We report a case of a primary perineal posterior hernia in an 81-year-old woman, who presented with progressive bulging in the perineal area, preventing comfortable excretion. The diagnosis was established by herniography. We operated via an abdominal approach and repaired the hernia by reconstructing the pelvic floor using the uterus. To our knowledge, reconstruction using the uterus to repair a pelvic defect has not been reported before. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00595-008-4036-8Authors Mitsutsune Washiro, Suzaka Hospital Department of Surgery 1332 Ooaza Suzaka Suzaka, Nagano 382-0091 JapanHideharu Shimizu, Suzaka Hospital Department of Surgery 1332 Ooaza Suzaka Suzaka, Nagano 382-0091 JapanTatsusi Katakura, Suzaka Hospital Department of Surg...