Abstract：
Conditions such as genital prolapse and hernia are known to be related to connective tissue dysfunction. In this report on cases of the rare simultaneous finding of large genital prolapse and post-prolapse repair female inguinal bladder hernia, we aim to contribute to the discussion of a possible clinical definition of connective tissue weakness, for its clinical assessment and preoperative patient counselling.
Three cases of medial third-grade (MIII, Aachen classification) inguinal bladder hernia developing or enlarging after successful stage-IV pelvic organ prolapse (POP) repair at a university pelvic floor centre are presented. All patients were aged ≥ 80 years with long-standing postmenopausal status. One patient was followed for 5 years and two patients were followed for 6 months. In all patients, ultrasound revealed that the hernia sac contained the urinary bladder, which had herniated through the inguinal hernia orifice. A literature search revealed only one case report of direct female inguinal bladder hernia and few investigations of the simultaneous occurrence of POP and hernia in general.
The simultaneous occurrence of inguinal hernia and female POP can lead to bladder herniation following prolapse surgery in the sense of a \"locus minoris resistentiae\". Clinical examination for simultaneous signs of connective tissue weakness and counselling prior to pelvic reconstructive surgery could help to increase patients\' compliance with further surgical treatment for hernia.
Three cases of medial third-grade (MIII, Aachen classification) inguinal bladder hernia developing or enlarging after successful stage-IV pelvic organ prolapse (POP) repair at a university pelvic floor centre are presented. All patients were aged ≥ 80 years with long-standing postmenopausal status. One patient was followed for 5 years and two patients were followed for 6 months. In all patients, ultrasound revealed that the hernia sac contained the urinary bladder, which had herniated through the inguinal hernia orifice. A literature search revealed only one case report of direct female inguinal bladder hernia and few investigations of the simultaneous occurrence of POP and hernia in general.
The simultaneous occurrence of inguinal hernia and female POP can lead to bladder herniation following prolapse surgery in the sense of a \"locus minoris resistentiae\". Clinical examination for simultaneous signs of connective tissue weakness and counselling prior to pelvic reconstructive surgery could help to increase patients\' compliance with further surgical treatment for hernia.
摘要：
已知诸如生殖器脱垂和疝的病症与结缔组织功能障碍有关。在这份关于罕见的同时发现大生殖器脱垂和脱垂修复后女性腹股沟膀胱疝的报告中，我们的目标是有助于讨论可能的临床定义的结缔组织弱点，用于其临床评估和术前患者咨询。
3例内侧三级（MIII，Aachen分类）在大学盆底中心成功进行IV期盆腔器官脱垂（POP）修复后发生或扩大的腹股沟膀胱疝。所有患者年龄≥80岁，长期绝经后状态。一名患者随访5年，两名患者随访6个月。在所有患者中，超声显示疝囊包含膀胱，从腹股沟疝口疝出.文献检索仅显示一例直接女性腹股沟膀胱疝，而一般同时发生POP和疝的调查很少。
同时发生腹股沟疝和女性POP可导致脱垂手术后的膀胱疝，其意义为“微型电阻”。在骨盆重建手术之前，同时进行结缔组织无力迹象的临床检查和咨询可能有助于提高患者对进一步手术治疗疝气的依从性。
3例内侧三级（MIII，Aachen分类）在大学盆底中心成功进行IV期盆腔器官脱垂（POP）修复后发生或扩大的腹股沟膀胱疝。所有患者年龄≥80岁，长期绝经后状态。一名患者随访5年，两名患者随访6个月。在所有患者中，超声显示疝囊包含膀胱，从腹股沟疝口疝出.文献检索仅显示一例直接女性腹股沟膀胱疝，而一般同时发生POP和疝的调查很少。
同时发生腹股沟疝和女性POP可导致脱垂手术后的膀胱疝，其意义为“微型电阻”。在骨盆重建手术之前，同时进行结缔组织无力迹象的临床检查和咨询可能有助于提高患者对进一步手术治疗疝气的依从性。
