Coccygeal Fistula


Coccygeal fistulae (Pilonidal Fistula) are cysts which form under the skin in the gluteal folds. The cause of the formation of these cysts in many cases is a broken hair which due to the rubbing of the skin, forms or grows. These foreign bodies are encapsulated by the formation of a cyst and can be severely infected by the bacteria of an ingrown hair. An abscess can result.


Coccygeal fistulae can be both acute and chronic. An acutely infected coccygeal fistula needs rapid treatment. When chronic coccygeal fistula present no problems, they can first of all remain untreated and the necessary treatment can be planned accordingly. They do however, need to be regularly examined by a doctor.

An acutely inflamed coccygeal fistula

Pain in the coccyx area, especially when sitting or in the lying position can point to an infected coccygeal fistula. The affected area and the fistula tissue are red and sensitive to pressure. The curve between the buttocks feels warm and is painful to touch. When a so called fistula has formed, an unpleasant smelling liquid filled with blood or pus can leak into the gluteal fold area.

Chronic Coccygeal Fistula

Coccygeal Fistula can also be chronic. This does not immediately result in a painful complaint but can appear at any time. When the coccygeal fistula has already developed, it can lead to pus secreting from the wound and this is inevitably very painful. An examination by a doctor is urgently required. Even feelings of pressure can be an indication of a coccygeal fistula. In order to avoid infection, an early trip to the surgeon is strongly advised. Painful infections can be timely avoided by undergoing the gentle procedures which the treatment of fistula requires.


The anamnesis interview as well as the typical optical appearance of an inflamed coccygeal fistula make the diagnosis easy and clear. If necessary, to see the depth of infection, a bulb-headed probe is introduced into the fistula where the tissue and tract to the infected cyst is inspected.


According to the severity of infection, there are different procedures to treat a coccygeal fistula. It is important to treat both the infection and the fistula. Various procedures can help those affected to sit comfortably and free of pain again.

  • FiLaC – minimal-invasive Laser therapy
  • Pit-Picking according to Bascom
  • Karydakis Flap Surgery