Abstract
Purpose
Postoperative perineal hernias are rare complications from procedures, which compromise the pelvic floor, mainly abdominoperineal resection, proctocolectomy, and partial or total pelvic exenteration. Surgical repair can be accomplished through abdominal, laparoscopic, or transperineal approaches.
Methods
We present a case report of a 70-year-old man who underwent two prior operations for recurrent perineal hernia and was ultimately successfully treated with a third operation, a synthetic mesh redo procedure that utilized a synthetic mesh system marketed for women with pelvic organ prolapse.
Results
Although there is no "gold standard" for perineal hernia repair, our patient had multiple surgeries employing a variety of approaches. Final success was achieved using a mesh system with improved fixation to secure pelvic ligaments, using an exclusive perineal approach. Now, more than five years following the final surgery, the patient remains symptom free with no clinical evidence of perineal hernia recurrence.
Conclusions
This is a preview of subscription content, log in via an institution to check access.
References
Aboian E, Winter DC, Metcalf DR, Wolff BG (2006) Perineal hernia after proctectomy: prevalence, risks, and management. Dis Colon Rectum 49(10):1564–1568
Abdul Jabbar AS (2002) Postoperative perineal hernia. Hernia 6(4):188–190
Yeomans FC (1939) Hernia, perineal and pudendal. Am J Surg 43:695–697
Hullsiek HE (1956) Perineal hernia after abdominoperineal resection. Am J Surg 92:735–738
So JB, Palmer MT, Shellito PC (1997) Postoperative perineal hernia. Dis Colon Rectum 40:954–957
Beck DE, Fazio VW, Jagelman DG, Lavery IC, McGonagle BA (1987) Postoperative perineal hernia. Dis Colon Rectum 30:21–24
Ruiz DE, Kaikin M, Vivas D, Newman M, Wexner SD (2007) Multimedia article. Recurrent postoperative perineal hernia: transperineal redo mesh repair. Dis Colon Rectum 50(7):1080–1081
Skipworth RJ, Smith GH, Anderson DN (2007) Secondary perineal hernia following open abdominoperineal excision of the rectum: report of a case and review of the literature. Hernia 11(6):541–545
Dulucq JL, Wintringer P, Mahajna A (2006) Laparoscopic repair of postoperative perineal hernia. Surg Endosc 20(3):414–418
Portilla AG, Martin E, de Lecea CM, Gomez C, Magrach L, Cendoya I, Uzquiza E (2010) Recurrent postoperative perineal hernia: laparoscopic redo mesh repair. Hernia 14(5):535–537
Connor CA, Noblett K, Lane FL (2007) Repairing perineal hernia. Am J Obstet Gynecol 197(5):554.e1–2
Gomez Portilla A, Cendoya I, Uzquiza E, Martin E, Martinez de Lecea C, Gomez C, Romero EE (2010) Giant perineal hernia: laparoscopic mesh repair complemented by a perineal cutaneous approach. Hernia 14(2):199–201
Gynecare Prolift® (2007) Ethicon, Somerville, NJ
Stamatiou D, Skandalakis JE, Skandalakis LJ, Mirilas P (2010) Perineal hernia: surgical anatomy, embryology and technique of repair. Am Surg 76(5):474–479
Conflict of interest
Dr. P. Copas Jr. reports that he serves as a consultant to Gynecare Worldwide. Dr. J. Berendzen reports no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Berendzen, J., Copas, P. Recurrent perineal hernia repair: a novel approach. Hernia 17, 141–144 (2013). https://doi.org/10.1007/s10029-011-0821-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10029-011-0821-1