Recurrent Perineal Hernia After Benign Pelvic Reconstructive Surgery

Abstract

Abstract Background: Secondary acquired perineal hernias are rare events usually associated with extensive pelvic surgery. Although most are asymptomatic, when symptoms are present surgical intervention is warranted. There is currently no consensus regarding the management of these hernias. An unusual case of a recurrent perineal hernia following sacrospinous fixation resulting in large bowel incarceration is reported. Case: A 64-year-old woman presented with an anterior vaginal wall prolapse and multiple pelvic-floor defects. She subsequently underwent a sacrospinous fixation and enterocele repair. The enterocele recurred and she underwent a second enterocele repair. Approximately 6 months later, she presented with a perineal hernia that involved an incarceration of the large bowel. Results: The hernia was reduced, the pelvic-floor defect was repaired, and a biologic, absorbable mesh was applied. Approximately 5 months later, the patient presented with a recurrence of the perineal hernia. The hernia was ...