Dyspareunia Secondary to a Clitoral Pilonidal Sinus: A Case Report and Literature Review

Dyspareunia is a general term used to describe painful sexual intercourse. It can occur due to a variety of reasons ranging from structural problems to psychological concerns. Dyspareunia frequently occurs due to pelvic inflammatory disease, endometriosis, absence of lubrication and previous trauma. Additionally, eczema, hidradenitis or other skin diseases of the vulva may cause pain with intercourse. Pilonidal sinus is a common skin disease presenting with hair-nests and sinus tracts occurring in deep skin folds such as the inter-gluteal sulcus. A 30-year-old dark haired Asian housewife, gravid 1 para 1 was seen at the general surgery outpatient clinic with complaints of foul smelling thick umbilical discharge and dyspareunia. Dyspareunia due to clitoral pilonidal sinus can successfully be cured with early diagnosis, appropriate antibiotics and wide surgical excision of the lesion. Delay in diagnosis and treatment is associated with development of complications such as abscess formation, prolongs time to definitive treatment and affects the prognosis of the disease. In cases of swelling at the mons pubis, vulvar pain and unexplained dyspareunia observed in menstrual aged women, clitoral pilonidal sinus should be kept in mind as a potential cause. Herein, we present a young woman with dyspareunia secondary to clitoral pilonidal sinus.