Welcome & Good evening Your concern is 1. Pilonidal sinus issue 2. Surgery 1and half year before 3. It's recurrence at same place & very painful 4. You don't want surgery right now 5. You want temporary solution In this context I want to confirm one thing that is weather the pilonidal sinus has been opened and discharging or it is closed and there is collection inside what we call is abscess. It can be very painful only when Pilonidal sinus is closed and not discharging.

For the time being you can go for incision and drainage. On return back,go for permanent solution surgery

Mri and followed by surgery

as it's a repeat fistula .. do mri sinogram need to know which surgery was done before..

You need to get mri sinogram to delineate all the primary and secondary tracks,based on that treatment plan can be made

There are many procedures which can solve your issues permanently. Consult over call to know more about it.