Chao-Yuan Chang, Chung-You Tsai, Shyi- Chun Yii,  Shiu-Dong Chung

Divisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan

 

腹股溝膀胱疝氣—以全腹膜外腹腔鏡修補術治療
張肇元、蔡宗佑、俞錫全、鍾旭東
亞東紀念醫院外科部泌尿科

 

BACKGROUND:
  Urinary bladder herniation is an uncommon condition, encountered in 1% to 4% of all inguinal
hernias. Inguinoscrotal bladder hernias often go unrecognized preoperatively. Accurate diagnosis can be readily established radiologically and/or with cystoscopy. Resection of bladder tissue is rarely indicated.

 

OBJECTIVES:
  Understanding of regional anatomy is essential when assessing and managing inguinal hernias. This case study aims to present a rare condition of inguinal hernia with bladder herniation and the surgical management of this uncommon case. We also reviewed related literature.

 

CASE REPORT:
  We present a case report of a patient who suffered form right inguinaoscrotal protruding mass for over 1 year. Patient complained that the hernia engorged while bladder distention and when micturition. CT scan revealed bladder wall thickening and protruding into groin region. We performed flexible cystoscopy and total extraperitoneal (TEP) hernioplasty for this patient. Direct bladder inguinal hernia was noted intra-operatively. Smooth recovery was reported during outpatient clinic follow-up.

 

CONCLUSION:
  Inguinoscrotal bladder hernias are rare. Radiology exam and cystoscopy can help with accurate diagnosis. The TEP hernioplasty is a feasible and safe option when encountering this uncommon condition.

 

REFERENCES:
1. Kate H. K, Sarah S, Aaron S. F, Chad W.M. R, Muta M. I et al. Inguinoscrotal bladder hernias: report of a series and review of the literature. Can Urol Assoc J 2008;2(6):619-23
2. HL She, KC Lam, KK Wong, Wendy WM Lam et al. Urinary bladder inguinal hernia: an uncommon cause of scrotal swelling. Hong Kong Med J 2014;20:351.e1-2