The prevention and treatment of the persistent perineal sinus.

There is a high reported incidence of persistent perineal sinus after proctectomy for inflammatory bowel disease. The cause and prevention are discussed. In a consecutive series, persistent perineal sinuses occurred in 4 of 17 patients with Crohn's colitis, and in none of 20 patients with ulcerative or unclassified colitis (1 died soon after operation). The technique is described for patients with a sinus persisting for more than 6 months, using total excision, primary closure, and suction drainage. Six of 7 patients so treated healed primarily and the seventh healed within 2 weeks. In males, sexual dysfunction was often decreased.