PMC6351357_01
Most of the pelvic floor was closed with single knots, a small defect was left anterior to the urethra.
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PMC6351357_01_gr1.jpg
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A significant part of the musculature of the pelvic floor was intact, and was closed with single knot Ethibond 2-0 sutures in a posterior to anterior direction, leaving a small defect anterior to the urethra (Fig. 1).
Mesh placement and subsequent fixation to the pelvic floor with single knots at 0, 90, 180 and 270 .
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PMC6351357_01_gr2.jpg
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The mesh was circular with a 12-cm diameter, and was sutured to the muscles of the pelvic floor with four Ethibond single knots at 0, 90, 180 and 270  (Fig. 2).
The edge of the mesh was approximated to the peritoneum with a running suture.
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The edge of the mesh was approximated to the peritoneum with running V-loc 3-0 sutures (Fig. 3).
Image of the hernia (a) preoperatively and (b) postoperatively at 3 months follow-up.
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At the next follow-up visit at 3 months postoperative, the patient reported no bulging and experienced no symptoms (Fig. 4).