DOI: 10.36347/sjmcr.2023.v11i04.066

Pages: 685-687

Urinary bladder hernia is a rare event corresponding to the externalization of a bladder segment through the inguinal orifice, resulting from the association of wall weakness with increased intra-abdominal pressure. We report the case of a 38-year-old patient with no particular pathological history who presented to the urological surgery department complaining of dysuria associated with pollakiuria, intermittent left inguinoscrotal bulge, with the need to compress the scrotum to finish urination. The physical examination revealed a large, painless left inguinoscrotal hernia, the pressure of which caused an urge to urinate. Retrograde cystography noted filling of a left inguinoscrotal bladder portion during voiding with upstream bladder emptying. The examination was completed by a CT scan which revealed an inguinal parietal defect with a passage of the anterosuperior part of the bladder which fills up with contrast product at the delayed acquisition. Urinary bladder hernia is most often asymptomatic and its discovery is intraoperative in most cases. The diagnosis is suspected due to the association of inguinoscrotal hernia and urinary signs, especially two-step urination with the need to compress the scrotum during urination. Retrograde cystography is the best technique to image, showing a dogear-shaped bladder in the scrotum.