ABSTRACT
Primary perineal hernias are extremely uncommon but secondary perineal hernias, which are essentially another form of incisional hernia, are seemingly increasing in frequency. Conversely a posterior perineal hernia protrudes through a defect in the levator ani or between the levator ani and coccygeus muscles, presents as a perineal lump between the anus and ischial tuberosity lateral to the median raphe and occurs in males or females. The mesh is sutured to the back of the vagina or prostate, the presacral fascia and the lateral pelvic sidewalls which are the remnants of the levator ani using a permanent monofilament suture. When compared to the evidence for myocutaneous flap reconstruction the use of a biologic mesh appears to be comparable in terms of outcomes and complications, without the disadvantages of prolonged operative times and hospital stay, need for plastic surgical assistance, donor site complications and the longer-term risk of donor site incisional hernia.
