A Rare Case Report of Inguinal Herniation with Urinary Bladder as its Content

Background: Although inguinal hernias are common, cases of inguinal hernia involving the bladder were observed to be very rare (<5%). Diagnosis of Inguinal Bladder Herniation (IBH) is very challenging, and it was reported to be identified only in ≤10% of cases prior to an operation and ≤20% during surgical intervention. The majority of the patients are asymptomatic or have non-specific symptoms, making the condition difficult to diagnose pre-operatively. In many cases, the condition is usually diagnosed intraoperatively. Therefore, diagnosis, surgical planning, and careful management can play a vital role in avoiding any unwanted complications. Case Presentation: In the present case, a 60-year-old male patient with a known history of malignancy was presented to our hospital without any symptoms related to inguinal hernias. Conclusion: During his routine check-ups, the patient was fortuitously diagnosed with IBH. The patient underwent surgery, and the defect was repaired using Bassini hernioplasty without any complications. Postoperative recovery was uneventful. On follow-up, no pain or urinary-related symptoms were reported.

Isolated Herniation of the Bladder into the Inguinal Canal: A Rare Case Report

Herniation of the bladder towards the inguinal canal is a rare condition. A 76-year-old male patient with long-term left groin swelling was admitted to the emergency clinic complaining of abdominal pain that started about 5 hours ago. The patient, whose abdominal examination was normal, had an incarcerated hernia in the left inguinal region. On superficial ultrasonography, intestinal loop herniation in the left inguinal canal and adjacent loculated fluid of 60x20 mm in size was observed. In the computed abdominal tomography, it was determined that the majority of the bladder had passed through the left inguinal canal and into the hernia sac. Lichtenstein method hernioplasty was applied to the patient who was taken to emergency surgery. Isolated bladder herniation is an extremely rare condition. Recognition of bladder herniation in the preoperative period may prevent possible complications during surgery.

Presentation of a Rare Case: Acute Kidney Failure Developed Following Complete Urinary Bladder Herniation and Management of Postoperative Voiding Dysfunction

Inguinal bladder herniation is seen in 1% -4% of all inguinal hernia cases; most of them are asymptomatic and come up with swelling in the groin. In symptomatic cases, nonspecific findings such as lower urinary tract symptoms or pain due to strangulation of the hernia sac are seen. Two-stage micturition (manual pressure to the scrotum to empty residual urine) is a pathognomonic sign for the advanced case. Vesicoureteral reflux (VUR), bilateral hydronephrosis, urinary tract infection, acute kidney failure and bladder wall necrosis are complications that may be seen if the problem is not appropriately managed. Preoperative diagnosis rates are low (<7%) and 16% of the cases are diagnosed in the postoperative period, and most cases are detected intraoperatively. Radiologic examination performed for other indications such as non-contrast abdominal computed tomography (CT) may diagnose the bladder herniation. CT, cystography and ultrasonography are the techniques that can be used in the diagnosis and differential diagnosis. Intraoperatively, reduction of the herniated bladder with herniorrhaphy is a routine procedure. Partial cystectomy has to be made in case of bladder wall necrosis, presence of a tumor in the herniated bladder and narrow bladder neck which don"t allow reduction. In this case report, our aim is to explain the management of left inguinoscrotal complete bladder herniation and postoperative voiding problem.

Computed tomography urography findings of complete inguinoscrotal bladder herniation

Inguinoscrotal bladder herniation (IBH) is a rare type of inguinal hernia associated with significant urologic complications such as acute renal failure, hydronephrosis, obstructive uropathy, and sepsis. Diagnosis of this condition can be made with common imaging modalities including excretory urography, retrograde cystography, computed tomography (CT), and magnetic resonance imaging. We present the classic symptomatology and imaging findings of inguinoscrotal bladder herniation on CT urogram in two patients. Although the majority of IBH are diagnosed intraoperatively, radiologists and the surgical team should be aware of this diagnosis when working up a patient, as preoperative diagnosis is crucial to assist with surgical planning and avoid intraoperative complications. Level of evidence: 4.