The saxophonist's hernia: a rare case report of anterior primary perineal hernia in a young male patient.

Perineal hernia is the protrusion of an intra-abdominal structure into the perineal area, that could be primitive or secondary to trauma or abdominoperineal resection. Main treatment could be transabdominal, transperineal or combined. Here is a rare case of anterior perineal hernia in a young saxophone male patient, treated with a mininvasive perineal approach. A 25-year-old Caucasian male patient referred 1-year history of perineal pain. The pain was more severe when he played his saxophone. Local exam was negative but a dynamic perineal ultrasonography revealed a small anterior perineal hernia. The defect was repaired with a polypropylene plug and the patient was discharged the day after. At one year, no signs of remission have been signalled. Perineal mesh hernioplasty of primary perineal hernia is technically feasible, is associated with rapid recovery and minimal complications, and has a good long-term outcome. The use of ultrasonography to detect the hernia could be considered the best choice whenever it is of small size. Ultrasonography allow to identify weakness areas, reducing diagnostic time and avoiding further costs.