Groin hernias are extremely common surgical pathologies and usually contain intra-abdominal viscera surrounded by peritoneum. Femoral hernias are the least common types of hernia and are predominately found in females. In rare cases, an extraperitoneal organ may be pulled into the hernia sac to become part of the content. Urinary bladder diverticulum should be considered as a possible femoral hernia content in elderly patients presenting with recurrent symptoms of lower urinary tract infections and hematuria. A high index of suspicion followed by appropriate imaging assists in making a correct preoperative diagnosis and improves postoperative outcomes. We present an uncommon case of herniation of a urinary bladder diverticulum into a femoral hernia presenting with recurrent hematuria in an elderly female.
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