Hello, In most cases, an operation will be advised. There are various operations which are done to cure this problem. Your surgeon will be able to give the details and the pros and cons of each operation. The options include the following: Wide excision and healing by secondary intention. This operation involves cutting out (excision of) the sinus but also cutting out a wide margin of skin which surrounds the sinus. The wound is not closed but just left open to heal by natural healing processes (healing by secondary intention ). This usually requires several weeks of regular dressing changes until it heals fully. The advantage of this method is that all inflamed tissue is removed and the chance of the condition coming back (a recurrence) is low. Excision and primary closure. This means taking out the section of skin which contains the sinus. This is done by cutting out an oval-shaped (ellipse) flap of skin either side of the sinus, which takes out the sinus. The two sides of the ellipse are then stitched together. The advantage for this is, if successful, the wound heals quite quickly. The risk of a recurrence or of developing a wound infection after the operation is higher than with the above procedure. This risk may be reduced by using a wound technique in which the line of stitches is moved away from between the buttocks. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sanjay Kini