Perineal hernia surgery aims to repair a weakness in the pelvic floor. This weakness most commonly occurs in older, male dogs and results in protrusion of various abdominal organs like the prostate, bladder and intestine into the perineal area which surrounds the anal and urogenital canals. This commonly causes swelling on one or both sides of the anus and difficulty defaecating. If the bladder is herniated and the animal cannot urinate the condition becomes an emergency to treat.

The cause of pelvic floor weakness is not clear and is likely to be due to several factors including hormonal imbalances, prostatic disease, chronic constipation and straining due to other diseases.

Before surgery, the diagnosis must be confirmed. Your vet will do a physical examination including a rectal examination If your pet is in pain your vet may need to sedate or anaesthetise your pet. Occasionally an abdominal ultrasound, blood tests and urinalysis can provide more information.

Many dogs are initially managed non-surgically with stool softeners and a high fibre diet. While this may help in the short term it will not provide a permanent solution.

Once a dog is confirmed as a surgical candidate, a date for surgery will be arranged. This procedure is generally considered to be ‘non urgent’ however, if the patient cannot urinate or the bladder has herniated into the perineal area, the bladder should be drained immediately and surgery urgently arranged.

Surgery involves elevating a muscle flap from the pelvis to create a ‘sling’ to prevent the abdominal contents from herniating. Occasionally we also have to enter the abdomen to do a procedure called a ‘pexy’ to anchor some abdominal organs to the abdominal wall to prevent further herniation. All dogs are castrated as part of the hernia surgery as this significantly reduces the risk of hernia recurrence.

Resolution of the hernia is expected in up to 90% of patients but depends on experience of the surgeon, surgical technique used and if castration is concurrently performed.

WHAT CAN GO WRONG?

Whilst the vast majority of procedures result in success, there are a number of potential complications that can occur. Every step possible is taken along the way to minimise the risk of complications and therefore maximise the chances of a good outcome.

Potential complications include: straining, wound infection, recurrence, rectal prolapse and urinary tract problems (if the bladder is part of the hernia). Nerve injury resulting in temporary or permanent faecal incontinence or hind limb dysfunction is uncommon but can be very serious if it occurs.

Once a dog is confirmed as a surgical candidate, the surgery will be scheduled. Most dogs are well enough to go home within 24 hours of surgery. We supply antibiotics and pain relieving drugs.

Your dog will need to be kept indoors and wear an Elizabethan collar for two weeks to keep the wound clean. They can be taken outside for toileting as needed on a lead (so you can monitor defecation). After two weeks your dog should be fully recovered and can return to normal activity.

What you need to do BEFORE the day of surgery:

• Read the Post Surgery Care Instructions for Perineal Hernia Repair (link below).

• Have at least one easy to clean area to confine your dog to at home (eg a laundry, bathroom). You may need to purchase a gate and get your dog used to this new arrangement.

• Arrange a skin check, and if necessary, a pre-anaesthetic blood test, 7-10 days before surgery. If your dog has any skin lesions, a medicated body wash and antibiotics may be prescribed. If skin lesions are found on the day of surgery, this may result in the procedure being rescheduled to a later date due to the risk of infection.

• Wash your dog the weekend or day before surgery. This will reduce the time spent under anaesthesia cleaning your dog on the day of surgery.

• Consider “enrichment” for your dog in the postoperative recovery period (eg stuffed toys, sniffing games, food dispensing toys, chewing and licking time etc).

View, download or print these post surgery care instructions for Perineal Hernia Repair.