All Topics  
Perineal hernia

 

 
   Email Print
   Bookmark   Link
 

 

Perineal hernia
 
 
  Topics Perineal hernia Topic Home

Perineal hernia is a hernia
Hernia

A hernia is a wiktionary:protrusion of a Biological tissue, structure, or part of an organ through the muscle tissue or the biological membrane by which it is normally contained....
 involving the perineum
Perineum

In human anatomy, the perineum is generally defined as the surface region in both males and females between the pubic symphysis and the coccyx. The perineum is the region of the body inferior to the pelvic diaphragm and between the legs....
 (pelvic floor
Pelvic floor

The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis....
). The hernia may contain fat
Fat

Fats consist of a wide group of compounds that are generally soluble in organic solvents and largely insoluble in water. Chemistry, fats are generally ester of glycerol and fatty acids....
, any part of the intestine
Intestine

In anatomy, the intestine is the segment of the Gastrointestinal tract extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine....
, the rectum
Rectum

The rectum is the final straight portion of the large intestine in some mammals, and the Gastrointestinal tract in others, terminating in the anus....
, or the bladder
Urinary bladder

In anatomy, the urinary bladder is a solid, muscle, and distensible organ that sits on the pelvic floor in mammals. It is the organ that collects urine excreted by the kidneys prior to disposal by urination....
. It is known to occur in human
Human

A human being, also human or man, is a member of a species of bipedalism primates in the family Hominidae . Mitochondrial DNA evidence indicates that modern humans originated in east Africa about 200,000 years ago....
s, dog
Dog

The dog is a domesticated subspecies of the Gray Wolf, a member of the Canidae family of the order Carnivora. The term is used for both feral and pet varieties....
s, and other mammals, and often appears as a sudden swelling to one side (sometimes both sides) of the anus
Anus

The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to expel feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest, such as coprolite ; food material after all the nutrients have b...
.

A common cause of perineal hernia is surgery involving the perineum. Perineal hernia can be caused also by excessive straining to defecate (tenesmus
Tenesmus

Tenesmus is a feeling of incomplete defecation. It is experienced as an inability or difficulty to empty the bowel at defecation. It is frequently painful and may be accompanied by involuntary straining and other gastrointestinal symptoms....
). Other causes include prostate
Prostate

The prostate is a compound tubuloalveolar exocrine gland of the male mammalian reproductive system. Females do not have a prostate gland, although females do have tiny paraurethral Skene's glands connected to the distal third of the urethra in the prevaginal space that are homologous to the prostate....
 or urinary disease, constipation
Constipation

Constipation, costiveness, or irregularity, is a condition of the digestive system in which a person experiences hard feces that are difficult to expel....
, anal sac
Anal glands

The anal glands or anal sacs are small, paired sacs located on either side of the anus between the Sphincter ani externus muscle and Sphincter ani internus muscle....
 disease (in dogs), and diarrhea
Diarrhea

In medicine, diarrhea, also spelled diarrhoea , is characterized by frequent loose or liquid bowel movements. The spelling of "diarrhea" is an appropriation of the Greek "diarrhoia" meaning "a flowing through." ....
.






Discussion
Ask a question about 'Perineal hernia'
Start a new discussion about 'Perineal hernia'
Answer questions from other users
Full Discussion Forum



Encyclopedia


Perineal hernia is a hernia
Hernia

A hernia is a wiktionary:protrusion of a Biological tissue, structure, or part of an organ through the muscle tissue or the biological membrane by which it is normally contained....
 involving the perineum
Perineum

In human anatomy, the perineum is generally defined as the surface region in both males and females between the pubic symphysis and the coccyx. The perineum is the region of the body inferior to the pelvic diaphragm and between the legs....
 (pelvic floor
Pelvic floor

The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis....
). The hernia may contain fat
Fat

Fats consist of a wide group of compounds that are generally soluble in organic solvents and largely insoluble in water. Chemistry, fats are generally ester of glycerol and fatty acids....
, any part of the intestine
Intestine

In anatomy, the intestine is the segment of the Gastrointestinal tract extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine....
, the rectum
Rectum

The rectum is the final straight portion of the large intestine in some mammals, and the Gastrointestinal tract in others, terminating in the anus....
, or the bladder
Urinary bladder

In anatomy, the urinary bladder is a solid, muscle, and distensible organ that sits on the pelvic floor in mammals. It is the organ that collects urine excreted by the kidneys prior to disposal by urination....
. It is known to occur in human
Human

A human being, also human or man, is a member of a species of bipedalism primates in the family Hominidae . Mitochondrial DNA evidence indicates that modern humans originated in east Africa about 200,000 years ago....
s, dog
Dog

The dog is a domesticated subspecies of the Gray Wolf, a member of the Canidae family of the order Carnivora. The term is used for both feral and pet varieties....
s, and other mammals, and often appears as a sudden swelling to one side (sometimes both sides) of the anus
Anus

The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to expel feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest, such as coprolite ; food material after all the nutrients have b...
.

A common cause of perineal hernia is surgery involving the perineum. Perineal hernia can be caused also by excessive straining to defecate (tenesmus
Tenesmus

Tenesmus is a feeling of incomplete defecation. It is experienced as an inability or difficulty to empty the bowel at defecation. It is frequently painful and may be accompanied by involuntary straining and other gastrointestinal symptoms....
). Other causes include prostate
Prostate

The prostate is a compound tubuloalveolar exocrine gland of the male mammalian reproductive system. Females do not have a prostate gland, although females do have tiny paraurethral Skene's glands connected to the distal third of the urethra in the prevaginal space that are homologous to the prostate....
 or urinary disease, constipation
Constipation

Constipation, costiveness, or irregularity, is a condition of the digestive system in which a person experiences hard feces that are difficult to expel....
, anal sac
Anal glands

The anal glands or anal sacs are small, paired sacs located on either side of the anus between the Sphincter ani externus muscle and Sphincter ani internus muscle....
 disease (in dogs), and diarrhea
Diarrhea

In medicine, diarrhea, also spelled diarrhoea , is characterized by frequent loose or liquid bowel movements. The spelling of "diarrhea" is an appropriation of the Greek "diarrhoia" meaning "a flowing through." ....
. Atrophy
Atrophy

Atrophy is the partial or complete wasting away of a part of the body. Causes of atrophy include poor nourishment, poor circulatory system, loss of hormone support, loss of nerve supply to the target Organ , disuse or lack of exercise or disease intrinsic to the tissue itself....
 of the levator ani muscle and disease of the pudendal nerve
Pudendal nerve

The pudendal nerve is a somatic nerve in the pelvic region that innervates the external genitalia of both sexes, as well as sphincters for the urinary bladder and the rectum....
 may also contribute to a perineal hernia.

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 pelvic cavity
Pelvic cavity

The pelvic cavity is a body cavity that is bounded by the bones of the pelvis and which primarily contains reproductive organs, the urinary bladder, and the rectum....
, particularly in the presacral space
Presacral space

In human anatomy, the presacral space is inside the pelvis, behind the rectum and in front of the coccyx and sacrum. Normally it is empty, or it contains a pocket of fat....
. Surgeries here include repair of rectal prolapse
Rectal prolapse

Rectal prolapse normally describes a medical condition wherein the walls of the rectum protrude through the anus and hence become visible outside the body....
 and anterior meningocele, radical perineal prostatectomy
Radical perineal prostatectomy

Radical perineal prostatectomy is a surgery wherein the prostate gland is removed through an incision in the area between the anus and the scrotum ....
, removal of tumor
Tumor

A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells . Tumor is not synonymous with cancer. A tumor can be Benign neoplasm, Carcinoma in situ or malignant, whereas cancer is by definition malignant....
s including sacrococcygeal teratoma
Sacrococcygeal teratoma

Sacrococcygeal teratoma is a teratoma located at the base of the coccyx . It is thought to be a derivative of the primitive streak....
, and coccygectomy
Coccygectomy

Coccygectomy is surgery to remove the coccyx, e.g. for patients with coccyx pain . Typically, surgery is reserved for patients with cancer or those whose tailbone pain has failed to respond to nonsurgical treatment ....
. Perineal hernia is a common complication of coccygectomy in adults, but not in infants and children (see coccygectomy
Coccygectomy

Coccygectomy is surgery to remove the coccyx, e.g. for patients with coccyx pain . Typically, surgery is reserved for patients with cancer or those whose tailbone pain has failed to respond to nonsurgical treatment ....
).

The standard surgical technique for repair of perineal hernia uses a prosthetic mesh, but this technique has a high rate of failure due to insufficient anchoring. Promising new techniques to reduce the rate of failure include an orthopedic anchoring system, a gluteus maximus muscle flap, an acellular human dermis graft,, and an acellular pig collagen graft.

In dogs and cats

In dogs, perineal hernia usually is found on the right side. Most cases are in older intact (not neutered
Neutering

Neutering, from the Latin neuter , is the removal of an animal's reproductive organ, either all of it or a considerably large part. It is the most drastic surgical procedure with sterilization purposes....
) male dogs (93 percent in one study). Breeds that may be at risk include Welsh Corgi
Welsh Corgi

The Welsh Corgi is a Dog type of small herding dog that originated in Wales....
s, Boxer
Boxer (dog)

Developed in Germany, the Boxer is a dog breed of stocky, medium-sized, short-haired dog. The coat is smooth and fawn or brindled, with or without white markings....
s, Australian Kelpie
Australian Kelpie

The Kelpie is an Australian sheep dog successful at Muster and droving with little or no command guidance. They are medium-sized dogs and come in a variety of colours....
s, Boston Terrier
Boston Terrier

The Boston Terrier is a dog breed of dog of the Terrier dog Dog type, originating in the United States of America....
s, Collie
Collie

A collie is a distinctive type of herding dog, ultimately originating in Great Britain, especially in the upland areas of the north and west....
s, Dachshund
Dachshund

The dachshund is a short-legged, elongated dog breed of the hound family. Variations of the pronunciation include d?ks'hoont, -h?nt, -h?nd, -?nd, d?ks-, d?ks-, d??-), the breed's name is German language and literally means "badger dog", from [der] Dachs, "badger", and [der] Hund, "dog"....
s, Old English Sheepdog
Old English Sheepdog

The Old English Sheepdog is a large dog breed of dog which was developed in England from very old herding dog dog type of dog. The Old English Sheepdog has very long coat covering the face and eyes....
s, and Pekingese
Pekingese

The Pekingese or Peke is an ancient dog breed of toy dog, originating in China. They were the favored pet of the Chinese sovereign court, and the name relates to the city of Beijing where the Forbidden City resides....
. Perineal hernias are rare in female dogs and uncommon in cat
Cat

The cat , also known as the Domestication cat or house cat to distinguish it from other Felinae and Felidae, is a small predationy carnivore species of crepuscular mammal that is valued by humans for its companionship and its ability to hunt vermin, snakes, scorpions, and other unwanted household pests....
s.

Dogs with benign prostatic hyperplasia
Benign prostatic hyperplasia

Benign prostatic hyperplasia also known as nodular hyperplasia, benign prostatic hypertrophy or benign enlargement of the prostate refers to the increase in size of the prostate in middle-aged and elderly men....
 have been found to have increased relaxin
Relaxin

Relaxin is a peptide hormone that was first described in 1926 by Frederick Hisaw.The relaxin-like peptide family belongs in the insulin superfamily and consists of 7 peptides of high structural but low sequence similarity; relaxin-1 , 2 and 3, and the insulin-like peptides, INSL3, INSL4, INSL5 and INSL6....
 levels and suspected subsequent weakening of the pelvic diaphragm. In cats, perineal hernias are seen most commonly following perineal urethrostomy
Urethrostomy

Urethrostomy is a surgical procedure that creates a permanent opening in the urethra, commonly to remove obstructions to urine flow. The procedure is most often performed in male cats, where the opening is made in the perineum....
 surgery or secondary to megacolon
Megacolon

Megacolon is an abnormal dilatation of the colon that is not caused by mechanical obstruction. The dilatation is often accompanied by a paralysis of the peristalsis movements of the bowel....
. Medical treatment consists of treatment of the underlying disease, enema
Enema

An enema is the procedure of introducing liquids into the rectum and Colon via the anus. Enemas can be carried out for medical reasons as a remedy for encopresis, as part of alternative health therapies, as punishment, and also for eroticism purposes, particularly to prepare for anal sex, and as part of BDSM activities....
s, and stool softeners. Because only about 20 percent of cases treated medically are free of symptoms, surgery is often necessary. 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
Obturator internus muscle

The obturator internus muscle originates on the medial surface of the obturator membrane, the ischium near the membrane, and the rim of the pubis ....
. This technique has a lower recurrence and complication rate than traditional hernia repair. A new technique uses porcine
Pig

Pigs, also called hogs or swine, are a genus of even-toed ungulates within the Family Suidae. The name pig, hog, or swine most commonly refers to the Domestic pig in everyday parlance, but technically encompasses several distinct species, including the Wild Boar....
 small intestinal
Small intestine

In vertebrates, including mammals, reptiles, birds, and bony fish, the small intestine is the part of the gastrointestinal tract following the stomach, and is where the vast majority of digestion takes place....
 submucosa
Submucosa

In the gastrointestinal tract, the submucosa is the layer of dense irregular connective tissue that supports the mucosa, as well as joins the mucosa to the bulk of underlying smooth muscle ....
 as a biomaterial
Biomaterial

The development of biomaterials is not a new area of science, having existed for around half a century. The study of biomaterials is called biomaterial science....
 to help repair the defect. This is can also be done in combination with internal obturator muscle transposition, especially when that muscle is weak.