Please surgery is comming up..very scared!

Did anybody had Modifaed Karydakis with pits wery near anus

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Hi everybody
I have first pilonidal apcess when I was 18 -they lance it..painfull!Come back in 1 year same place but it burst itself.For long time I did not have any simptoms( for 30 years)...maybe same discomfort,unconfortable after long sating extr.Last year had infections(I have 4 pits in my crac and 2 hot infected) Got antibiotic at ER..and advise to remove it.Went for GP,private check up MRI ( come back excelent) blad ok extr..Gastroenterologist advise me to leave it and see how it goes as I have been loong without simptoms..
Well this sumer I got infections again..same sinuses..and got antibiotic( been on holiday)My apcess is on right hand side cheek..somwhear in the middle ..4 pits are in the midle of crack or lower3-4 cm above anus.On my way back to London went to see privately colorectal surgeon specialising in Pilonidals.
He advise me to go ahead with surgery( Modifaed Karydakis of line with wide exisions)or something like that..He also mentioned that is a bit tricky as sinuses are quite low ..3-4 cm abow anus..but said should be ok.Mind you his name is mentioned here in Surgeont hall of fame.He gave to me 90% reasurance it will be ok but with 10 % of posibilities of infections( it wories me as it is very near anus)
I have booked surgery for 24 of September but I am very scered to end up wit failed surgery ,infections, or unheald woond.Please help!One day,I want to go ahead,next I wont to cancel surgerie.In need of advice!!!


Very Helpful
Hi again suzana. I was worried about you so I went back to your first post and I thought you might like to know that when we first linked up with Asha Senapati my son was in the middle of his legal practice course and did not want surgery. She just kept an eye on it - seeing him every four months or so and that was reassuring that it was not getting worse. Then he had a really bad flare up and we knew it had to be done. But Ms Senapati would keep you as a patient until you decided what to do. You could also transfer to the NHS and go to the pilonidal centre to see her. Afer 30 years being fine I think I would also wait to see what happens if I were you but it sounds as though your problem might have just come to a head so to speak!!!! Unless your local GP can refer you to another cleft lifter I would not change surgeons though.


Hi Linda

I am going to stay with Asha...But most probably I will wait for the surgery.She sugest to me only Bascom pit and picking ( which is less invasive then the cleft ) .Buy sugesting that ,she said that Karydakis will be to invasive for me
as she tought that would be better to start with pits picking and then if that fails we will do cleft.

Interestingly, I am glad that I felt when I have seen first surgeon ( which is listed here on hole of fame anyway) and thanks that I read more about it..I desided to see Asha ..and I am glad I did.
When you see surgeon in general they are in frame of minde "cut,cut..." Anyway,Asha was great and said not need for cleft lift lets tray Bascom pits picking...
Well I will get 3 opinion and then if I have to do I will go eventualy with Asha


Hi Linda

Just to add up..First surgeon said Modifaed Karidakis ( but in addition letter send to my GP he just stated Karidakis flap with wide excision ) This is not my field and I would think Karydakis flap is easier to perform and is classic operations
Modifaed Karidakis is new tehnic ..well I said NO to that.
Asha opinion was tat it was not necessary to go ahead with cleft lift ( in a way is similar to Modifaed Karidakis but again is less invasive as Modifaed Karidakis removes the fat ,take out cist and goes to the bone..
Cleft lift is addressing skin problem and is creating flap wich goes over cleft and is pritty thin layer of the skin..
So I presume it is quicker heeling time..
Now ,she suggested Bascom pits picking..Wich is fair enough!
But I will get 3 opinion from NHS surgeon performing Bascom pit and picking..My GP said did I ask Asha can I leave it.
I said No.I did not usk her that question.
Bear in minde that my MRI scan results are excellent ( no cists,no apseses,no infections...)I am curently no on medications and I am ( my god :) 49 years old.
I have read that this lines is in decline when you get older and sometimes it's bur out itself( that would be great. :)
It is sensible to me leave it for a while and see what happens..In minhwile I will get 3 opinion.
Today is 21 st ..and originally I had seculed Karidakis operation for 24 th.
I can tell you I am glad that I did not go ahead wit that one !!!
At the moment I am in milde discomfort..but I might have that issue even after operation or even being worst off.
If I am very young I will think about it more seriously as all life is ahead...but the fact that this lines is less aggressive
when you get older the end If I get bad flare up all I need to take antibiotic and in matter of hourse schedule my operations.
It's big dessision to do operation and consequences are good and bad.Jurry is out on that one.
Something wich is not related to pilonidal sinus I had dilemma to do operation or not on my Sinuses in the head
They told me I have to do it..put me on corticosteroids stay ( wich cose me panic atac and hart palpitations ..nightmare ..
I stops medications and used homeopathic remedies and now I am completely 100%ok.
Of course that is not the case with the pilonidal sinus.As you noticed..usually young people are getting it (80%)
and I think hormones are part of it.When I am getting my period I feel my bum is irritating me more.
I am now perhaps premenopausal...
I am just trying to understand everything and not to my hush desission ..Bascom pits picking is relatively
simple operation...I am giving my self a couple of month to work on it and then make sure I am comfortable with
my desission..I do not think this couple of month will be an issue and the lines will develop much more.
Even when I have seen first surgeon he said to me that is not urgent and that I can do it after New Year.
Now ,everything in life is gamble and all depend how lacky we are ..and how it will tur out to be.
I have to order that cushion ( I do not know which one is the best ?,!?) and defenetly I will stay on Asha list as her patience ..she must have done a hell of a lot of this operation.
However, I am not hairy person ,not fat...but there you are. :( I got pilonidal sinus. I am going to look into
laser removal hair..
If anybody has done this I would like to have feed back about it.What about your son.
Sorry ,I went far to long..:)
We will see what happens .Wish your son pilo free time and hope he enjoy his life in full as any other young adult!