Urinary bladder herniation in the differential diagnosis of inguinal hernia

Abstract

Urinary bladder hernia is a clinical condition that mimics symptoms of inguinal hernia. It is vital to predict and prevent the iatrogenic bladder injury that may develop secondary to inguinal bladder herniation during inguinal hernia surgery, which is frequently performed, and to be able to determine our preoperative and perioperative surgical approaches. Patients with a diagnosis of inguinal hernia who underwent elective and emergency surgery between 2018 and 2020 were reviewed retrospectively. Age, gender, body mass indexes, imaging modalities, operation techniques, duration of hospital stay, perioperative and postoperative morbidity and mortality of the patients were recorded. Bladder herniation was found in seven patients, five of whom underwent elective surgery and two of whom underwent emergency surgery. The median age of the patients was 84 (min.52-max 89). Perioperative bladder injury was observed in two of the 6 patients who underwent computed tomography in the past year. Two patients, who had a bladder injury, underwent primary repair and were followed up with a foley catheter. Postoperative duration of hospitalization was 3.28 (2-7) days on average and the duration of hospitalization was prolonged up to an average of 6 (5-7) days in two patients with bladder injury. No postoperative mortality and morbidity were observed. It should be taken into consideration that there may be urinary bladder herniation in the differential diagnosis of inguinal swelling in patients presenting with symptoms of inguinal hernia at an advanced age. There is a need for methods that may reduce the morbidity and mortality secondary to bladder herniation.