Complications of inguinoscrotal bladder hernias: a case series

Abstract

Although the urinary bladder is involved in 1-4% of all inguinal hernias, extensive inguinoscrotal herniation of the bladder, termed scrotal cystocele, is very rare. Most small asymptomatic bladder hernias are commonly encountered and reduced successfully via the same incision during elective inguinal hernia repair. However, larger bladder herniations can be associated with bladder infarction or obstruction, which require urgent intervention to preserve renal function and reduce morbidity and mortality. We present two cases of elderly men presenting with significant scrotal cystocele complications which necessitated urgent surgical intervention. We compare and contrast the two cases and discuss the presentation, investigation, diagnosis and treatment of these pathophysiological conditions.

A Rare Cause of Inguinal Herniation: Bladder Herniation Two Cases Report

“…The possible etiopathogenic factors for bladder hernias; chronically distended bladder, bladder outlet obstruction, decreased bladder tone, obesity, and weakness of the pelvic wall [4,5]. Our two cases had problem of bladder outlet obstruction but were not obese.…”

Massive Ingunoscrotal Bladder Herniation with Calculi, and Bladder Outlet Obstruction

“…1 Even more scarce are case reports describing massive scrotal cystoceles. 2 Despite their low incidence, it is crucial to document and diagnose patients with large scrotal cystoceles because of their increased risk for bladder infarction or obstruction leading to renal impairment.…”

“…7 They must be weighed against the risks of continued herniation including hydronephrosis, UTI, urinary obstruction, scrotal abscess, and urinary leakage leading to sepsis. 1 Most important, scrotal cystocele should be suspected in any patient with scrotal mass and urologic symptoms. 4 Of course, the best course of treatment for scrotal cystocele will depend on the overall health of the patient.…”

Urinary bladder diverticulum as an unusual content of the inguinal canal

“…The main risk factors for the bladder inguinal hernia are obesity, increased abdominal pressure, chronic urinary obstruction, decreased bladder tone, previous herniorrhaphy, as well as weakness of abdominal and pelvic muscles [1,3,8]. In case of incisional bladder hernia, a previous therapy with steroids, diabetes mellitus, chronic obstructive pulmonary disease, inappropriate technical procedure used for wound closure during previous operations and postoperative complications like wound infections and ileus have been postulated [10].…”