Perineal hernias.

Perineal hernia is a protrusion of the intraabdominal viscera through a defect in the pelvic floor, and may be classified as primary (congenital or acquired) or secondary (postoperative). When symptomatic, surgical repair is warranted and may be performed using abdominal, perineal, combined abdominoperineal, or laparoscopic approaches. In rare instances, a primary repair may be performed, although in the majority of cases, successful repair of a perineal hernia requires the use of a synthetic graft, bioprosthetic graft, or autologous flap. This article reviews the classification, pathophysiology, diagnosis, and surgical management of perineal hernias.