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We report on a rare case of massive incarcerated inguinoscrotal bladder herniation in a direct hernia and present the review of the literature on urological findings in relation to the inguinal hernial sac. The English-based literature was searched using the words inguinal hernia, bladder, ureter, diverticule, and incarceration and discussed in relation to the present case. We found 190 cases of inguinal hernia associated with urological findings, such as herniation of the bladder, ureter, and diverticulum. We also found that 11.2% of these hernias were associated with urological malignancies and 23.5% of these were associated with a variety of complications. The high-risk patients, who are males, obese, older than 50 years and who have symptoms that indicate urological pathologies to a physician, are more likely to be in the high-risk group for bladder herniation.

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Postoperative care units are run by an anesthesiologist or a surgeon, or a team formed of both. Management of postoperative fluid therapy should be done considering both patients' status and intraoperative events. Types of the fluids, amount of the fluid given and timing of the administration are the main topics that determine the fluid management strategy. The main goal of fluid resuscitation is to provide adequate tissue perfusion without harming the patient. The endothelial glycocalyx dysfunction and fluid shift to extracellular compartment should be considered wisely. Fluid management must be done based on patient's body fluid status. Patients who are responsive to fluids can benefit from fluid resuscitation, whereas patients who are not fluid responsive are more likely to suffer complications of over-hydration. Therefore, common use of central venous pressure measurement, which is proved to be inefficient to predict fluid responsiveness, should be avoided. Goal directed strategy is the most rational approach to assess the patient and maintain optimum fluid balance. However, accessible and applicable monitoring tools for determining patient's actual fluid need should be further studied and universalized. The debate around colloids and crystalloids should also be considered with goal directed therapies. Advantages and disadvantages of each solution must be evaluated with the patient's specific condition.