Review of Postoperative Perineal Hernia and Available Reconstruction Techniques

Abstract

Postoperative Perineal hernia (PerH) is a recognised rare complication of radical pelvic oncologic procedures for rectal cancer, with a reported prevalence of 0.6-7%. PerH is a swelling in the perineum caused by herniation of abdominal or pelvic viscera through a defect in the pelvic floor. The cause of postoperative PerH is not known, however, wide extent of dissection, wound infection, neoadjuvant radiotherapy, length of small bowel and wider female pelvis, have been identified as risk factors for development of postoperative PerH. Cause of PerH is not known. Universal case definition of PerH does not exist, except it is a bulge in the perineum. Patients who are fit for surgery, have no recurrency, and are bothered or have severe symptoms (perineal swelling, perineal skin necrosis, urinary problems and/or intestinal obstruction) are offered surgical treatment. The aim of surgical repair is to exclude recurrency, closure of the pelvic defect with reconstruction of a new pelvic floor and repair of hernia.