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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 .
Pelvic organ prolapse (POP) is characterized by descent of pelvic organs from their normal positions into the vagina. In women, the condition usually occurs when the pelvic floor collapses after gynecological cancer treatment, childbirth or heavy lifting. [ 2 ]
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.
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.
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]
After elective surgery, the 30-day mortality rate for inguinal or femoral hernia repair stands at 0.1 percent, but it increases to 2.8 to 3.1 percent after urgent surgery. [42] When a bowel resection is part of the hernia repair, the mortality rate is even higher. [ 43 ]
POCD is just as likely to occur after operations under regional anesthesia as under general anesthesia. [2] [4] More likely after major operations than minor operations. [9] [11] More likely after heart operations than other types of surgery. [9] [11] More likely in aged than in younger patients. [9] [11] More likely in older patients with high ...
The certification applies to somatic death, corresponding to death of the person, which has varying definitions but most commonly describes a lack of vital signs and brain function. [9] Death at the level of cells, called molecular death or cell death , follows a matter of hours later. [ 10 ]