In 2012,
the incidence of pilonidal cysts and tailbone fistulas in Germany was around
48/100,000 inhabitants. For unknown reasons, the number of people affected by
fistulas is increasing. This is shown by figures collected from the German
Armed Forces (mainly young men): in 1985 the figure was 30/100,000, but rose to
a remarkable 240/100,000 in 2007.
The tailbone
fistula is usually noticeable between the 2nd and 3rd decade of life, mainly in
men below the age of 40. Men are affected 2.2 times as often as women. In 2013,
a study was conducted to determine whether hormone levels might play a role as
risk factors for the development of a fistula. Hormone levels were compared in
men with and without tailbone fistula, and no differences were found. However,
women with a tailbone fistula had elevated prolactin levels (prolactin is
produced in the pituitary gland, especially during pregnancy and lactation).
Pilonidal
cysts and tailbone fistulas do not necessarily cause symptoms such as pain,
abscesses or leakage of wound secretion or pus. Sometimes the cysts and
fistulas are simply present, do not cause any symptoms and are discovered by
chance. There are also figures for this: During the Second World War, over
77,000 American soldiers underwent pilonidal sinus surgery, and another 9000
were found to have tailbone fistulas without any symptoms. A more recent study
from Turkey showed that 8.8% of 1,000 soldiers had a fistula during the initial
examination, 4.8% had symptoms and 4.0% had no symptoms.
The
pilonidal cyst occurs predominantly in people of European descent, rarely in
black-skinned people. In Asian countries the disease pattern is rarely
observed, in China it is said to be completely unknown.
Literature
sources:
Akinci OF, Bozer M et al (1999) Incidence and aetiological factors in pilonidal sinus among Turkish
soldiers. Eur J Surg 165:339–342
Casberg, MA (1949) Infected pilonidal cysts and
sinuses. Bull U S Army Med Dep 9:493–496
Chijiwa T, Suganuma T et al (2006) Pilonidal sinus
in Japan maritime self-defense force at Yokosuka. Mil Med 171:650–652
Da Silva JH (2000) Pilonidal cyst: cause and treatment. Dis Colon Rectum 43:1146–1156
Doll D, Friederichs J et al (2008) Surgery for asymptomatic pilonidal sinus disease. Int J Colorectal
Dis 23:839–844
Evers T, Doll D et al (2011) Trends in incidence
and long-term recurrence rate of pilonidal sinus
disease and analysis of associated influencing
factors. Zhonghua Wai Ke Za Zhi 49:799–803
Lee HC, Ho YH et al (2000) Pilonidal disease in
Singapore: clinical features and management. Aust N Z J Surg 70:196–198
Özkan Z, Aksoy N et al (2013) Investigation of the relationship between serum hormones and pilonidal sinus disease: a cross-sectional study. Colorectal Dis 16:311–314
Sondenaa K, Andersen E et al (1995) Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis 10:39–42
