Perineal hernia has been described as a failure of the muscular pelvic diaphragm to support the rectal wall, resulting in herniation of pelvic and occasionally abdominal viscera into the subcutaneous perineal region.1 Urinary bladder retroflexion occurs in 18% to 25% of affected dogs.2–4
Internal obturator muscle transposition is considered the gold standard technique for treatment of perineal hernia, with long-term success rates > 90%.1,5–7 Many other surgical techniques for treatment of perineal hernia have been proposed, including muscle appositional technique,8 superficial gluteal muscle transposition,9 semitendinosus flap creation,10 use of implants (synthetic mesh, porcine dermal collagen, porcine small intestinal submucosa, or fascia lata graft),11–14 and pexy of the colon, urinary bladder, and ductus deferens during a laparotomy.4,15,16,a Colopexy, cystopexy, and ductus deferens pexy are almost always performed in combination with other techniques. They have been described as an adjunct to perineal herniorrhaphy when UBR or rectal prolapse is present, with some different effects on long-term success rate.4,15,16,a Urinary bladder retroflexion with perineal hernia has been associated with a poor outcome, with mortality rates up to 30%.3,7,17 In another study,4 UBR was shown to have no effect on outcome.4 Therefore, the purpose of the study reported here was to retrospectively evaluate the effects of UBR and surgical technique on postoperative complication rates and long-term outcome of dogs treated for perineal hernia.
Internal obturator muscle transposition
Initial laparotomy procedure plus internal obturator muscle transposition
Urinary bladder retroflexion
Huber DJ, Seim HB, Goring RL. Cystopexy and colopexy for the management of large or recurrent perineal hernias in the dog: 11 cases (1994 to 1997) (abstr). Vet Surg 1997;26:418.
JMP, version 10, SAS Institute Inc, Cary, NC.
PDS II, Ethicon, Cornelia, Ga.
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