What Is a Perineal Hernia Surgery?
Perineal hernia is a condition in which abdominal contents protrude into the perineal region adjacent to the anus. The exact cause is not known, but it is thought that hormones may be involved in weakening of the muscles around the anus. This condition almost always affects non-neutered male dogs. Perineal hernia surgery is the surgical repair of the hernia.
What Are the Indications for Performing a Perineal Hernia Surgery?
Surgery is indicated in perineal hernias that involve the urinary bladder or intestines. Some veterinarians prefer to delay surgery until straining or herniation of abdominal contents occurs.
What Preoperative Examinations or Tests Are Needed?
Preoperative tests depend in part on the age and general health of the animal. Most often, blood count, serum biochemical tests, and urinalysis are recommended. In some situations, more extensive tests, such as radiographs and possibly an EKG may be necessary.
What Type of Anesthesia is Needed For a Perineal Hernia Surgery?
As in a human patient, the procedure requires general anesthesia to induce complete unconsciousness, immobility, and relaxation. Usually, the pet will receive a pre-anesthetic sedative-analgesic drug to help him relax, an intravenous anesthetic to induce unconsciousness and allow placement of a breathing tube in the windpipe, and subsequently inhalation anesthesia (volatile anesthetic in oxygen) during the actual surgery.
How Is the Perineal Hernia Operation Done?
Following anesthesia, the pet is placed on a surgical table, lying on his stomach or side. The hair is clipped around the area of the anus and the skin is scrubbed with surgical soap to disinfect the area. A sterile drape is placed over the surgical site. A scalpel is used to incise the skin alongside the anus over the hernia. Even if a hernia is located on both sides of the anus, usually only one side is operated at a time. Any abdominal contents are pushed back into the abdomen and the defect in the muscles is then sutured closed. The most common repair involves the use of a muscle flap, created from pelvic muscle, to cover the defect. Sutures (stitches) that dissolve over time are used to close the deeper tissue layers. The outer layer of skin is closed with sutures or surgical staples; these need to be removed after about 10 to 14 days. In intact males, castration is performed to help reduce the risk of reoccurrence.
How Long Does the Perineal Hernia Operation Take to Perform?
The procedure takes about one to two hours to perform in most cases, including the needed time for preparation and anesthesia. In some cases, the procedure can take longer and may require the expertise of a board certified surgeon.
What Are the Risks and Complications of a Perineal Hernia Operation?
The overall risk of this surgery is low. The major risks are those of general anesthesia, bleeding (hemorrhage), post-operative infection, and wound breakdown (dehiscence). The most common complications associated with perineal hernia repair are fecal incontinence, hernia reoccurrence, or straining. The serious complication rate is low.
What Is the Typical Postoperative Care For Perineal Hernia Surgery?
Postoperative medication should be given to relieve pain, which is mild to moderate in most cases. Pain can be effectively controlled with safe and effective pain medicines. Home care requires reduced activity until the stitches are removed in 10 to 14 days. The suture line should be inspected daily for signs of redness, discharge, swelling, or pain. Most dogs need stool softeners to help reduce straining.
How Long Is the Hospital Stay Following Perineal Hernia Surgery?
The typical hospital stay for perineal hernia is one to two days, but this will vary depending on overall health of your pet.