Repair of symptomatic perineal hernia with a titanium mesh.
OBJECTIVE
Surgical repair of symptomatic perineal hernia is challenging, especially via a perineal approach with limited exposure of the hernia sac. Furthermore, insecure fixation of autologous or synthetic materials to bony structures often results in recurrence. Here, we describe the application of a titanium mesh for perineal hernia repair.


METHODS
We performed hernia repair with a thin titanium mesh via a perineal approach in three patients who developed secondary perineal hernia following abdominoperineal resection. After the hernia sac was isolated and dissected, the titanium mesh was molded and placed over the ischium and coccyx to support the pelvic floor.


RESULTS
No major complications occurred, and all three patients were free of recurrence at follow-up after 73, 109, and 6 months, respectively. The patients experienced slight pain in the perineal region when sitting, which resolved within 6 months.


CONCLUSIONS
Our successful preliminary results indicate that a titanium mesh is useful for perineal hernia repair by the perineal approach, as it can provide rigid support for the pelvic floor by its entire surface while ensuring stability without any fixation.
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University, 2-2 C11 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
Y
Y
Imagawa
K
K
Tomita
K
K
Kitahara
K
K
Yano
K
K
Hosokawa
D000368:Aged; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006547:Hernia / Q000209:etiology; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010502:Perineum / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D013526:Surgical Mesh; D014025:Titanium
D014025:Titanium