ISSN 2398-2942      

Perineum: hernia repair

icanis
Contributor(s):

Rachel Burrow

Laura Owen


Introduction

  • Repair of a perineal hernia using the internal obturator muscle transposition technique.

Uses

Advantages

  • This technique allows closure of the hernia using local, autogenous tissues. It achieves a more robust closure of the ventral part of the defect with less tension on the sutures and reduced deformity of the anus compared to the traditional/anatomic re-apposition technique.

Disadvantages

  • The internal obturator transposition technique is technically more difficult than the traditional anatomic re-apposition technique.
  • The local muscles used in the repair may be severely atrophied which makes repair with all techniques using these muscles tenuous and more difficult.
  • Penetration of a suture through the rectal wall or anal sac may cause a perineal abscess and discharging sinus
  • Inclusion of the sacrotuberous ligament in the repair can cause sciatic nerve injury.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Fair to good when hernia repair is performed by an experienced surgeon.
  • Retroflexion of the bladder worsens the prognosis.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Szabo S, Wilkens B, Radasch R M (2007) Use of polypropylene mesh in addition to internal obturator transposition: a review of 59 cases (2000-2004). JAAHA 43 (3), 136-142 PubMed.
  • Bongartz A, Carofiglio F, Balligand M et al (2005) Use of autogenous fascia lata graft for perineal herniorrhaphy in dogs. Vet Surg 34 (4), 405-413 PubMed.
  • Brissot H N, Dupré G P, Bouvy B M (2004) Use of laparotomy in a staged approach for resolution of bilateral or complicated perineal hernia in 41 dogs. Vet Surg 33 (4), 412-421 PubMed.
  • Gilley R S, Caywood D D, Lulich J P et al (2003) Treatment with a combined cystopexy-colopexy for dysuria and rectal prolapse after bilateral perineal herniorrhaphy in a dog. JAVMA 222 (12), 1717-1721 PubMed.
  • Stoll M R, Cook J L, Pope E R et al (2002) The use of porcine small intestinal submucosa as a biomaterial for perineal herniorrhaphy in the dog. Vet Surg 31 (4), 379-390 PubMed.
  • Hosgood G, Hedlund C S, Pechman R D et al (1995) Perineal herniorrhaphy: perioperative data from 100 dogs. JAAHA 31 (4), 331-342 PubMed.
  • Popovitch C A, Holt D, Bright R (1994) Colopexy as a treatment for rectal prolapse in dogs and cats: a retrospective study of 14 dogs and cats. Vet Surg 23 (2), 115-118 PubMed.
  • Sjollema B E, van Sluijs F J (1989) Perineal hernia repair in the dog by transposition of the internal obturator muscle. II. Complications and results in 100 patients. Vet Q 11 (1), 18-23 PubMed.
  • van Sluijs F J, Sjollema B E (1989) Perineal hernia repair in the dog by transposition of the internal obturator muscle. I. Surgical technique. Vet Q 11 (1), 12-7 PubMed.

Other sources of information

  • Cheryl S Hedlund & Theresa Welch Fossum (2007)Surgery of the Digestive System: perineal hernia.In: Fossum (ed):Small Animal Surgery,3rd ed. Mosby, St. Louis, pp 515-520.
  • Christopher R Bellenger & Rhonda B Canfield (2003)Perineal Hernia.In: Slatter (ed):Textbook of Small Animal Surgery, 3rd ed, Saunders, Saunders, pp 487-498.

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