We present a case of a recurrent inguinal bladder hernia that was previously unsuccessfully operated on three times and was repaired using totally extraperitoneal repair (TEP). A 79-year-old man presented with a right inguinal swelling that had been treated three times on the same side with anterior approaches. Computed tomography confirmed a recurrent inguinal bladder hernia. TEP was performed after identifying the bladder hernia preoperatively, with previous surgeries that used a plug-and-patch technique through an anterior approach. The extraperitoneal approach allowed the bladder to be reduced without injury and the hernia to be safely repaired using a 3D Max® Light Mesh. The postoperative recovery was uneventful, with no recurrence after 1 year. TEP facilitates the diagnosis and repair of bladder hernias, emphasizing the importance of preoperative diagnosis and the efficacy of endoscopic procedures in bladder hernia repair, even in recurrent cases.

Inguinal hernias involving the bladder are exceedingly rare and pose a diagnostic challenge. Identifying bladder involvement within an inguinal hernia is imperative to avoid iatrogenic bladder injuries and subsequent complications. Here we discuss a case of inguinal bladder herniation and bladder visualization using methylene blue dye intraoperatively. We present a case of a 45-year-old male who presented with a six-hour history of dysuria and a painful non-reducible right-sided groin mass that had previously been reducible for 17 years. Computed tomography demonstrated an irreducible indirect inguinal hernia-containing bladder. Open Lichtenstein repair was performed, and intraoperative methylene blue-dyed saline successfully identified the herniated bladder, preventing iatrogenic bladder injury. This case report demonstrates the importance of preoperative imaging and intraoperative visualization for the prevention of complications in a rare occurrence of a strangulated indirect inguinal hernia-containing bladder.

An inguinal bladder hernia (IBH) is an abnormal protrusion of the bladder into the inguinal canal accompanied by a peritoneum sheath that creates the hernia sac. Clinical presentations vary greatly from lower urinary tract symptoms (LUTS) and reduction in scrotal size after voiding to being entirely asymptomatic. Since inguinal bladder hernias are uncommon and often accompanied by varied and nonspecific symptoms, it is challenging to diagnose and rarely included in differentials. Currently, computerized tomography (CT) imaging with contrast or voiding cystourethrography is recommended for diagnosis. There is no consensus on the best treatment for inguinal bladder hernias, with options ranging from laparoscopic repair to catheterization. In this study, we report the case of inguinal bladder hernia in an 86-year-old male presenting with symptoms of recurrent hematuria and two failed voiding trials after a Foley catheter placement from prostatomegaly resulting in bladder diverticula, and IBH. He was treated with prostate artery embolization (PAE) to address LUTS related to benign prostatic hyperplasia (BPH). The resultant decreased prostatic volume resolved his symptoms of IBH, hematuria, and urinary retention.

UNASSIGNED: 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.
METHODS: 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.
UNASSIGNED: 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).
CONCLUSIONS: 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.

暂无摘要。

Inguinal bladder hernia (IBH) is an extremely rare occurrence and remains a challenge to the surgeon in the preoperative, intraoperative, and in the postoperative period. Its diagnosis requires a high index of suspicion, especially in the high-risk patients: elderly overweight/obese males with a recurrent hernia and lower urinary tract symptoms. Here, we report the case of a 78-year-old overweight male who presented with a bilateral direct inguinal hernia with the right being recurrent and irreducible. The diagnosis of IBH was made incidentally during the hernia repair. The patient was managed successfully by the replacement of the bladder in the pelvic position and inguinal herniorrhaphy done using the modified Bassini technique. The left groin hernia was also repaired using the modified Bassini technique. Our goal here is to reawaken the consciousness of the surgeons involved in inguinal hernia repair about IBH, particularly in high-risk patients.
Résumé L\'hernie inguinale de réservoir souple (IBH) est une occurrence extrêmement rare et demeure un défi au chirurgien dans le préopératoire, peropératoire, et dans la période postopératoire.Son diagnostic exige un index élevé de soupçon, particulièrement dans les patients à haut risque : vieux mâles de poids excessif/obèses avec une hernie récurrente et des symptômes inférieurs d\'appareil urinaire.Ici, nous rapportons le cas d\'un mâle de poids excessif de 78 ans qui s\'est présenté avec une hernie inguinale directe bilatérale avec le droit étant récurrent et irréductible.Le diagnostic d\'IBH a été fait fortuit pendant la réparation d\'hernie.Le patient a été contrôlé avec succès par le remplacement du réservoir souple en position pelvienne et herniorrhaphy inguinal fait utilisant la technique modifiée de Bassini.L\'hernie gauche d\'aine a été également réparée utilisant la technique modifiée de Bassini.Notre but ici est de réveiller la conscience des chirurgiens impliqués dans la réparation inguinale d\'hernie au sujet d\'IBH, en particulier dans les patients à haut risque. Mots-clés: vessie, herniorrhaphie, hernie de la vessie inguinale, symptômes des voies urinaires inférieures, hernie récurrente.

Inguinal bladder herniation (IBH) is an uncommon case, observed in only 1-5 % of all inguinal hernias. Obesity, the elderly, gender, and previous operations are vigorous determinants for IBHs. Symptoms depend on the size of the hernia. We report a case of an obese male aged 40 presenting with a bulge increasing gradually in the right groin with a history of two-stage micturition (Mery\'s sign). With imaging-assisted diagnosis modalities (US, CT, and MRI), the patient was diagnosed with IBH. Although IBH is not common, it should always be suspected in patients with Mery\'s sign and predisposing factors.

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.

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.