A perineal hernia is defined as a protrusion of intra-abdominal viscera through a pelvic floor defect, and it can be classified as primary (congenital or acquired) or secondaiy (postoperative). The latter type may occur with rare frequency after abdominoperineal resection or pelvic exenteration, which was first recognized by Yeoman in 1939. Although many of these secondaiy hernias remain asymptomatic and undiscovered, the occasional case becomes symptomatic and requires elective surgical repair. The most common presenting symptoms in this context include a nonspecific dragging sensation and discomfort on standing. Less frequent but more specific symptoms such as pain, urinary problems, intestinal obstruction, or erosion of overlying perineal skin may occur, as well. It has been reported more recently that asymptomatic patients may not require surgical treatment due to the relatively poor long-term success of pelvic floor repair.
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