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Global Gender Differences in Pilonidal Sinus Disease: A Random-Effects Meta-Analysis

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Abstract

Background

Pilonidal sinus disease (PSD) is traditionally associated with young male patients. While PSD is rare in Asia and Africa, lifestyles are changing considerably throughout the so-called developed world. We question that PSD is an overwhelmingly male disease and that the proportion of women suffering from PSD is worldwide evenly distributed in a homogenous matter.

Methods

We analysed the world literature published between 1833 and 2018, expanding on the database created by Stauffer et al. Following correction for gender bias with elimination of men-only and women-only studies, data were processed using random-effects meta-analysis in the technique of DerSimonian and Laird.

Results

The share of female pilonidal sinus disease patients analysed from all studies available in the world literature is 21%. There are marked regional differences including South America (39%), North America as well as Australia/New Zealand (29%) and Asia (7%), which are highly significant. These results stand fast even if analysis without gender bias corrections was applied.

Conclusion

The share of female patients suffering from PSD is considerable. It is time to think of PSD as a disease of both men and women. Previously unknown, there are significant regional differences worldwide; the reason(s) for the regional differences is still unclear.

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Acknowledgements

We acknowledge the editorial assistance of Jeannie Wurz, Science Writer in the Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Funding

No funding or grants from any other funding agency in the public, commercial or not-for-profit sectors were received. There are no relevant or minor financial relationships between relatives or next of kin and external companies.

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Authors and Affiliations

  1. Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

    Markus M. Luedi

  2. Department of Anesthesiology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands

    Patrick Schober

  3. Department of Emergency Medicine, Lindenhof Group Bern, Bern, Switzerland

    Verena K. Stauffer

  4. Department of Procto-Surgery, St. Marienhospital Vechta, Academic Teaching Hospital of the MHH Hannover, Vechta, Germany

    Maja Diekmann & Dietrich Doll

Authors
  1. Markus M. Luedi
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  2. Patrick Schober
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  3. Verena K. Stauffer
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  4. Maja Diekmann
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  5. Dietrich Doll
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Contributions

PS, DD, MML and MD performed statistical analysis and calculations. PS, MML, VKS, DD and MD contributed to manuscript editing and interpretation of data. PS, DD, VKS, MML and MD were involved in manuscript writing and critical reviewing. PS, MD, DD and MML designed the graphics. MD and DD performed data acquisition.

Corresponding author

Correspondence to Dietrich Doll.

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Luedi, M.M., Schober, P., Stauffer, V.K. et al. Global Gender Differences in Pilonidal Sinus Disease: A Random-Effects Meta-Analysis. World J Surg 44, 3702–3709 (2020). https://doi.org/10.1007/s00268-020-05702-z

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