Gender differences in pilonidal disease
*Ashley Stoeckel, *Gheed Murtadi, *Madelyn McArthur, *Kathleen Renzi, *Rachael Cohen, David Mooney
General Surgery, Boston Children's Hospital, Boston, MA, United States.
Background: We studied the effect of gender on the age of onset, mental health comorbidities, disease severity, quality of life impact, interventions, and outcomes of pilonidal disease in adolescents.
Study design: Prospectively collected data on demographics, mental health comorbidities, disease severity, quality of life impact, interventions, and outcomes were retrieved from a Pilonidal Clinic REDCap database.
Results: Of 1,356 patients evaluated, 562 (41%) were female and 794 male. The average age of disease onset was 14.5 years for females and 16.9 years of males. Females had a higher incidence of diagnosed depression (8.9% vs 7.1%) and anxiety (15.5% vs 10.3%) with a lower incidence of attention deficit (7.49% vs 10.6%). Females presented with less severe disease than males (66% vs 65% mild, 21% vs 33% moderate, and 3% vs 10% severe). Females presented less frequently with dehiscence from prior operation (3.2% vs 8.1%). Total quality of life impact was more severe for females (3.77) than males (3.08) with greater impacts in pain (5 vs 3), embarrassment (4 vs 3) and disruption of routine (4 vs 3). More females underwent pit picking on their first clinic visit (33.1% vs 26.7%), with similar rates of laser follicle ablation (52.8% vs 54.9%). Females and males experienced similar program graduation rates (19.2% vs 22.9%) and of ongoing care (28.6% vs 23.9%).
Conclusion: Pilonidal disease has an earlier onset, higher rate of mental health comorbidities, lower disease severity and greater impact on quality of life in females. Initial clinic visit treatments and outcomes are comparable.
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