The pilonidal sinus is an acquired disease caused by the penetration of broken hair in the gluteal fold. The hairs lead to inflammatory reactions in the subcutaneous fatty tissue, as a result of which a cyst-shaped pilonidal sinus develops. The actual fistulae then develop from this sinus.
Although predominantly acquired, the pilonidal disease can occur more frequently in the family. If, for example, siblings have a fistula, the probability of fistula formation is greater for a sibling who has previously been free of the disease than in families in which the disease was previously unknown. The probability of a renewed fistula formation after surgery is also significantly increased over an observation period of 25 years.
Studies have shown that in 12% of patients with a pilonidal cyst the disease already occurred in family members in the past. Fathers, mothers, siblings, aunts and uncles, grandfathers and grandmothers or even their own children were affected.
In just under 40% of patients with a family history, the pilonidal sinus reappeared after successful surgery (without a family history, depending on the surgical procedure: approx. 20% of cases). It does not matter who in the family had already developed the disease in the past.
The conclusion is that the more frequently a pilonidal cyst has occurred in family members in the past, the greater the probability that previously spared family members will develop the same problem and that the fistula will reoccur more frequently after surgery. Most fistula relapses occur in the first 5 years after surgery, especially in families with preexisting conditions, in up to 50% of cases.
Earlier studies showed that the younger the patient, the greater the risk of a fistula recurrence after the first operation. However, this applies almost exclusively to members of a predisposed family.
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