perineal hernia
Introduction
Introduction to the perineum The abdominal visceral organs are separated from the perineum by the muscles and fascial space at the base of the pelvis, which is called perineal hemia. The perineum is the soft tissue structure of the closed pelvic outlet below the basin. The connection of the ischial tuberosity on both sides will be divided into two triangles: the front is called the urogenital triangle, which is closed for urogenital sputum, the male has urethra, the female has urethra and The vagina passes; the back is called the anus triangle, which is closed by the pot and has a rectum. There is a weak point between the pelvic floor appendix and the pubic tail muscle, and most of the ticks pass through this gap. basic knowledge The proportion of illness: 0.002% Susceptible people: good for women Mode of infection: non-infectious Complications: bloating
Cause
Cause of perineal sputum
(1) Causes of the disease
The perineal sputum is induced by factors such as weak pelvic floor muscles, decreased tension, multiple births, pelvic tumors and other pelvic pressures.
(two) pathogenesis
According to the relationship between sputum and perineal transverse muscle, it is divided into the former perineal sputum and the posterior perineum.
1. The anterior perineal sac is passed through the levator ani muscle and protrudes from the urogenital aponeurosis in front of the perineal transverse muscle. The sputum is almost only seen in women. Because of the different parts of the sputum, it can be divided into genital warts and vaginal fistulas. The labia sputum, the contents of the sputum can be the small intestine or the sigmoid colon, and usually a part of the bladder, almost all can be reset.
2. After the perineum is in the male, the sac is descending from the rectum and the bladder, appearing in the rectal fossa or the perineum close to the middle seam. In the female, the sputum is pulled out from the levator ani muscle or the levator ani muscle and the coccygeal muscle. , can appear in the ischial rectal fossa, and can continue to swell and bulge in the lower edge of the gluteus maximus. Therefore, it should be differentiated from the ischial sac, and the patient will increase when standing. If the pregnancy can cause dystocia, it will be cloudy. Less common than the former, both men and women can occur, but women are far more than men.
Prevention
Perineal prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
1. Develop good habits, stop smoking and limit alcohol. Smoking, the World Health Organization predicts that if people no longer smoke, after five years, the world's cancer will be reduced by 1/3; secondly, no alcohol. Smoke and alcohol are extremely acidic and acidic substances. People who smoke and drink for a long time can easily lead to acidic body.
2. Don't eat too much salty and spicy food, don't eat food that is overheated, too cold, expired and deteriorated; those who are frail or have certain genetic diseases should eat some anti-cancer foods and high alkali content as appropriate. Alkaline foods maintain a good mental state.
Complication
Perineal complications Complications
When the block is small, it is located in one side of the labia majora or next to the anus, protruding forward, sometimes painful or discomfort in sexual life. The mass gradually increases with the progress of the disease, occupying one side of the perineum. It is even reported that the life of the child is extremely inconvenient, but incarceration or strangulation is rare. When the block is small, it is located in one side of the labia majora or next to the anus, protruding forward, sometimes painful or discomfort in sexual life.
Symptom
Symptoms of perineal sputum Common symptoms Painful labia majora or anus large... Female genital perineum appears red...
Perineal sputum is rare in clinical practice. It usually occurs in women. It can have multiple pregnancy or childbirth or pelvic tumors. For example, patients often have self-reported perineal masses, standing, walking fast or intra-abdominal. When the pressure is increased (labor force, coughing or forced bowel movement), it disappears after lying down or pushing the mass by hand. When the block is small, it is located in one side of the labia majora or next to the anus, protruding forward, sometimes painful. Or sexual life has discomfort, the mass gradually increases with the progress of the disease, occupying one side of the perineum, and even some reports such as the size of the head of the child, life is extremely inconvenient, but rarely incarcerated or strangulated.
Medical examination:
It can be seen on the side of the labia majora or the anus. It is soft and has no tenderness. The surface is intact and there is no redness. The supine position is easy to retract. The cough has an impulse and the force is increased. Intra-abdominal pressure can make the labia majora bulge or mass reappear, the vagina, the attachment is normal, and the pelvic floor tissue is more relaxed.
Examine
Check of the perineum
B-ultrasound, X-ray gastrointestinal angiography and CT scan can assist in diagnosis.
Diagnosis
Diagnosis of perineal sputum
Diagnostic criteria
History
Female patients have multiple births or diseases that cause increased pelvic pressure; in the labia majora or by the anus, reversible masses appear, which occur when standing upright or intra-abdominal pressure, and disappear when lying down.
2. Signs
On the side of the labia majora or anus can touch the soft, painless mass; abdominal pressure appears, can be manually reset, the impact test is positive.
3. Auxiliary inspection.
Differential diagnosis
The disease is extremely rare in clinical practice, often misdiagnosed as a labia majora cyst (Pap's cyst), ischial tuberosity cyst, ischial hernia, cold abscess, hematoma, lipoma, etc., should be noted to identify with it.
