A perineal hernia is a protrusion of organs and tissues into the abdominal cavity. It develops when the pelvic floor muscles become too weak to keep the organs and tissues in place. Typically, this type of hernia is caused by damage to the pelvic area muscles, which drives them to stretch and weaken over time.
The risk of developing a perineal hernia is higher after getting pelvic surgery, but other injuries and pregnancy can also drive its development. In some cases, a person can be born with a perineal hernia. The only treatment option available is surgery.
This article explains everything you should know about perineal herniasWhat Does Perineal Hernia Mean (and What Organs Does It Affect)?
Perineal hernias are rare types of hernias caused by weakness in the transverse perineal muscle. The word “perineal” is used to describe the perineum, which is the area between the anus and genitals. This can be either the scrotum or the vagina. When the muscle and skin in this area become weak, nearby organs and tissues can protrude through the muscle, leading to a visibly noticeable bulge in the pelvic region.
What Organs Are Affected by a Perineal Hernia?
Various organs can be affected by perineal hernias, including:
- Bladder
- Large and small intestine
- Omentum (layer of fat that covers the intestine, liver, and stomach)
- Uterus
Types of Perineal Hernia
Perineal hernias are characterized by whether they occur in front of or behind the pelvic diaphragm. When they are in front, they are referred to as anterior, and when they are in the back, they are referred to as posterior.
Related: Different Types of Hernia in Men
How Common Are Perineal Hernias?
Perineal hernias are incredibly rare. According to research, the type that develops following injury, illness, pregnancy, or surgery occurs in between 0.6 and 7% of people.
Related: Pelvic Pain in Men
What Causes Perineal Hernias?
Perineal hernias develop when the pelvic floor muscles and area become damaged. This damage can occur in various ways, including with pelvic surgeries, injuries, illnesses, or pregnancy.
Having open surgery (surgery that requires a large incision in the abdomen) is correlated with the development of perineal hernias. During this type of surgery, the pelvic floor muscles are stretched to the point of weakening.
During pregnancy, pressure on the pelvic region can also drive the weakening of the muscles and lead to a perineal hernia. Congenital perineal hernias are also rare but can occur if the development of the perineal cavity does not occur properly in the womb. In some cases, experiencing chronic constipation or straining while having a bowel movement can also drive the development of a perineal hernia.
Risk Factors for Hernia
The factors that increase a person’s risk of developing a hernia include:
- Heavy lifting
- Strain on the abdominal wall
- Chronic cough
- Pregnancy
- Surgical procedures
Which Surgeries Increase the Risk of a Perineal Hernia?
There are several pelvic surgeries correlated with the heightened risk of developing a perineal hernia, including:
- Abdominal resection, which involves removing the anus, rectum, and part of the large intestine to treat rectal or anal cancer
- Low anterior resection to remove cancer from the rectum through an incision made in the lower abdomen
- Pelvic exenteration, which removes the rectum and nearby organs such as the uterus, bladder, or prostate to treat various types of pelvic cancers
What Are the Symptoms of a Perineal Hernia?
In some cases, a person with a perineal hernia won’t experience any symptoms. However, when they do develop, the hernia will present with:
- Bowel obstructions
- Difficulty urinating or having a bowel movement
- Feeling a pulling sensation or discomfort when in a standing position
- Pain in the area
- Swelling or bulging in the area, often in one butt cheek or near the anus
- Topical skin erosion
Related: Groin Pain When Walking: 8 Possible Causes
How Are Perineal Hernias Diagnosed?
Since perineal hernias are visible, the diagnostic process will start with a physical exam. A healthcare provider will also evaluate a person’s medical history to determine if they fall into any of the high-risk categories, such as those who have recently undergone major pelvic surgery.
