Alvarez Garzón Horacio J, Maubon Thomas, Jauffret Camille, Vieille Pierre, Fatton Brigitte, de Tayrac Renaud
Department of Urology, Hospital Privado Centro Medico de Córdoba, Argentina.
Department of Obstetrics and Gynaecology, Nîmes University Hospital, Nîmes, France.
Int Braz J Urol. 2017 Sep-Oct;43(5):982-986. doi: 10.1590/S1677-5538.IBJU.2016.0534.
Perineal hernia is a protrusion of intra-abdominal viscera through a defect in the pelvic floor and is a rare but challenging complication after extensive abdominoperineal surgery. There have been small series published after colorectal exenteration, but no cases have been reported after radical cystectomy and urethrectomy.
A 68 years old woman developed an anterior perineal hernia, with no vaginal prolapse, after an anterior exenteration for bladder cancer. A perineal approach with the use of a synthetic polypropylene mesh was chosen to resolve the condition. After 6 months of follow-up, the patient has no symptoms or recurrence of the anterior perineal hernia.
To our knowledge, this case is the first report of perineal hernia after radical urethrocystectomy. Although being a case report, this article describes a potential and challenging complication after extensive anterior pelvic surgery, that could increase its incidence in the future. Literature review shows that whether perineal, abdominal or combined approach is chosen, surgery must respect hernia repair principles.
会阴疝是腹腔内脏器经盆底缺损处突出，是广泛腹会阴手术后一种罕见但具有挑战性的并发症。结直肠癌根治性切除术后有少量病例系列报道，但根治性膀胱切除术和尿道切除术后尚无病例报告。
一名68岁女性在因膀胱癌行前盆腔脏器清除术后出现无前阴道脱垂的前会阴疝。选择采用合成聚丙烯网片的会阴入路来解决该问题。经过6个月的随访，患者无前会阴疝症状或复发。
据我们所知，该病例是根治性尿道膀胱切除术后会阴疝的首例报告。尽管这是一篇病例报告，但本文描述了广泛前盆腔手术后一种潜在且具有挑战性的并发症，未来可能会增加其发生率。文献综述表明，无论选择会阴、腹部还是联合入路，手术都必须遵循疝修补原则。
