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A cul-de-sac hernia (also termed a peritoneocele) is a herniation of peritoneal folds into the rectovaginal septum (in females), [2] or the rectovesical septum (in males). The herniated structure is the recto-uterine pouch (pouch of Douglas) in females, [ 2 ] or the rectovesical pouch in males.
Perineal hernia is a hernia involving the perineum (pelvic floor). The hernia may contain fluid, fat , any part of the intestine , the rectum , or the bladder . It is known to occur in humans , dogs , and other mammals, and often appears as a sudden swelling to one side (sometimes both sides) of the anus .
When operating a pelvic organ prolapse, introducing a mid-urethral sling during or after surgery seems to reduce stress urinary incontinence. [13] Transvaginal repair seems to be more effective than transanal repair in posterior wall prolapse, but adverse effects cannot be excluded. [14] According to the FDA, serious complications are "not rare ...
Mechanistically, the causes of pelvic floor dysfunction are two-fold: widening of the pelvic floor hiatus and descent of pelvic floor below the pubococcygeal line, with specific organ prolapse, graded relative to the hiatus. [10] People with an inherited deficiency in their collagen type may be more likely to develop pelvic floor dysfunction.
An obturator hernia is a rare type of hernia, encompassing 0.07-1% of all hernias, [2] of the pelvic floor in which pelvic or abdominal contents protrudes through the obturator foramen. The obturator foramen is formed by a branch of the ischial (lower and back hip bone) as well as the pubic bone.
Chronic pelvic pain is a common condition with rate of dysmenorrhoea between 16.8 and 81%, dyspareunia between 8-21.8%, and noncyclical pain between 2.1 and 24%. [ 30 ] According to the CDC , Chronic pelvic pain (CPP) accounted for approximately 9% of all visits to gynecologists in 2007. [ 31 ]
After pelvic exenteration, many patients will have perineal hernia, often without symptoms, but only 3–10% will have perineal hernia requiring surgical repair. [4] Many problems can occur with the stoma. [1] Bowel obstruction may occur, or the anastomosis created by the surgery may leak. [1] The stoma may retract, or may prolapse. [1]
Abnormal descent of the pelvic floor can also be a sign of pelvic floor weakness. Abnormal descent manifests as descending perineum syndrome (>4 cm perineal descent). [5] This syndrome initially gives constipation, and later FI. The pelvic floor is innervated by the pudendal nerve and the S3 and S4 branches of the pelvic plexus.