthesia | €1,200–1,500 |
| Excision of a large pilonidal sinus and flap | €1,800–2,000 |
Specialist and team
Specialty: general surgery.
When the procedure is done under sedation or general anaesthesia, the anaesthesia is led by a specialist in anaesthesiology, resuscitation and intensive care who works full time at the clinic.
In the operating theatre, the surgeon is assisted by head nurse Martina Šereg, with the help of nurses Kristina Jurešić and Mateja Tomorad, and in recovery the care assistant Mirjana Kovačić is with you. Martina also looks after preparation, scheduling and contact after the procedure.
Who will operate is decided at the examination, based on the findings and the type of procedure. You know the name of the surgeon before the procedure and meet them at the examination.
What happens at the examination?
The first examination lasts 30 to 45 minutes on average. The surgeon examines the area you are concerned about, asks about illnesses, medicines, allergies and previous operations, and talks with you about what you expect. If the procedure is appropriate and likely to help, you receive a plan: which procedure is proposed, under which anaesthesia, what recovery looks like and what is included in the price. If the procedure is not needed or would not give you what you expect, you will hear that at the examination too.
What if the result is not as agreed?
The result of a procedure is assessed at a follow-up visit, once the swelling has gone down and the scar has matured, not in the first weeks. If it differs from what was agreed at the examination, the same surgeon carries out the correction.
→ Poliklinika Barbel's correction policy
Frequently asked questions
Does a pilonidal sinus go away by itself? The inflammation can settle by itself or after opening and emptying, but the tract does not disappear with it.
How does it form? Hairs from the surrounding skin are pressed into the skin of the cleft above the tailbone — helped by a deep cleft, heavier hair growth, sweating, long periods of sitting and friction. A tract forms around the ingrown hair and becomes inflamed from time to time. It most often appears in younger adults, more often in men. It is not the result of poor hygiene.
How long should I avoid sitting after the operation? In the first few days sit as little as possible, then with a cushion. Most people can sit normally after two to three weeks, depending on whether the wound was stitched or left open.
Why is the wound sometimes left open? Because with an open wound the condition comes back least often, and it cannot fester under the stitches. The cost is longer healing and dressing changes. Which option is right for you depends on the size of the sinus, the depth of the cleft and your job — it is agreed at the examination.
How much does pilonidal sinus surgery cost? It depends on whether the sinus is only opened, removed under local or general anaesthesia, or removed with a flap — prices are in the table above.
How much does the result depend on care after the procedure? The larger the procedure, the more it depends on it, but it always does. Healing takes weeks and months and happens almost entirely at home, so the instructions you receive when you go home, about the wound, physical activity and the scar, are part of the procedure, not a recommendation.
Medical review: doctors of Poliklinika Barbel · October 2026.