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Yang G, Tung KLM, Tumtavitikul S, Li MKW. A new groin hernia classification with clinical relevance. Hernia 2024:10.1007/s10029-024-03000-4. [PMID: 38662243 DOI: 10.1007/s10029-024-03000-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/20/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Groin hernia is one of the most commonly managed surgical diseases around the world. The typical question asked by patients is "Does my hernia require urgent surgery?". The currently available classifications are insufficient to stratify patients into different groups. We propose a new classification that incorporates diverse clinical elements together with anatomical and other vital information, which allows us to stratify patients into different groups. METHOD A task force was formed by the Hong Kong Hernia Society, working with international expert hernia surgeons. The framework of the classification system was formulated. Clinical elements that are important in groin disease stratification were identified. A comprehensive literature review was conducted using PubMed. Those which dictate the severity of the disease were selected and compiled to form the new proposed classification. Application of this classification model to a single hernia surgeon's registry in The Hong Kong Adventist Hospital Hernia Centre was done for initial evaluation. RESULT This new classification incorporates important clinical characteristics forming a total of nine grades of differentiation, together with the anatomical details and special information. This comprehensive system allows the stratification of patients into different groups based on disease severity. It also enables more accurate data collection for future audits, comparisons of disease progression over time, and the effect of different management strategies for different-stage patients. CONCLUSION This is the first classification system which incorporates essential clinical parameters, which allows the stratification of groin hernia into different stages. Further studies and validation should be performed to evaluate the usefulness and value of this classification in groin hernia management.
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Affiliation(s)
- George Yang
- Hong Kong Adventist Hospital, Stubbs Road, Hong Kong, China.
| | | | | | - M K W Li
- Hong Kong Sanatorium & Hospital, 2 Village Road, Happy valley, Hong Kong, China
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2
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Sripathi S, Farooqi N, Kamel MK, Baroody R, Alashari A. Inguinoscrotal Hernia of the Urinary Bladder. Cureus 2024; 16:e56636. [PMID: 38646366 PMCID: PMC11032151 DOI: 10.7759/cureus.56636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Inguinal bladder hernia (IBH) is a rare clinical condition that may present as scrotal swelling. Most patients are asymptomatic and found incidentally at the time of herniorrhaphy. IBH continues to pose a challenge to surgeons before, during, and even after herniorrhaphy. This case report aims to describe the case of the incarcerated right inguinal hernia containing the small bowel and the urinary bladder herniation. An 81-year-old male presented to the emergency department with complaints of abdominal pain, distension, and swelling in the right groin. Physical examination was remarkable for incarcerated right inguinal hernia with tenderness to palpation. A CT scan demonstrated a right inguinal hernia containing a small bowel. The urinary bladder was noted to be adherent to the hernia sac. The hernia sac and urinary bladder were reduced, and Lichtenstein tension-free hernia repair was performed. The postoperative course was uneventful without any complications. IBHs are uncommon. Unrecognized bladder hernias can cause bladder injury during surgery. It is particularly common in individuals with long-standing hernias and should be anticipated during surgery. High-risk patients including obese, older men, who have urinary symptoms that need further evaluation with a CT scan, ultrasound, or cystography to prevent iatrogenic injury and complications. Management consists of reduction or resection of the herniated bladder followed by hernia repair.
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Affiliation(s)
- Shravani Sripathi
- Department of General Surgery, Central Michigan University (CMU) Medical Education Partners, Saginaw, USA
| | - Najiha Farooqi
- Department of General Surgery, Central Michigan University (CMU) Medical Education Partners, Saginaw, USA
| | - Mohamed K Kamel
- Department of General Surgery, Central Michigan University (CMU) Medical Education Partners, Saginaw, USA
| | - Rikat Baroody
- Department of General Surgery, Central Michigan University (CMU) Medical Education Partners, Saginaw, USA
| | - Akram Alashari
- Department of General Surgery, Central Michigan University (CMU) Medical Education Partners, Saginaw, USA
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Christina NM, Tansol C, Candrawinata VS, Haryanto EM, Kemuning M. A rare intraperitoneal inguinal bladder hernia (IBH) in a 58-year-old Indonesian male: A case report and review of the literature. Int J Surg Case Rep 2023; 109:108446. [PMID: 37494778 PMCID: PMC10391599 DOI: 10.1016/j.ijscr.2023.108446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/28/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Inguinal bladder hernia (IBH) accounts for <5 % of inguinal hernias. As to our knowledge, this is the first case report of a rare intraperitoneal IBH in Indonesia. CASE REPORT Here we present a case report of a 58-year-old Indonesian male complaining of a groin mass on the right side since 1 year ago, accompanied by lower urinary tract symptoms (LUTS), two-stage micturition, lower abdominal discomfort and pain during urinating and coughing. Ultrasound revealed widened inguinal canal containing peritoneum and "teardrop" lesion at the inguinal continuing until the right scrotal. The patient was scheduled for open repair of inguinal hernia (herniorrhaphy) with tension-free mesh. Intraoperative findings include the entire bladder herniation located at intraperitoneal. CLINICAL DISCUSSION Symptoms of IBH include inguinal or scrotal swelling with or without pain, LUTS, two-stage micturition, to various symptoms owing to complications. Pre-operative imaging might help to confirm diagnosis. The definitive treatment of IBH is either reduction or resection of the herniated bladder followed by surgical repair (herniorrhaphy). CONCLUSION IBH is rare but should be suspected in older males (≥50 years old), individuals with weak abdomino-pelvic musculature, and obesity. Pathologies of the bladder, such as bladder outlet obstruction (BOO), chronically distended bladder, and decreased bladder tone related to benign prostate hyperplasia (BPH) or bladder neck stricture can also increase risk of IBH. Treatment with open repair of inguinal hernia (herniorrhaphy) with tension-free mesh is the most common and preferred surgical approach.
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Affiliation(s)
- Natalia Maria Christina
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Siloam General Hospital, Tangerang, Indonesia
| | - Christiano Tansol
- Department of Urology, Faculty of Medicine, Pelita Harapan University, Siloam General Hospital, Tangerang, Indonesia
| | | | | | - Michaela Kemuning
- Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
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4
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Sankaranarayanan VS, Napa M, Giridharan B, Palit S, Prabhuram N. Strangulated Sliding Inguinoscrotal Hernia with a Gangrenous Bladder and Ileum. Cureus 2023; 15:e43028. [PMID: 37674969 PMCID: PMC10479955 DOI: 10.7759/cureus.43028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2023] [Indexed: 09/08/2023] Open
Abstract
An inguinal bladder hernia (IBH) is a common ailment in males above 50 years of age, with serious consequences of strangulation, if neglected. It is highly uncommon to have a strangulated inguinal hernia and bladder gangrene. This case reports a strangulated sliding inguinoscrotal hernia with a gangrenous bladder and ileum. We present a case of a 75-year-old man, presenting to the emergency room, with complaints of abdominal pain, distension, and absolute constipation. Examination revealed a large, firm, tender left-sided irreducible inguinal hernia. X-ray showed small bowel obstruction. Intraoperatively, a hernia sac was found with a gangrenous ileum as a slider along with a gangrenous fundus of the urinary bladder. Gangrenous segments were removed, and herniorrhaphy and bladder wall defect repair were performed. Even though a bladder can be involved in inguinal hernias, it is very rarely diagnosed preoperatively. In our case, there were no urinary symptoms, and the symptoms of strangulation outweighed bladder involvement. In any elderly patient with a giant hernia, a bladder entrapment should be ruled out with a strong index of suspicion. Failure to do so may result in complications after surgery. Hence, we conclude that it is better if all patients with long-standing giant hernias have a computed tomography (CT) prior to surgery.
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Affiliation(s)
| | - Madhusudhan Napa
- General Surgery, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Chennai, IND
| | - Bhanumati Giridharan
- General Surgery, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Chennai, IND
| | - Sandhya Palit
- General Surgery, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Chennai, IND
| | - Nikhithaa Prabhuram
- General Surgery, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Chennai, IND
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5
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Katoh R, Ogawa H, Takada T, Ozawa N, Suga K, Osone K, Okada T, Shiraishi T, Sano A, Sakai M, Sohda M, Shirabe K, Tsushima Y, Saeki H. Significance of routine preoperative prone computed tomography for predicting intractable cases of inguinal hernias treated by transabdominal preperitoneal repair. Medicine (Baltimore) 2022; 101:e31917. [PMID: 36482573 PMCID: PMC9726382 DOI: 10.1097/md.0000000000031917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Physical examination is the standard diagnostic approach for adult inguinal hernias. We aimed to evaluate the clinical utility of routine preoperative computed tomography scans in the prone position for predicting intractable cases of inguinal hernias before performing transabdominal preperitoneal repairs. We retrospectively analyzed 56 lesions in 48 patients with inguinal hernias who underwent prone computed tomography scans prior to transabdominal preperitoneal repairs. To assess the ability of prone computed tomography to enable the accurate preoperative diagnosis of inguinal hernias, we compared preoperative hernia types as classified through hernia computed tomography and intraoperative diagnosis. We also analyzed the relationship between operation time and hernia type in unilateral cases (n = 40). The overall hernia computed tomography detection and classification accuracy rates were 81.0% and 83.9%, respectively, using the Japan Hernia Society classification system (2009 version) and 84.3% and 91.2%, respectively, using the European Hernia Society classification system. There were no differences in the hernia type frequencies between the shorter (n = 20) and longer (n = 20) operation time groups. Two patients had sliding inguinal hernias with prolapsing bladders, both of which were detectable using preoperative prone computed tomography. Although transabdominal preperitoneal repairs were completed in both cases, the operation times were exceptionally long (185 and 291 minute). Preoperative prone computed tomography is useful for predicting intractable cases of inguinal hernias. Prone computed tomography can play a significant role in not only typing and differentiating hernias from other diseases, but also in helping surgeons appropriately treat unexpected intractable cases with laparoscopic surgery.
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Affiliation(s)
- Ryuji Katoh
- Department of Gastroenterological Surgery, Gunma Prefectural Cancer Center, Ohta, Gunma, Japan
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
- Diagnostic Radiology and Nuclear Medicine Department, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hiroomi Ogawa
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Takahiro Takada
- Department of Gastroenterological Surgery, Gunma Prefectural Cancer Center, Ohta, Gunma, Japan
| | - Naoya Ozawa
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Kunihiko Suga
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Katsuya Osone
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Takuhisa Okada
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Takuya Shiraishi
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Akihiko Sano
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Makoto Sakai
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Makoto Sohda
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Ken Shirabe
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Yoshito Tsushima
- Diagnostic Radiology and Nuclear Medicine Department, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hiroshi Saeki
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
- * Correspondence: Hiroshi Saeki, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan (e-mail: )
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6
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Chitrambalam TG, George N, Christopher PJ, Panicker KM, Sekhar S. Irreducible Hernia With Unusual Content. Cureus 2022; 14:e31162. [DOI: 10.7759/cureus.31162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 11/08/2022] Open
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7
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Muacevic A, Adler JR, Terron C, Habart J, Torres G, Mederos R. A Rare Case of a Non-strangulated Bladder Pantaloon Hernia. Cureus 2022; 14:e31208. [PMID: 36505160 PMCID: PMC9729010 DOI: 10.7759/cureus.31208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 11/09/2022] Open
Abstract
A pantaloon hernia occurs when an indirect and direct hernia develop at the same time. The urinary bladder is a rare component of pantaloon hernias. There is a lack of literature regarding an ipsilateral pantaloon with a herniated urinary bladder. Clinically, it has a vague presentation associated with abdominal pain and urinary retention symptoms. The best diagnostic modality is an abdominal CT scan. Surgery is the treatment of choice, rendering a good prognosis. Untreated bladder hernia may lead to strangulation and necrosis of the urinary bladder. We present a rare case of a right-sided pantaloon hernia with a bladder herniation in a 65-year-old man.
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Read P, Ng Z, Wong SL. Massive scrotal cystocoele in a patient with perforated bowel cancer. ANZ J Surg 2022; 93:1060-1061. [PMID: 36195991 DOI: 10.1111/ans.18098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Phillipa Read
- Department of General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Zi Ng
- Department of General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Sze Ling Wong
- Department of General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia
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9
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Pham CT, Hanna B, Samra J, Winter M. Robotic repair of indirect inguinoscrotal bladder hernia. UROLOGY VIDEO JOURNAL 2022. [DOI: 10.1016/j.urolvj.2021.100122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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10
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Afzal MZ, Thomas R. A case of a large extraperitoneal inguinal bladder hernia causing urinary retention. ANZ J Surg 2022; 92:2376-2377. [PMID: 35088503 DOI: 10.1111/ans.17490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/10/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Mohamed Zaafer Afzal
- Acute Surgical Unit, Lyell McEwin Hospital, Adelaide, South Australia, Australia
| | - Rebecca Thomas
- Acute Surgical Unit, Lyell McEwin Hospital, Adelaide, South Australia, Australia
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11
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Ogbetere F, Imoisili U. Recurrent inguinal hernia containing the urinary bladder: A rare occurrence. Ann Afr Med 2022; 21:288-290. [DOI: 10.4103/aam.aam_100_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Yokoi R, Yamada S, Hatanaka Y, Kato H. Laparoscopic repair of femoral hernia involving the bladder with coexisting indirect inguinal hernia in a young man: a case report. Surg Case Rep 2021; 7:252. [PMID: 34874482 PMCID: PMC8651960 DOI: 10.1186/s40792-021-01334-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 11/23/2021] [Indexed: 11/12/2022] Open
Abstract
Background Bladder hernias are rare conditions that are difficult to diagnose preoperatively; many cases are diagnosed intraoperatively or postoperatively due to bladder injury. Most bladder hernias are direct inguinal hernias that involve the bladder in obese men older than 50 years old. We describe a rare case of a left femoral hernia involving the bladder in a young man. Case presentation A 32-year-old man with a bulge in the left inguinal region underwent laparoscopic transabdominal preperitoneal repair. Laparoscopy revealed a left indirect inguinal hernia. When the preperitoneal space was dissected toward the Retzius space along the vesicohypogastric fascia, the bladder was found to be protruding into the femoral ring and adhere to the hernial orifice severely. The bladder was reduced carefully without causing injury. After dissection, we repaired the left myopectineal orifice with a mesh. The patient was discharged on postoperative day 1 without complications. No recurrences or symptoms were noted at the 12-month follow-up. Conclusions A femoral hernia involving the bladder in a young man is rare. This case demonstrated that dissection along anatomical landmarks is important for preventing injuries to the bladder because even young men may have bladder hernias.
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Affiliation(s)
- Ryoma Yokoi
- Department of Surgery, Tajimi City Hospital, 3-43, Maebata, Tajimi, Gifu, 507-8511, Japan.
| | - Shigetoshi Yamada
- Department of Surgery, Tajimi City Hospital, 3-43, Maebata, Tajimi, Gifu, 507-8511, Japan
| | - Yuji Hatanaka
- Department of Surgery, Tajimi City Hospital, 3-43, Maebata, Tajimi, Gifu, 507-8511, Japan
| | - Hiroki Kato
- Department of Surgery, Tajimi City Hospital, 3-43, Maebata, Tajimi, Gifu, 507-8511, Japan
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13
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Mejri R, Chaker K, Mokhtar B, Rhouma SB, Nouira Y. Inguinal bladder hernia: a case report. J Surg Case Rep 2021; 2021:rjab386. [PMID: 34567514 PMCID: PMC8458905 DOI: 10.1093/jscr/rjab386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/11/2021] [Indexed: 11/25/2022] Open
Abstract
Inguinal hernia is a common disorder that requires urgent and adequate surgical management. Multiple organs may be associated with inguinal hernias, but bladder involvement is rarely seen. The diagnosis is frequently done during surgery. It can be evoked before surgery when the patient presents with irritative and obstructive lower urinary tract symptoms. Retrograde urethrocystography or intravenous urography confirms the diagnosis. We report a case of inguinal hernia involving the bladder at the right side with a 72-year-old man. We performed a hernia repair after reintegration of the bladder.
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Affiliation(s)
- Ramzi Mejri
- Department of Urology, Hospital Mongi Slim La Marsa, Tunisia
| | - Kays Chaker
- Department of Urology, La Rabta Hospital, Tunisia
| | - Bibi Mokhtar
- Department of Urology, La Rabta Hospital, Tunisia
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Repair of Inguinal Bladder Hernias Concomitant with Localized Prostate Cancer: A Case Report and Review of the Literature. Case Rep Urol 2021; 2020:8877694. [PMID: 33381349 PMCID: PMC7748886 DOI: 10.1155/2020/8877694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 11/30/2022] Open
Abstract
This study reports two rare cases of inguinal bladder hernias accompanied by localized prostate cancers. They were treated with simultaneous repair of inguinal bladder hernias and open retropubic radical prostatectomy. Additionally, we performed a literature review on previous inguinal bladder hernias case reports. In this present study, the first patient was a 64-year-old man histopathologically diagnosed with prostate cancer; computed tomography for staging of prostate cancer revealed a “Pelvic Mickey Mouse Sign.” The second patient was a 75-year-old man with right inguinal swelling that gradually increased in size for 30 years. He was referred to our department due to nocturia and urge incontinence. His prostate-specific antigen level was 4.17 ng/mL, and a transrectal prostate biopsy revealed prostate cancer. Preoperative imaging studies revealed a right hernia wherein most of the bladder slid beyond the inguinal channel filling the scrotum. Both patients underwent the Lichtenstein technique for inguinal bladder hernias simultaneously with retropubic radical prostatectomy using separate surgical incisions to avoid urinary contamination of the mesh. In our comprehensive review of patients who underwent inguinal bladder hernias surgical repair, there were 51 cases (50 males and 1 female). The mean patient age was 60.6 ± 12.3 years. Five cases demonstrating concomitant prostate cancer were observed. This present case report is the first to describe two patients who underwent surgeries for the simultaneous repair of inguinal bladder hernias and retropubic radical prostatectomy with separate surgical incisions. Supposedly, this simultaneous approach is suitable for concomitant inguinal bladder hernias and prostate cancer treatment.
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Kohga A, Okumura T, Yamashita K, Isogaki J, Suzuki K, Kawabe A. A case of indirect inguinal bladder hernia treated by laparoscopic hernia repair. Asian J Endosc Surg 2021; 14:128-131. [PMID: 32500655 DOI: 10.1111/ases.12818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/04/2020] [Accepted: 05/10/2020] [Indexed: 02/04/2023]
Abstract
Inguinal bladder hernia is a rare clinical condition, and only a small number of reported cases have been treated by laparoscopic surgery. In the present case, the patient was a 78-year-old man who presented to our emergency department with a chief complaint of right inguinal bulge and pain. CT imaging revealed an incarcerated right inguinal hernia containing the small intestine and a portion of the urinary bladder. We performed manual reduction of the incarcerated intestine, and he was admitted to the surgical ward for follow-up. On the 19th day after discharge, recurrence of incarceration developed, and he was readmitted after manual reduction. A laparoscopic transabdominal preperitoneal repair was performed. After careful reduction of the protruding bladder from the hernial orifice, we repaired the right inguinal hernia with a mesh prosthesis. We experienced a rare case of right indirect inguinal bladder hernia that was treated successfully with laparoscopic repair.
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Affiliation(s)
- Atsushi Kohga
- Division of Surgery, Fujinomiya City General Hospital, Fujinomiya, Japan
| | - Takuya Okumura
- Division of Surgery, Fujinomiya City General Hospital, Fujinomiya, Japan
| | - Kimihiro Yamashita
- Division of Surgery, Fujinomiya City General Hospital, Fujinomiya, Japan
| | - Jun Isogaki
- Division of Surgery, Fujinomiya City General Hospital, Fujinomiya, Japan
| | - Kenji Suzuki
- Division of Surgery, Fujinomiya City General Hospital, Fujinomiya, Japan
| | - Akihiro Kawabe
- Division of Surgery, Fujinomiya City General Hospital, Fujinomiya, Japan
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16
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Adasonla K, Gabriel J, Quraishi MK, Watson G. Massive inguinoscrotal herniation of the bladder: challenges in non-operative management. J Surg Case Rep 2020; 2020:rjaa540. [PMID: 33391659 PMCID: PMC7769572 DOI: 10.1093/jscr/rjaa540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 11/24/2020] [Indexed: 11/21/2022] Open
Abstract
Massive inguinoscrotal hernias containing the bladder are rare but can present with significant complications such as obstructive uropathy and urinary sepsis. A comorbid 71-year-old gentleman presented with an enlarging inguinoscrotal mass and an acute kidney injury (AKI). Imaging revealed a large inguinoscrotal hernia containing the bladder, and bilateral hydronephrosis. Renal function improved on urethral catheterization. Admitted under general surgery originally, the patient declined any surgical intervention and had his catheter removed as an outpatient, without urological follow up. He represented 6 months later with urinary sepsis and a new AKI. Repeat imaging revealed a progression of the bilateral hydronephrosis. Subsequently admitted under urology, bilateral nephrostomies as well as a catheter were inserted. Once stable, he was discharged with both as part of his long-term management. Non-operative management of this condition may occasionally be necessary, and so requires effective multidisciplinary decision making. Real-world organizational and geographical factors contributed to the challenges in this case.
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Affiliation(s)
- Kelvin Adasonla
- Correspondence address. Department of Urology, East Sussex Healthcare NHS Trust, Eastbourne District General Hospital, Kings Drive Eastbourne, BN21 2UD, UK. E-mail:
| | - Joseph Gabriel
- Department of Urology, Eastbourne District General Hospital, Eastbourne, UK
| | | | - Graham Watson
- Department of Urology, Eastbourne District General Hospital, Eastbourne, UK
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Feasibility of robotic-assisted minimally invasive inguinal hernia repair in patients with urologic considerations including artificial urinary sphincters and bladder herniation. J Robot Surg 2020; 15:695-699. [PMID: 33107011 DOI: 10.1007/s11701-020-01163-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/18/2020] [Indexed: 10/23/2022]
Abstract
Robotic surgical technology has the potential to broaden the applicability of minimally invasive approaches into more complex, technically challenging inguinal hernia repairs. A unique patient population requiring inguinal hernia repair are those patients who either have artificial urinary sphincters (AUS) or inguinal bladder herniation (IBH). Traditionally, these patients have not been considered candidates for minimally invasive inguinal hernia repairs. Through this retrospective series, we aim to contribute to the growing body of literature on robotic-assisted inguinal hernia repair (RIHR) by describing our experience with RIHR in this patient subset. We performed a retrospective chart review of RIHR cases performed from June 2017 to April 2019 by a single surgeon at our university-affiliated community hospital. Charts were reviewed for preoperative considerations, operative complications, and postoperative outcomes. A total of three patients with an AUS and six patients with IBH were included, all of whom were male. All the patients received transabdominal preperitoneal (TAPP) approaches, and all received placement of mesh. There were no intraoperative complications and no conversions to open surgery. Postoperatively, one patient with IBH had persistent surgical site pain that resolved after 3 weeks and one patient, also with IBH, had a surgical site seroma that resolved without further intervention. Mean follow-up time was 10.71 and 12.13 months for patients with AUS and IBH, respectively. No patients reported hernia recurrence during this time. This review suggests that the use of robotic assistance for laparoscopic inguinal hernia repair is safe and effective and may provide additional benefits for patients with concurrent urological considerations such as AUS and IBH.
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Ahmed KB, Bouassida K, Ktari K, Jaidane M. Bladder hernia complicated with cystolithiasis and bladder tumor: Two cases' analysis. Urol Ann 2019; 11:432-434. [PMID: 31649467 PMCID: PMC6798298 DOI: 10.4103/ua.ua_135_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Inguinal hernia is frequent and reaches up to 8% of the population. It was reported that over 20 million inguinal hernia repairs are performed annually. The bladder may herniate in 1%-3% of the cases through the inguinal canal that can be responsible for various symptoms. The most specific is the classic "two-stage micturition." However, the diagnosis usually remains unspecific, and a surgeon can fall in the trap of a "simple" inguinal hernia and cause accidental damages to an undiagnosed bladder hernia. Therefore, a clear diagnosis must be assessed based on clinical and radiological findings to avoid complications. In these two presented cases, the patients presented cystolithiasis complicating the bladder herniation. One of the patients also developed a bladder tumor which appeared to be urothelial carcinoma.
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Affiliation(s)
- Khaled Ben Ahmed
- Department of Urology, Sahloul University Hospital, Sousse, Tunisia
| | | | - Kamel Ktari
- Department of Urology, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Mehdi Jaidane
- Department of Urology, Sahloul University Hospital, Sousse, Tunisia
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19
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Bilateral inguinal bladder hernia following unilateral transabdominal preperitoneal repair. A case report and review of the literature. Ann Med Surg (Lond) 2019; 46:23-26. [PMID: 31485328 PMCID: PMC6717051 DOI: 10.1016/j.amsu.2019.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 08/13/2019] [Accepted: 08/15/2019] [Indexed: 11/20/2022] Open
Abstract
Sliding hernia occurs when the hernia sac is partially formed by the wall of a viscus. The most common components of a sliding hernia includes the sigmoid colon, cecum, appendix, urinary bladder, and the ascending colon. However, the presence of bilateral vesical sliding hernia is rare and few cases have been reported in the literature. Patients with vesical sliding hernia may present with groin swelling with an associated lower urinary tract symptom. Computed tomography (CT) scan is the modality of choice for suspected cases which may reveal the classic pelvic micky mouse sign. The method of repair should be individualized taking in account the diagnostic findings. Although laparoscopic repair is becoming the mainstay management for inguinal hernia, the majority of sliding hernias are repaired using an open approach, which could be attributed to the presence of large hernias, associated complications, or recurrence with associated adhesions. We present a case of a 60-year-old male patient presented with bilateral inguinal swelling associated with urinary hesitancy and intermittency. He had undergone transabdominal preperitoneal (TAPP) repair for a left inguinal hernia 8 years ago. CT scan confirmed the presence of a bilateral hernia with the bladder herniating bilaterally. He underwent an elective bilateral open Lichtenstein tension-free mesh repair. Bilateral vesical hernia has been rarely reported in the literature. CT scan is the modality of choice for the diagnosis, which may reveal Micky mouse sign on an axial view. Laparoscopic and open repair have been reported for such cases. An open approach should be considered in large, complicated hernias, and those with extensive adhesions.
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20
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Inguinal bladder hernia, a rare cause of inguinal herniation: Report of two cases. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.518960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Gonzalez-Urquijo M, Mayagoitia-Gonzalez JC, Rodarte-Shade M, Bermea-Mendoza JH, Gil-Galindo G. Large inguinal bladder hernias: can a preoperative diagnosis be made? Hernia 2019; 23:1221-1227. [PMID: 31055706 DOI: 10.1007/s10029-019-01955-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 04/16/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Bladder hernias are asymptomatic in most cases and are found incidentally during exploration for inguinal hernia repair. The treatment of inguinal bladder hernia is either reduction or resection of the herniated bladder, followed by herniorrhaphy. We present a case series with preoperative diagnoses, along with their surgical outcomes. METHODS We retrospectively reviewed the medical records from a single institution over a 5-year period (2012-2017) of five patients with diagnosis of large bladder inguinal hernia. Demographics, clinical status, medical history, anatomical structure of the hernia, and surgical outcomes were all analyzed. RESULTS Patients' median age was 51 years (range 45-81 years). The median size of the hernial sac was 13 cm (range 8-20 cm). The diagnosis was made with computed tomography in three patients and with ultrasonography and cystography in two patients. Median length of hospital stay was 2 days (range 1-6 days), and median length of follow-up was 28 months (range 18-72 months). All patients continue to be alive and well, without hernia recurrence. The five cases are described separately along with their surgical managements. CONCLUSION The main objectives in treatment of inguinal bladder hernia are to preserve the voiding function and to avoid bladder injuries in a tension-free hernia repair. To our knowledge, this is the first series of cases in which all inguinal bladder hernias were diagnosed preoperatively.
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Affiliation(s)
- M Gonzalez-Urquijo
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Dr. Ignacio Morones Prieto O 3000, 64710, Monterrey, Nuevo León, Mexico.,Hospital Metropolitano "Dr. Bernando Sepúlveda", Adolfo López Mateos No. 4600, 66400, San Nicolás de los Garza, Nuevo León, Mexico
| | - J C Mayagoitia-Gonzalez
- Centro Especializado en el Tratamiento de Hernias, Hospital Médica Campestre y Unidad Médica de Atención Ambulatoria 55 (UMAA 55) del Instituto Mexicano del Seguro Social (IMSS), Guanajuato, Mexico
| | - M Rodarte-Shade
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Dr. Ignacio Morones Prieto O 3000, 64710, Monterrey, Nuevo León, Mexico.,Hospital Metropolitano "Dr. Bernando Sepúlveda", Adolfo López Mateos No. 4600, 66400, San Nicolás de los Garza, Nuevo León, Mexico
| | - J H Bermea-Mendoza
- Hospital Metropolitano "Dr. Bernando Sepúlveda", Adolfo López Mateos No. 4600, 66400, San Nicolás de los Garza, Nuevo León, Mexico
| | - G Gil-Galindo
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Dr. Ignacio Morones Prieto O 3000, 64710, Monterrey, Nuevo León, Mexico. .,Hospital Metropolitano "Dr. Bernando Sepúlveda", Adolfo López Mateos No. 4600, 66400, San Nicolás de los Garza, Nuevo León, Mexico.
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Cimadamore A, Palagonia E, Piccinni P, Misericordia M, Galosi AB, Montironi R. Inguinal bladder hernia with lipomatosis of the bladder wall: A potential clinical pitfall for cancer. Urologia 2019; 86:35-38. [DOI: 10.1177/0391560319834494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A 70-year-old man was referred to the Urology Service of our University Hospital for an irregular thickening of the left anterior–lateral urinary bladder wall found in a computed tomography scan following gross haematuria. In particular, the computed tomography scan showed irregularity of the mucosal aspect and an irregular thickening of the bladder wall in close proximity of an inguinal hernia. The computed tomography exam also showed an unusual little fatty seizure in the parietal planes. A magnetic resonance imaging confirmed the thickening in the same area as the hernia with a mainly extraluminal presentation and extension in the perivesical adipose tissue. Cystoscopy did not show alteration of the mucosal surface. Urine cytology showed normal urothelium cells. At the time of the left inguinal hernia repair, the bladder was isolated from the inguinal hernia fat tissue and then opened with median cystotomy. Biopsy of the anterior–lateral bladder wall showed normal urothelium and an abundant component of mature lobules of adipose tissue in the sub-epithelial connective tissue extending among the muscle bundles of muscularis propria, compatible with a diagnosis of lipomatosis, a very rare lesion in the urinary bladder.
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Affiliation(s)
- Alessia Cimadamore
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
| | - Erika Palagonia
- Department of Urology, Polytechnic University of the Marche Region, Ancona, Italy
| | - Paola Piccinni
- Department of Radiology, Polytechnic University of the Marche Region, Ancona, Italy
| | - Marco Misericordia
- Department of Radiology, Polytechnic University of the Marche Region, Ancona, Italy
| | | | - Rodolfo Montironi
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
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Inguinal Bladder and Ureter Hernia Permagna: Definition of a Rare Clinical Entity and Case Report. Case Rep Surg 2018; 2018:9705728. [PMID: 30363987 PMCID: PMC6186383 DOI: 10.1155/2018/9705728] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 08/24/2018] [Accepted: 09/12/2018] [Indexed: 11/17/2022] Open
Abstract
Background Inguinoscrotal herniation of the bladder is a rare clinical entity, with a frequency between 0.5% and 4% of all inguinal hernias. The bladder can partially or entirely herniate into the inguinal canal; when the whole bladder and ureters migrate into the scrotum, it may cause urinary disorders. Case Presentation A 62-year-old male patient presented with urinary disorders and right-sided inguinoscrotal hernia. Under clinical suspicion of bladder involvement in the inguinal canal, abdominal and pelvic computed tomography (CT) scan with endovenous contrast was performed, revealing a right inguinoscrotal hernia, containing the whole urinary bladder and the right pelvic ureter. Without violating the urinary bladder wall integrity, the content of the hernial sac was reduced into the abdominal cavity. Hernioplasty was performed by means of Lichtenstein's method. Conclusions Ureteral involvement should be suspected when a clinical inguinal hernia is diagnosed concurrently with unexplained hydronephrosis, renal failure, or urinary tract infection, as in the case described. When suspected, the preoperative diagnosis, particularly with CT scan, is essential to avoid complications and to reduce risk of bladder and ureter injuries during hernia repair.
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24
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Hernández-Nájera V, Barrera-Juárez E, González-Oyervides R. Massive bilateral inguinal hernia comprising bladder carcinoma: A case report. JOURNAL OF CLINICAL UROLOGY 2018. [DOI: 10.1177/2051415818807525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Verónica Hernández-Nájera
- Escuela de Medicina, Tecnologico de Monterrey, Mexico
- Hospital Metropolitano ‘Dr. Bernardo Sepúlveda’, Secretaría de Salud de NL, Mexico
| | - Eduardo Barrera-Juárez
- Escuela de Medicina, Tecnologico de Monterrey, Mexico
- Hospital Metropolitano ‘Dr. Bernardo Sepúlveda’, Secretaría de Salud de NL, Mexico
| | - Roberto González-Oyervides
- Escuela de Medicina, Tecnologico de Monterrey, Mexico
- Hospital Metropolitano ‘Dr. Bernardo Sepúlveda’, Secretaría de Salud de NL, Mexico
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25
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Branchu B, Renard Y, Larre S, Leon P. Diagnosis and treatment of inguinal hernia of the bladder: a systematic review of the past 10 years. Turk J Urol 2018; 44:384-388. [PMID: 30487042 DOI: 10.5152/tud.2018.46417] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 06/12/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Inguinoscrotal hernia (ISH) of the bladder is a rare condition involved in less than 4% of inguinal hernias. In most cases, it occurs to men older than 50 years who are overweight. Little is known about the subject and mainly based on case reports. When undiagnosed, it may be associated with bladder injuries during hernia repair. There is also no consensus on the ideal repair technique to use. The aim of the study is to evaluate the particularity of the management of the inguinal herniation of the bladder in term of diagnosis, choice and results of treatments. METHODS A Prisma systematic review of the literature was performed over the last 10 years using a database. We selected 51 articles including 64 patients with ISH of the bladder. RESULTS ISH of the bladder mainly occurred in overweight men aged over 50 years (Body Mass Index >30). Symptoms were reported for 76% of the patients (n=49), including inguinal swelling 60% of cases (n=38), lower urinary tract symptoms (48%), pain (40%) and a reduction of an inguinal mass after voiding (12.7%). Diagnosis was incidental on imaging for 7 patients, during inguinal repair surgery for 8, or on imaging performed following symptoms for the remaining 49 patients. Surgical repair was reported for 46 patients (71%) including various procedures as open surgery (80%) and laparoscopic approaches (20%). Excellent short term results were reported. CONCLUSION ISH of the bladder seams more likely to occur with patients suffering from lower urinary tract obstruction and best diagnosed with a computerized tomography scan. Various surgical techniques are reported.
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Affiliation(s)
| | - Yohann Renard
- Academic Department of Digestive Surgery, Chu Reims, Reims, France
| | - Stephane Larre
- Academic Department of Urology, Chu Reims, Reims, France
| | - Priscilla Leon
- Academic Department of Urology, Chu Reims, Reims, France
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26
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Capitano S, Castellani D. Unusual Scrotal Swelling. JAMA Surg 2018; 153:856-857. [PMID: 29799922 DOI: 10.1001/jamasurg.2018.0883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Sante Capitano
- Department of Surgery, National Institute of Health and Science on Aging-INRCA, Ancona, Italy
| | - Daniele Castellani
- Department of Urology, National Institute of Health and Science on Aging-INRCA, Ancona, Italy
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Wang P, Huang Y, Ye J, Gao G, Zhang F, Wu H. Large sliding inguino-scrotal hernia of the urinary bladder: A case report and literature review. Medicine (Baltimore) 2018; 97:e9998. [PMID: 29595706 PMCID: PMC5895406 DOI: 10.1097/md.0000000000009998] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Sliding inguinal hernias of the urinary bladder are protrusions of the bladder through the internal inguinal ring, most of which are insignificant and diagnosed intra-operatively. Large inguino-scrotal bladder hernias commonly present with lower urinary tract symptoms and may cause severe complications, including bladder incarceration or necrosis, bladder hemorrhage, obstructive or neurogenic bladder dysfunction, and even renal failure. PATIENT CONCERNS We describe and discuss the clinical findings and management of a 59-year-old man who complained of a decrease in scrotal size after voiding and 2-stage voiding requiring pressure to the scrotum. DIAGNOSES The patient was diagnosed preoperatively as massive, bilateral, inguinoscrotal hernias, and a large, left-sided, sliding bladder hernia. INTERVENTIONS The patient underwent a timely open re-peritoneal inguinal herniorrhaphy using a mesh. OUTCOMES The surgical outcomes were good, and no surgical site infection, chronic postoperative inguinal pain or recurrence were recorded during the follow-up. LESSONS Better knowledge of this rare condition of large inguino-scrotal sliding bladder hernia could help in making a correct diagnosis preoperatively and provide proper surgical management timely, so as to reduce delay in treatment and avoid potential complications.
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28
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Habib A. A Rare Case of Inguinal Hernia with Complete Bladder Herniation. Case Rep Surg 2017; 2017:4658169. [PMID: 29312792 PMCID: PMC5684559 DOI: 10.1155/2017/4658169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/29/2017] [Accepted: 10/16/2017] [Indexed: 11/17/2022] Open
Abstract
Involvement of the bladder in inguinal hernias is rare and occurs in less than 5% of the cases. The diagnosis and management of this condition may present a challenge to the surgeon. We present a case of an elderly gentleman who presented with a large left-sided inguinoscrotal hernia causing an obstructive uropathy which was surgically repaired. The patient made a quick postoperative recovery with complete resolution of renal function.
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Affiliation(s)
- Ayaaz Habib
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK
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29
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Cybułka B, Podgórny M, Rapeła J, Wach A. Surgical Trap of a Routine Procedure. Scrotal Hernia with Concomitant Sliding of the Urinary Bladder--Case Report. POLISH JOURNAL OF SURGERY 2017; 87:587-91. [PMID: 26816407 DOI: 10.1515/pjs-2016-0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Indexed: 11/15/2022]
Abstract
The content of the hernial sac may comprise peritoneal cavity elements, such as small and large bowel loops, visceral adipose tissue, the greater omentum, appendix (amyand hernia), and Meckel's diverticulum. The sliding of part of the urinary bladder wall to the inguinal canal is rare, being observed in 1%-4% (0.5%-3%) of inguinal hernia cases. Complete migration of the urinary bladder to the scrotum is considered a rare anomaly. As of today, 100 such cases have been described.
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30
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Sarr A, Ondo CZ, Sow Y, Fall B, Thiam A, Sine B, Djoufang R, Diao B, Fall PA, Ndoye AK, Ba M. [Inguinal hernia of the bladder: about 8 cases]. Pan Afr Med J 2015; 22:7. [PMID: 26600907 PMCID: PMC4643152 DOI: 10.11604/pamj.2015.22.7.7474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 08/16/2015] [Indexed: 11/11/2022] Open
Abstract
Décrire notre expérience de la prise en charge des hernies inguinales de la vessie (HIV). Il s'agit d'une étude rétrospective descriptive colligeant les dossiers des patients opérés pour une HIV entre janvier 2005 et décembre 2012. Les paramètres suivants ont été étudiés: l’âge des patients, les aspects anatomo-cliniques de la hernie, les circonstances de découverte, l'attitude thérapeutique et les résultats de la cure. Huit HIV ont été diagnostiquées sur une période de 7 ans. Tous les patients étaient de sexe masculin. La moyenne d’âge était de 57,6 ans. La HIV siégeait à droite chez 5 patients et était associée à une HBP chez 3 patients, deux patients avaient des antécédents de herniorraphie. La découverte était per opératoire chez 6 patients, postopératoire (fistule vesicocutanée) chez un patient et préopératoire chez un patient. Ce dernier a présenté une HIV géante diagnostiquée à l'Uroscanner. L'attitude thérapeutique était fonction des circonstances de découverte de la HIV et de la pathologie associée. Six patients ont été opérés selon la technique de Bassini et deux selon la technique de Mac Way. La durée moyenne de l'hospitalisation était de 7 jours. Après un suivi régulier de 2 ans nous n'avons pas noté de récidive herniaire. La HIV est une affection rare dont la découverte est le plus souvent per-opératoire après une taille vésicale. Il faut l’évoquer chez tout patient aux antécédents d'herniorraphie et chez les sujets âgés de plus de 50 ans qui présentent une hernie inguinale associée à des TUBA.
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Affiliation(s)
- Alioune Sarr
- Service d'Urologie-Andrologie, Hopital Aristide Le Dantec, avenue Pasteur, Dakar, Sénégal
| | - Cyrille Ze Ondo
- Service d'Urologie-Andrologie, Hopital Aristide Le Dantec, avenue Pasteur, Dakar, Sénégal
| | - Yaya Sow
- Service d'Urologie-Andrologie, Hopital Aristide Le Dantec, avenue Pasteur, Dakar, Sénégal
| | - Boubacar Fall
- Service d'Urologie-Andrologie, Hopital Aristide Le Dantec, avenue Pasteur, Dakar, Sénégal
| | - Amath Thiam
- Service d'Urologie-Andrologie, Hopital Aristide Le Dantec, avenue Pasteur, Dakar, Sénégal
| | - Babacar Sine
- Service d'Urologie-Andrologie, Hopital Aristide Le Dantec, avenue Pasteur, Dakar, Sénégal
| | - Rodrigue Djoufang
- Service d'Urologie-Andrologie, Hopital Aristide Le Dantec, avenue Pasteur, Dakar, Sénégal
| | - Babacar Diao
- Service d'Urologie-Andrologie, Hopital Aristide Le Dantec, avenue Pasteur, Dakar, Sénégal
| | - Papa Ameth Fall
- Service d'Urologie-Andrologie, Hopital Aristide Le Dantec, avenue Pasteur, Dakar, Sénégal
| | - Alain Khassim Ndoye
- Service d'Urologie-Andrologie, Hopital Aristide Le Dantec, avenue Pasteur, Dakar, Sénégal
| | - Mamadou Ba
- Service d'Urologie-Andrologie, Hopital Aristide Le Dantec, avenue Pasteur, Dakar, Sénégal
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31
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Ryan ST, Jumper B. Scrotal Cystocele Managed With Trans-scrotal Neocystostomy Tube. Urol Case Rep 2015; 3:117-9. [PMID: 26793523 PMCID: PMC4672638 DOI: 10.1016/j.eucr.2015.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 04/01/2015] [Indexed: 12/03/2022] Open
Abstract
Inguinal herniation of the bladder is relatively common, reported in as many as 4% of inguinal hernias. In the majority of those cases, it is a sliding hernia that is noted at time of herniorrhaphy. Complete herniation of the bladder or “scrotal cystocele” is very rare and normally managed with herniorrhaphy. This case report presents a case of massive inguinal scrotal herniation of the urinary bladder successfully managed with trans-scrotal drainage via neocystostomy tube.
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Affiliation(s)
- Stephen T Ryan
- Maine Medical Center, Urology, 22 Bramhall St, Portland, ME 04102, USA
| | - Brian Jumper
- Maine Medical Center, Urology, 22 Bramhall St, Portland, ME 04102, USA
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32
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Christmas AB, Honaker D. Incarcerated Massive Sliding Hernia Treated with Bladder Resection and Mesh Repair. Am Surg 2015. [DOI: 10.1177/000313481508100314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A. Britton Christmas
- Division of Trauma/Surgical Critical Care Department of General Surgery Carolinas HealthCare System Charlotte, North Carolina
| | - Drew Honaker
- Division of Trauma/Surgical Critical Care Department of General Surgery Carolinas HealthCare System Charlotte, North Carolina
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Mittal V, Kapoor R, Sureka S, Patidar N, Arora S, Kumar M, Raj A, Kudchadkar S, Kapoor R. WITHDRAWN: Vesicocutaneous Fistula After Sliding Hernia Repair. Urol Case Rep 2014. [DOI: 10.1016/j.eucr.2014.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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34
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McKay JP, Organ M, Bagnell S, Gallant C, French C. Inguinoscrotal hernias involving urologic organs: A case series. Can Urol Assoc J 2014; 8:E429-32. [PMID: 25024798 DOI: 10.5489/cuaj.225] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We report 2 cases of inguinoscrotal hernias involving urologic organs. The first case involved an elderly gentleman with a history of micturition by squeezing his scrotum. He was diagnosed as having a right-sided indirect inguinal hernia involving the right ureter and bladder. Treatment was surgical. The second case involved an achondroplastic male who presented with acute kidney injury. He had bilateral hydronephrosis and ureteric obstruction secondary to an ureteroinguinal herniation bilaterally. The presentation, diagnosis, and treatment of inguinoscrotal hernias involving the bladder and ureters are discussed.
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Affiliation(s)
| | - Michael Organ
- Department of Urology, Dalhousie University, Halifax, NS
| | - Scott Bagnell
- Department of Urology, Dalhousie University, Halifax, NS
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35
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Khan A, Beckley I, Dobbins B, Rogawski KM. Laparoscopic repair of massive inguinal hernia containing the urinary bladder. Urol Ann 2014; 6:159-62. [PMID: 24833832 PMCID: PMC4021660 DOI: 10.4103/0974-7796.130654] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 12/09/2012] [Indexed: 11/04/2022] Open
Abstract
Inguinal herniation of the urinary bladder is an extremely rare occurrence involving less than 5% of inguinal hernias reported in literature. These hernias require a high index of suspicion for their diagnosis and pose significant challenges to the operating surgeon. The majority of these hernias have been repaired by an open technique. We report two cases managed laparoscopically.
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Affiliation(s)
- Atif Khan
- Department of Urology, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, West Yorkshire, United Kingdom
| | - Ian Beckley
- Department of Urology, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, West Yorkshire, United Kingdom
| | - Brian Dobbins
- Department of General Surgery, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, West Yorkshire, United Kingdom
| | - Karol M Rogawski
- Department of Urology, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, West Yorkshire, United Kingdom
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36
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El Anzaoui J, El Harrech Y, Abbaka N, Touiti D, Lahkim M, Fihri JF, Bakzaza W, Majdane M, Achour A. [Not Available]. Can Urol Assoc J 2014; 7:E837-9. [PMID: 24475009 DOI: 10.5489/cuaj.418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Si la hernie inguinale est une pathologie fréquente en chirurgie digestive, elle touche rarement la vessie. La hernie vésicale ne se manifeste généralement par aucun signe particulier, et son diagnostic est le plus souvent peropératoire, parfois même postopératoire lors de l’apparition de complications. Le traitement est chirurgical; il consiste à réintégrer la partie herniée et à réaliser une pariétorraphie. Le présent article fait état de l’observation médicale d’un patient présentant une hernie vésicale de découverte peropératoire.
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Affiliation(s)
| | - Y El Harrech
- Service d'urologie Hôpital Militaire Avicenne Marrakech
| | - N Abbaka
- Service d'urologie Hôpital Militaire Avicenne Marrakech
| | - D Touiti
- Service d'urologie Hôpital Militaire Avicenne Marrakech
| | - M Lahkim
- Service de chirurgie viscérale Hôpital Miltaire Avicenne Marrakech
| | - J Fassi Fihri
- Service de chirurgie viscérale Hôpital Miltaire Avicenne Marrakech
| | - W Bakzaza
- Service de chirurgie viscérale Hôpital Miltaire Avicenne Marrakech
| | - M Majdane
- Service de chirurgie viscérale Hôpital Miltaire Avicenne Marrakech
| | - A Achour
- Service de chirurgie viscérale Hôpital Miltaire Avicenne Marrakech
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37
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"Uncommon Contents of Inguinal Hernial Sac": A Surgical Dilemma. Indian J Surg 2013; 77:305-9. [PMID: 26730015 DOI: 10.1007/s12262-013-0806-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 01/02/2013] [Indexed: 12/08/2022] Open
Abstract
Inguinal hernia repair is the most common surgery done by both young and experienced surgeons. The hernia in the inguinal region usually contains the omentum and small intestine but rarely can contain unusual contents like the appendix, ovary with fallopian tubes, urinary bladder, sigmoid colon, and cecum. The aim of this study is to present our experience of uncommon contents in the inguinal hernia sac and their surgical management. A retrospective study of 330 patients who underwent inguinal hernia repair was carried out over a period of 3 years from January 2008 to December 2011. Only five patients presented with unusual contents in the inguinal hernia sac; an incidence of 1.5 %. Two of them had vermiform appendix, with acute appendicitis (Amyand's hernia) noted in one of them. The patient with acute appendicitis underwent appendicectomy with herniorrhaphy, while in the other, hernioplasty with mesh was done as the patient was with normal appendix. In one case, the urinary bladder was the content of the inguinal hernia sac and there were two cases with the ovary and fallopian tubes as its content. In all these cases, contents were replaced back and hernia repair was done. Unusual contents of the hernial sac may create a surgical dilemma (whether to save or sacrifice the organ) during hernia repair even to an experienced surgeon.
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38
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Petritz OA, Guzman DSM, Gandolfi RC, Steffey MA. Inguinal-Scrotal Urinary Bladder Hernia in an Intact Male Domestic Rabbit (Oryctolagus cuniculus). J Exot Pet Med 2012. [DOI: 10.1053/j.jepm.2012.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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39
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Abstract
Inguinoscrotal bladder hernias are rare, occurring in 1-4% of all inguinal hernias. Massive inguinoscrotal bladder hernias, where >50% of the bladder is found in the hernia sac are extremely rare. Patients can suffer significant morbidity from such a hernia. These include sepsis, unilateral or bilateral ureteric obstruction, renal failure and strangulation with secondary ischaemia of the bladder wall and bladder rupture. Inguinoscrotal bladder hernias are most commonly diagnosed at the time of surgery. This may lead to significant complications for the patient, particularly if undetected during surgery.
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Affiliation(s)
| | - J Meyer
- Paddington, Queensland, Australia
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40
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Malhotra MK, Kapoor Y. Pre surgical evaluation of scrotal cystocele by conventional radiography (cystogram). Niger J Surg 2012; 18:34-6. [PMID: 24027392 PMCID: PMC3716249 DOI: 10.4103/1117-6806.95492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Urinary bladder is a known content of sliding inguinal hernias but rarely presents as irreducible direct inguinal hernia. As inguinal hernia repair is commonly undertaken even at peripheral surgical centers. Cystogram a simple radiological investigation (picturesque view) is useful for pre-surgical evaluation as it can prevent iatrogenic bladder injury during inguinal hernia repair. This investigation can be performed where other radiological expertises like computerized tomography scan/magnetic resonance imaging or even ultrasound facilities are not readily available.
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Affiliation(s)
- Mohinder Kumar Malhotra
- Department of Surgery, SGT Medical College, Hospital and Research Institute, Village-Budhera, Gurgaon, Haryana, India
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41
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Kraft KH, Sweeney S, Fink AS, Ritenour CWM, Issa MM. Inguinoscrotal bladder hernias: report of a series and review of the literature. Can Urol Assoc J 2011; 2:619-23. [PMID: 19066682 DOI: 10.5489/cuaj.980] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Bladder involvement occurs in 1%-4% of cases of inguinal hernias. Among obese men aged 50 to 70, the incidence may reach 10%.1,2 The diagnosis of bladder involvement is often difficult to delineate at the time of presentation and may only become apparent at the time of herniorrhaphy. Surgical management pertaining to the approach, repair and potential need for bladder resection may challenge the surgeon. We report a series of 4 cases of large inguinoscrotal bladder hernias and provide a literature review. Our goal is to highlight the clinical presentation and the decisive issues surrounding the diagnosis and management of this condition.
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42
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Kim KH, Kim MU, Jeong WJ, Lee YS, Kim KH, Park KK, Chung MS, Chung BH, Lee SH. Incidentally detected inguinoscrotal bladder hernia. Korean J Urol 2011; 52:71-3. [PMID: 21344035 PMCID: PMC3037511 DOI: 10.4111/kju.2011.52.1.71] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 10/17/2010] [Indexed: 11/18/2022] Open
Abstract
The bladder is involved in less than 4% of inguinal hernias. Inguinoscrotal bladder hernias are difficult to diagnose, and less than 7% are diagnosed preoperatively. Inguinoscrotal bladder hernias are usually asymptomatic. However, they can result in significant complications, such as bladder necrosis or acute renal failure. Accurate diagnosis is crucial to avoid bladder injury during surgery and other complications. Here we report the case of a 64-year-old man who presented with a scrotal mass. Ultrasonography of the scrotal mass showed a nonspecific cystic mass. During surgery, the mass was revealed to be a herniated bladder.
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Affiliation(s)
- Kwang Hyun Kim
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
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43
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Abstract
Unlike small inguinal and femoral bladder hernias, massive bladder hernias into the scrotum, also named scrotal cystoceles, are rare. We describe and discuss the clinical appearance and management of a patient with a micturation related unilateral swelling of the scrotum.
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44
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Inguinal rupture with herniation of the urinary bladder through the scrotal fascia in a Shetland pony foal. EQUINE VET EDUC 2009. [DOI: 10.2746/095777309x462] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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45
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Clinical and radiographic findings of a sliding inguinoscrotal hernia containing the urinary bladder. Hernia 2009; 14:635-8. [PMID: 19953282 DOI: 10.1007/s10029-009-0597-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 11/13/2009] [Indexed: 10/20/2022]
Abstract
Large sliding inguinal hernias involving the urinary bladder are rare. We present the relevant clinical data, radiographic images, and the intraoperative findings of a sliding inguinoscrotal herniation of the urinary bladder. A 67-year-old male presented with a scrotal mass and the need to manually compress his scrotum in order to void. Diagnosed with a large sliding inguinal hernia with significant bladder involvement (scrotal cystocele), the patient underwent an inguinal herniorraphy and replacement of the bladder in the retroperitoneal space. Surgery proved to be successful in the management of the inguinal hernia and voiding dysfunction.
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46
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Okoro I, Anele A. Scrotal cystocele in a 2-year-old Nigerian child. J Pediatr Surg 2009; 44:e19-20. [PMID: 19735803 DOI: 10.1016/j.jpedsurg.2009.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Revised: 06/05/2009] [Accepted: 06/05/2009] [Indexed: 11/29/2022]
Abstract
Total herniation of the urinary bladder into the scrotum, also known as scrotal cystocele, is a rare condition. It has mostly been described in elderly patients, who often have obstructive symptoms. We report a case of scrotal cystocele in a 2-year-old Nigerian child with no evidence of obstructive uropathy. The diagnosis was made at operation. The bladder was reduced into the abdominal cavity followed by a herniorrhaphy. The child has remained symptom-free 8 months after the procedure.
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Affiliation(s)
- Iheanyi Okoro
- Department of Surgery, Imo State University Teaching Hospital, Orlu, 460001 Imo State, Nigeria.
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47
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Recurrent indirect scrotal hernia with incarcerated urinary bladder tamponade. Eur Surg 2009. [DOI: 10.1007/s10353-009-0465-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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48
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Mahadevappa B, Suresh SC, Natarajan K, Thomas J. Cystogram with dumbbell shaped urinary bladder in a sliding inguinal hernia. J Radiol Case Rep 2009; 3:7-9. [PMID: 22470640 DOI: 10.3941/jrcr.v3i2.91] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Sliding inguinal hernias present with various symptoms and these are usually direct inguinal hernias containing various abdominal viscera. Case reports and series have been published with various organs and rare organs being part of the hernia. Urinary bladder is a known content of sliding hernias. This case report emphasizes this aspect in a picturesque manner and the importance of radiological investigations for pre-surgical evaluation.
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Affiliation(s)
- Basant Mahadevappa
- Transplantation Surgery, Westchester Medical Center, Valhalla, New York, USA
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49
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Affiliation(s)
- L D George Angus
- Department of Surgery, Nassau University Medical Center, New York 11554, USA
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50
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Radiographic diagnosis of a large inguinal hernia involving the urinary bladder and causing obstructive renal failure. Urology 2008; 72:523. [PMID: 18602149 DOI: 10.1016/j.urology.2008.03.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Revised: 03/18/2008] [Accepted: 03/21/2008] [Indexed: 11/20/2022]
Abstract
The urinary bladder may be involved in up to 4% of all inguinal hernias; however, usually only a small amount of the bladder is involved. Extensive bladder involvement is a rare event and may result in obstructive renal failure. We present a case of renal failure caused by a large inguinal hernia involving the urinary bladder and include selected computed tomography images documenting this interesting diagnosis.
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