Inguinoscrotal bladder hernias: report of a series and review of the literature

Abstract

Bladder involvement occurs in 1%-4% of cases of inguinal hernias. Among obese men aged 50 to 70, the incidence may reach 10%.1,2 The diagnosis of bladder involvement is often difficult to delineate at the time of presentation and may only become apparent at the time of herniorrhaphy. Surgical management pertaining to the approach, repair and potential need for bladder resection may challenge the surgeon. We report a series of 4 cases of large inguinoscrotal bladder hernias and provide a literature review. Our goal is to highlight the clinical presentation and the decisive issues surrounding the diagnosis and management of this condition.

Fig. 1

Preoperative appearance of right inguinal hernia in patient 1 (A) and result after surgical repair (B).

Fig. 2

Cystogram showing the bladder of patient 1 herniating through the right inguinal canal into the right hemiscrotum. The insert shows the cystoscopic appearance of the bladder as it entered the inguinal canal.

Fig. 3

An intravenous urogram showing the bladder of patient 2 herniating through the right inguinal canal into the right hemiscrotum.

Fig. 4

Serial computed tomography images showing the bladder of patient 2 herniating into the right inguinal canal. The arrow identifies the bladder surrounded by the spermatic cord within the lower part of the inguinal canal.