Using the uterus to close a pelvic defect after primary perineal posterior hernia repair: Report of a case

Abstract

Perineal hernias rarely develop spontaneously, and their treatment is controversial. We report a case of a primary perineal posterior hernia in an 81-year-old woman, who presented with progressive bulging in the perineal area, preventing comfortable excretion. The diagnosis was established by herniography. We operated via an abdominal approach and repaired the hernia by reconstructing the pelvic floor using the uterus. To our knowledge, reconstruction using the uterus to repair a pelvic defect has not been reported before.

Update in the management of secondary perineal hernia: personal experience with a series of 11 cases

“…El uso de materiales protésicos en el tratamiento de las hernias surgió ante la necesidad de contar con procedimientos sencillos que permitieran aumentar la resistencia de los tejidos y evitar la tensión en las estructuras vecinas al defecto herniario. La colocación de mallas puede realizarse por vía abdominal o perineal, y estas pueden ser sintéticas o biológicas[49][50][51][52] .La mayoría de los autores aconsejan cubrir el área del defecto herniario con mallas de polipropileno o compuestas9 .La reparación por vía abdominal se recomienda para las HPS, sobre todo cuando aparecen después de cirugías oncológicas, ya que es posible explorar la cavidad en busca de metástasis o recidiva tumoral.Otra indicación de la reparación abdominal son las HP recidivantes o alguna enfermedad asociada, como el prolapso rectal9 . Pélissier E y cols 53.…”

The Uterine Flap: An Option for Autogenous Repair of Perineal Hernia after Abdominoperineal Resection

“…1 Congenital perineal hernias are rare, and acquired perineal hernias can be primary or secondary. [1][2][3] Primary acquired perineal hernias result from increased intraabdominal pressure, five times more commonly in women than men because of the broader pelvis and weakening of the pelvic floor during pregnancy and childbirth. 1,2 Secondary acquired perineal hernias are incisional hernias associated with extensive pelvic operations, most commonly seen after abdominal perineal resection of the anorectum.…”

“…1,2 Secondary acquired perineal hernias are incisional hernias associated with extensive pelvic operations, most commonly seen after abdominal perineal resection of the anorectum. [1][2][3] Perineal hernias are an infrequent complication after abdominoperineal resection, with prevalence rates of less than 1 per cent historically, but increasing in recent series of laparoscopic extralevator abdominoperineal excision. 2 Significant pain, intestinal obstruction, skin erosion, or dysuria necessitate the surgical repair of a perineal hernia.…”

“…2 Significant pain, intestinal obstruction, skin erosion, or dysuria necessitate the surgical repair of a perineal hernia. [1][2][3] Multiple approaches for perineal hernia repair have been described. [1][2][3][4] Repair can be accomplished via transabdominal, perineal, or combined abdominoperineal approaches.…”

“…[1][2][3] Multiple approaches for perineal hernia repair have been described. [1][2][3][4] Repair can be accomplished via transabdominal, perineal, or combined abdominoperineal approaches. This includes primary defect closure along with the application of synthetic mesh, biological mesh, or a myocutaneous flap.…”