Abstract
Perineal hernia is a rare disorder that develops after pelvic surgery or trauma. The etiology is unknown, but reported contributing factors include wound infection, diabetes, long-term steroid administration and length of the mesentery of the small intenstine. We experienced a case of recurrent perineal hernia developed 15 months after transperitoneal surgical repair by a dual faced mesh (Composix EX mesh), for which we performed transperineal repair using a Kugel patch. Hard tissue was used for circumferential anchoring, including the coccyx and the bilateral ischial tuberosity. The hernia was approached from the perineal wound and the hernia sac was identified. Detachment of the hernia sac from the surrounding tissue was carried out while displacing the sac toward the abdominal cavity with gauze. A M-sized (11cm×14cm) Kugel patch was detained in under lay, and fixed to the coccyx, the bilateral ischial tuberosity and transverse perineal muscles, using non-absorbable sutures. The recurrent hernia was accompanied by bladder prolapse, and therefore weakness of the pelvic floor was suspected as a predisposing factor. We herein report such a case and review the relevant literature.
