Inguinoscrotal herniation of the bladder: A rare case of obstructive uropathy

Abstract

Inguinoscrotal herniation of the bladder is a rare presentation of inguinal hernia that can result in significant complications if untreated. We describe a case of an elderly male with a delayed presentation of bladder herniation resulting in severe acute kidney injury requiring urgent placement of nephrostomy tubes. Ultimately surgery is required for definitive management.

Incarcerated inguinal hernia containing urinary bladder and bladder calculi

“…Inguinal hernia containing bladder is an uncommon presentation, frequently quoted at rates of 1–5% of all hernias [ 1–3 ]. Risk factors include older age, male sex, obesity, weakened abdominopelvic musculature and chronic bladder outlet obstruction, with resulting enlargement of the urinary bladder causing it to come into proximity of the hernia orifices [ 1 , 5 ]. Although inguinal bladder hernia is often described as an asymptomatic incidental finding, general surgeons should have a high index of suspicion when patients present with an inguinal hernia and associated lower urinary tract symptoms.…”

“…Although inguinal bladder hernia is often described as an asymptomatic incidental finding, general surgeons should have a high index of suspicion when patients present with an inguinal hernia and associated lower urinary tract symptoms. Cases described in the literature include symptoms such as difficulty initiating urination, double voiding and incomplete micturition [ 1 , 3 , 5 , 6 ]. Some cases presented with urinary retention, obstructive uropathy with acute renal failure and sepsis from urinary tract infection [ 2 , 3 , 5 ].…”

“…Cases described in the literature include symptoms such as difficulty initiating urination, double voiding and incomplete micturition [ 1 , 3 , 5 , 6 ]. Some cases presented with urinary retention, obstructive uropathy with acute renal failure and sepsis from urinary tract infection [ 2 , 3 , 5 ]. To our knowledge, this is one of the first reported cases in the literature where inguinal bladder hernia was present in a person with long term urinary catheter and with bladder calculi preventing reduction of the hernia.…”