Robotic Assisted Repair Of A Perineal Bladder Hernia

You have accessJournal of UrologyIncontinence & Female Pelvic Medicine/Reconstructive Surgery (V01)1 Sep 2021V01-06 ROBOTIC ASSISTED REPAIR OF A PERINEAL BLADDER HERNIA Dmitry Volkin and Christopher Tarnay Dmitry VolkinDmitry Volkin More articles by this author and Christopher TarnayChristopher Tarnay More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001970.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Perineal hernias are relatively uncommon but certainly may be encountered by the urologist or pelvic reconstructive surgeon. Diagnosis and management of these unusual hernias is limited to case reports in the literature. Our aim was to provide a video guide demonstrating our technique of how to successfully repair such a hernia. METHODS: This is a video presentation of a 70 year old female patient who developed lower urinary tract symptoms and a palpable mass in her right buttocks. Imaging confirmed a bladder hernia in the right ischiorectal fossa. She underwent repair of her hernia via a robotic assisted abdominal approach, which confirmed a large defect in the levator muscle bordered medially by the vagina and bladder. We also perform a brief review of the literature on perineal hernias and review possible sites of herniation of the bladder. RESULTS: The patient underwent a patch repair of the hernia with soft polypropylene mesh cut to approximately the size of the defect but she recurred 6 weeks later. Repeat operation revealed a medial detachment of her mesh patch. A second repair was performed utilizing a larger piece of mesh, anchoring it more broadly to the levator musculature laterally and pubic bone anteriorly. The patient’s immediate post-operative course was complicated by a retroperitoneal hematoma that was managed conservatively. She was free of hernia recurrence 1 year after her second operation. CONCLUSIONS: Perineal hernias are within the scope of practice of the urologist and pelvic reconstructive surgeon. They can successfully be repaired with reduction of the hernia and application of a broad mesh patch. Source of Funding: Not applicable © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e63-e63 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dmitry Volkin More articles by this author Christopher Tarnay More articles by this author Expand All Advertisement PDF downloadLoading ...