Puberty is a major factor in pilonidal sinus disease. Gender-specific investigations of case number development in Germany from 2007 until 2015

Background. Pilonidal sinus disease is an acute abscess-forming or chronic subacute inflammation, characterized by a fistula system with typical ostia. Treatment is primarily surgical. Objective. This study aimed to investigate and evaluate the evolution of pilonidal sinus disease in Germany on the basis of data provided by the Federal Statistical Office in Germany (Statistisches Bundesamt). Material and methods. From the diagnosis data of hospital inpatients generated by the Federal Statistical Office in Germany the data on the International Classification of Diseases (ICD) code L05 for pilonidal sinus from 2007 to 2015 were extracted and processed. Results and discussion. The number of cases increased from 25,835 cases in 2007 to 31,033 cases in 2011, followed by a decrease to 30,235 cases in 2015. Considering the number of patients under 20 years of age, there was also an increase from 40 cases per 100,000 population in 2007 to 50 cases per 100,000 population in 2013. Ever since, the case numbers have remained relatively constant and have reached a plateau. The maximum number of case numbers was in the age group of 20-24 years. The female age group 10-14 years old is the only group among all investigated age groups with more cases than the respective male age group. The investigated data did not permit any epidemiological conclusions for pilonidal sinus disease because outpatient cases have not been included. The higher incidence in the female age group 10-14 years old could be explained by the earlier onset of adolescence. Thus, adolescence appears to have a major impact on the development of pilonidal sinus disease.