Perineal hernia

Source: Wikipedia, the free encyclopedia.
Perineum in humans
The muscles of the male perineum
The muscles of the female perineum
Anatomical terminology

Perineal hernia is a

bladder. It is known to occur in humans, dogs, and other mammals, and often appears as a sudden swelling to one side (sometimes both sides) of the anus
.

A common cause of perineal hernia is surgery involving the perineum.[

levator ani muscle and disease of the pudendal nerve may also contribute to a perineal hernia.[medical citation needed
]

In humans

In humans, a major cause of perineal hernia is perineal surgery without adequate reconstruction. In some cases, particularly surgeries to remove the coccyx and distal sacrum, adequate reconstruction is very difficult to achieve. The posterior perineum is a preferred point of access for surgery in the

tumors including sacrococcygeal teratoma, and coccygectomy. Perineal hernia is a common complication of coccygectomy in adults,[1][2] but not in infants and children (see coccygectomy
).

The standard surgical technique for repair of perineal hernia uses a prosthetic mesh,

orthopedic anchoring system,[4] a gluteus maximus muscle flap,[1][5] an acellular human dermis graft,[5] and an acellular pig collagen graft.[6]

In dogs and cats

Advanced perineal hernia on the left side in a dog. The overlying skin is already blueish.

In dogs, perineal hernia usually is found on the right side.

Boxers, Australian Kelpies, Boston Terriers, Collies, Dachshunds, Old English Sheepdogs, and Pekingese.[9] Perineal hernias are rare in female dogs and uncommon in cats
.

Dogs with benign prostatic hyperplasia have been found to have increased relaxin levels and suspected subsequent weakening of the pelvic diaphragm.[10] In cats, perineal hernias are seen most commonly following perineal urethrostomy surgery or secondary to megacolon.[11] Medical treatment consists of treatment of the underlying disease, enemas, and stool softeners. Because only about 20 percent of cases treated medically are free of symptoms, surgery is often necessary.[11] Recurrence is common with or without surgery.

Several surgeries have been described for perineal hernias in dogs. The current standard involves transposition of the internal obturator muscle. This technique has a lower recurrence and complication rate than traditional hernia repair. A new technique uses porcine small intestinal submucosa as a biomaterial to help repair the defect. This is can also be done in combination with internal obturator muscle transposition, especially when that muscle is weak.[12]

References

  1. ^
    PMID 9207665
    .
  2. PMID 9840311
    .
  3. PMID 10743431
    .
  4. S2CID 10049165
    .
  5. ^
    S2CID 33604955
    .
  6. PMID 18439796
    .
  7. PMID 12184704
    .
  8. ^ Seim, Howard B., III (2004). "Perineal Hernia Repair". Proceedings of the 29th World Congress of the World Small Animal Veterinary Association. Retrieved 2007-03-25.{{cite web}}: CS1 maint: multiple names: authors list (link)
  9. ^ "Perineal Hernia". The Merck Veterinary Manual. 2006. Retrieved 2007-03-25.
  10. S2CID 5754439
    .
  11. ^ a b Hoskins, Johnny D. (September 2006). "Anorectal Disease". DVM. Advanstar Communications: 8S–10S.
  12. ISBN 1-4160-0110-7
    .
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