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perineal (pe-ri-nee-ăl) adj. relating to the perineum. p. descent abnormal bulging down of the perineum due to weakness of the pelvic floor muscles. p. pouch see ileal pouch. p. repair see colporrhaphy. p. tear (p. trauma) any injury to the perineum, which may be sustained during childbirth. It may involve only the perineal muscles (second-degree tear), the external and internal anal sphincters (third-degree tear), or the anal sphincters and rectal mucosa (fourth-degree tear).