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Hello. Thanks for the question.
A perineal hernia is fixable with surgery. The question would be, how well is the prostate cancer controlled. If the cancer is in remission, then I would not have a problem with doing the perineal hernia surgery. If the prostate cancer is active and has been worsening, then I would probably not do the surgery. In that case, I would use stool softeners and manually remove any stool stuck in the herniated rectum as needed.
It sounds like he is stable enough to do the surgery. He's not the greatest surgical candidate, but he should tolerate surgery and post-op care well.
I hope this helps, let me know if you have any other questions.
If there is a possibility of bladder entrapment, then this is an emergency. I would go in within the next 6-12 hours to get this assessed. I would definitely not wait until Monday. If it's a hernia with bladder entrapment, then sometimes we can pass a catheter to empty the bladder and let it fall out. Other times we have to surgically remove it- that is less common.
The surgery to repair a hernia is typically going to be in the 1000-2500 range. The lower if done by a general practice vet. Higher if done by a boarded surgeon.